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Handbook 

OF 

MATERIA MEDICA, PHARMACY, 
AND THERAPEUTICS. 



POTTER. 



A New Series of Manuals 

FOR 

Medical Students. 

Price of each Book, Cloth, $3.00; Leather, $3.50. 

MIDWIFERY. By Alfred Lewis Galabin, m.a., m.d., Obstetric 
Physician to, and Lecturer on Midwifery and the Diseases of Women 
at, Guy's Hospital, London, etc. 227 fine Engravings. 753 pages. 

PHYSIOLOGY. Second Edition. By Gerald F. Yeo, m.d.,f.r.c.s., 
Professor of Physiology in Kings College, London. Revised. 743 pages. 
301 carefully printed Illustrations. 

MATERIA MEDICA, PHARMACY, AND THERAPEUTICS, 

including the Physiological Action of Drugs, Special Therapeutics, 
Official and Extemporaneous Pharmacy, with numerous Tables, Form- 
ulae, Notes on Temperature, Clinical Thermometry, Poisons, Urinary 
Examinations and Patent Medicines. By Sam'l O. L. Potter, m.a., 
m.d., Professor of Practice of Medicine, Cooper Medical College, San 
Francisco ; Late A. A. Surgeon U. S. Army. 830 pages. 

CHILDREN. By J. F. Goodhart, m.d., Physician to the Evelina 
Hospital for Children ; Assistant Physician, Guy's Hospital, London. 
American Edition. Revised and Edited by Louis Starr, m.d., Clinical 
Professor of Diseases of Children in the Hospital of the University of 
Pennsylvania; Physician to the Children's Hospital, Philadelphia. 50 
Formula?, and Directions fjr preparing Artificial Human Milk, for the 
Artificial Digestion of Milk, etc. 738 pages. 

PRACTICAL THERAPEUTICS. Fourth Edition. With an Index 
of Diseases. By Ed. John Waring, m.d., f.r c.p. Rewritten and Re- 
vised. Edited by Dudley W. Buxton, Assistant to the Professor of 
Medicine, University College Hospital, London. 744 pages. 

MEDICAL JURISPRUDENCE AND TOXICOLOGY. By John 

J. Reese, m.d., Professor of Medical Jurisprudence and Toxicology, 
University of Pennsylvania, etc. 606 pages. 
ORGANIC CHEMISTRY. By Prof. Victor von Richter, Univer- 
sity of Breslau. Translated from Fourth German Edition by Edgar F. 
Smith, m.a., ph.d., Professor of Chemistry, Wittenberg College, Spring- 
field, O., formerly in the Laboratories of the University of Pennsylvania, 
etc. Illustrated. 710 pages. 

WINCKEL'S DISEASES OF WOMEN. By Parvin. Anew 
Text-Book. By Dr. F. Winckel, Professor of Gynaecology, etc., Royal 
University of Munich. The Translation Edited by Theophilus Parvin, 
m.d., Professor of Obstetrics and Diseases of Women and Children, Jef- 
ferson Medical College, Philadelphia. 132 Engravings, most of which 
are new. 700 pages. 

*#* Other Volumes in Preparation. A complete circular with illustrations 
and sample pages sent free, upon application. 

Price of each Book, Cloth, $3.00 ; Leather, $3 50. 
P. BLAKISTON, SON & CO., Medical Publishers & Booksellers, 

1012 Walnut Street, Philadelphia. 



HANDBOOK 



OF 



MATERIA MEDICA, PHARMACY, 
AND THERAPEUTICS, 



INCLUDING THE 



PHYSIOLOGICAL ACTION OF DRUGS, THE SPECIAL 

THERAPEUTICS OF DISEASE, OFFICIAL AND 

EXTEMPORANEOUS PHARMACY, AND 

MINUTE DIRECTIONS FOR 

PRESCRIPTION WRITING. 



y/ BY 

SAM'L O. L. POTTER, M.A., M.D., 

PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE IN THE COOPER MEDICAL COLLEGE 

OF SAN FRANCISCO: AUTHOR OF '' QUIZ-COMPENDS " OF ANATOMY AND MATERIA 

MEDICA, "AN INDEX OF COMPARATIVE THERAPEUTICS, " AND "A STUDY 

OF SPEECH AND ITS DEFECTS." LATE A. A. SURGEON. U. S. ARMY. 





PHILADELPHIA: 

P. BLAKISTON, SON & CO., 
1012 Walnut Street. 

1887. • 



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TO MY WIFE 

I DEDICATE MY FIRST LARGE BOOK, 

IN LOVING APPRECIATION OF 

THE PATIENCE 

WITH WHICH SHE HAS BORNE 

MY ABSORPTION IN THIS WORK 

DURING THE PAST 

TWO YEARS. 



Copyright, 1886, by P. Blakiston, Son & Co. 



PREFACE, 



The book, which this preface completes, has occupied the 
writer's leisure hours during the past two years, and in a measure 
has grown out of some less pretentious volumes previously written 
by him. The continued favor shown by teachers and students, 
both in this country and in England, to his three manuals in the 
" Quiz-Compend " series for students, and particularly to the 
volume on Materia Medica and Therapeutics, has encouraged 
their author to hope that a hand-book from him on the same sub- 
ject, but embracing a wider scope, might meet with a correspond- 
ing degree of appreciation. The fact that quite a number of 
new manuals on Materia Medica have lately appeared, has not 
deterred him from entering the field, nor diminished his confi- 
dence in the approbation of his readers ; but has rather seemed a 
proof that most of the older text-books on this branch of medi- 
cal knowledge are no longer satisfactory, even with the regular 
revisions which they undergo at stated periods. Hence he ex- 
pects for this hand-book a position, among the recent manuals of 
its class, as high as its merits and demerits may entitle it to re- 
ceive in the estimation of those for whose use it has been 
prepared. 

The author's intention has been to produce a book, which 
would embrace in a single volume the Essentials of practical 
Materia Medica and Therapeutics, treating of each subject in as 
concise phraseology as possible consistent with the delineation of 
every important feature. He has also endeavored to formulate 
such minute and definite directions for the framing of Prescrip- 
tions, as might elucidate what to many is a very difficult problem. 
Furthermore, he has tried to present as much information, upon 
the subject of Pharmacy, as every physician should possess, in 
order to handle the implements of his profession with confidence, 
and to direct their use by others with pharmaceutical accuracy. 



VI PREFACE. 

The complete fulfilment of these aims would be realized if the 
book should take rank as a working companion to the advanced 
student and the junior practitioner ; and be deemed by them a 
reliable guide through the forest of observations and experiments 
on drug actions and uses, which makes progress slow for the 
already over-burdened mind, when ploughing through the more 
exhaustive and exhausting text-books. 

Although this book is essentially a compilation, as all books of 
its class must be, there will be found in its pages much original 
matter derived from the writer's own experience in professional 
life. The arrangement of the matter will be found to be in 
some respects unique. After full consideration of the many 
arrangements of the Materia Medica in vogue, a modified alpha- 
betical plan was adopted, by which the advantages of the alpha- 
betical order might be retained, while permitting the grouping 
together of agents which are closely related, physiologically and 
therapeutically, under the title of the principal member of the 
class — the chief, as it were, of that particular clan. T nus > under 
the title Amyl Nitris (Nitrite of Amyl), will be found men- 
tion also of the Nitrites of Ethyl, Sodium and Potassium, and 
their congener Nitro-Glycerin, all of which are closely allied to 
the first-named and to each other, in respect of their actions and 
uses. A very elaborate section on Drug Classification is placed 
at the end of the Materia Medica, in order to supplement such 
deficiencies in grouping as are inevitable in an alphabetical 
arrangement. 

In detailing the characteristics of an important drug, its 
physical properties and chemical constituents are first briefly 
enumerated, then its preparations are described in the official 
language of the pharmacopoeia, usually somewhat abbreviated \ 
any important unofficial preparations being also noted, and all 
the compounds into which it enters enumerated. Next the phys- 
iological action is taken up, its characteristic features being first 
described ; then the actions resulting from an ordinary medicinal 
dose, next those produced by small doses continued, and finally 
those from a toxic dose. These are followed by a brief account 
of its antagonists, antidotes and incompatibles, if any; and a 



PREFACE. Vll 

concise summary of its therapeutical applications closes the 
article; — the whole presenting, it is hoped, a clearly defined 
word-picture of the drug under consideration. Every article 
and preparation comprised in the last edition of the U. S. Phar- 
macopoeia is fully noticed, while all the prominent unofficial 
agents receive such mention as their respective importance 
seems to demand. 

The second part of the book is devoted to Pharmacy, and has 
been written from the standpoint of a conviction that many 
young practitioners would gladly dispense their own medicines, 
if provided with a few practical directions on the subject; thereby 
saving many a dollar from the drug store, preventing in their 
own practices at least the " renewals" which constitute so bad a 
feature of modern pharmaceutics, and gaming for themselves a 
practical acquaintance with their professional weapons which 
cannot but make them better physicians and more accurate pre- 
scribes. In this section of the book Prescription Writing re- 
ceives full consideration, and many standard formulae are given 
as samples of prescriptions of each kind in extemporaneous use. 

In the third part the subject of Special Therapeutics is treated 
of elaborately, and in the form of an alphabetically arranged 
Index to the treatment of diseases, as laid down by the most 
recent authorities. - Every indication for the use of a drug is 
referred to its author by his initial, and to the most prominent 
articles are appended a few selected formulae, to serve as' guides 
to the neophyte in prescribing. 

The Appendix contains numerous tables, comprising diagnostic 
hints, Latin terms and phrases, formulae for hypodermic use, 
metric equivalents, specific gravities and volumes, and obstetric 
memoranda ; as also Notes on temperature in disease, the use of 
the clinical thermometer, the treatment of poisoning, and the 
examination of urine ; also formulae representing the most noted 
patent medicines. 

The Index has received especial attention, from a conviction 
that if well made it is the best part of a good book. Every title, 
synonym and other reference of importance is included therein, 
double and treble entries being made in every instance which 
seemed to require such repetition. 



VI 11 PREFACE. 

Nearly all the regular text-books have been laid under contri- 
bution in the preparation of the book, but especial use has been 
made of the works of Bartholow, Ringer, Wood, Phillips, Pif- 
fard, Waring and Brunton, in their latest editions; as well as of 
the writer's verbatim notes of two courses of didactic and clini- 
cal lectures delivered by Professors Bartholow and Da Costa in 
the Jefferson Medical College and Hospital and in the auditorium 
of the Pennsylvania Hospital. On pages 514 and 515 will be 
found a full list of the authorities referred to by initials in the 
section on Special Therapeutics. 

The term "officinal," as applied to drugs recognized by the 
pharmacopoeia has been discarded, the word "official" being 
used instead; for the simple reason that the idea to be conveyed 
is expressed more correctly by the latter term than by the former 
one. When none but official drugs and preparations were kept 
in the officina or drug store, it was eminently proper to call them 
"officinal," but inasmuch as this class does not nowadays con- 
stitute much over one-fourth part of the officinal stock, it is a 
wilful debasement of our professional weapons, as well as an 
inexcusable misnomer, to apply the shop-title to them any longer. 



SAM'L O. L. POTTER. 



San Francisco, 

December, 1886. 



TABLE OF CONTENTS. 



PAGE 

INTRODUCTION, 13 

Materia Medica, . 13 

Pharmacy, 13 

Empirical Therapeutics, 14 

Rational Therapeutics, 15 

Administration of Medicines, 16 

Dosage of Medicines, 20 

PART I.— MATERIA MEDICA AND THERAPEUTICS, . 17 

Abrus to Zingiber, x 7-398 

Classification of Medicines, 399 

Stimulants and Sedatives, 399 

Agents acting chiefly on the Nervous System, 400 

Agents acting on the Organs of Special Sense, 405 

Agents acting on Respiration, 408 

Agents acting on the Circulation, 410 

Agents acting on the Digestive System, 412 

Agents acting on Metabolism, 419 

Agents acting on Excretion, 422 

Agents acting on the Generative System, 426 

Agents acting on the Cutaneous Surface, 429 

Agents acting on Microbes, Ferments, etc., 431 

Agents acting upon each other, 433 

PART II.— PHARMACY AND PRESCRIPTION WRITING, 435 

Constituents of Vegetable Drugs, 436 

Official Operations, 437 

Official Preparations, 448 

Extemporaneous Pharmacy, 464 



X TABLE OF CONTENTS. 

Weights and Measures, . . 465 

Metric System, 467 

Approximate or Domestic Measures, 469 

Specific Gravity and Specific Volume, 470 

Prescriptions, 470 

Analysis of a Prescription, 470 

Principles of Combination, 473 

Prescription Writing, 474 

Abbreviations, 475 

Prescription Blanks, 475 

Renewals, 476 

Filling a Prescription, 478 

Stock Solutions, 479 

Rules for the Pharmaceutical Student, 480 

Incompatibility, 480 

Chemical Incompatibility, 480 

Pharmaceutical Incompatibility, 483 

Therapeutical Incompatibility, » . . 484 

Rules for Avoidance of Dangers, 4S5 

Extemporaneous Preparations and Formulae, .... 486 

Excipients for Mixtures, 488 

Excipients for Emulsions, 490 

Excipients for Pills, 497 

PART III.— SPECIAL THERAPEUTICS, 514 

References and Bibliography, 514 

Abdominal Plethora to Yellow Fever, ..... 515-748 

APPENDIX, 749 

Latin Terms, Phrases, etc., used in Prescriptions, . . . 749 

Hypodermic Formulae, 760 

Genitive Case-endings, 763 

Verbs, Participles, Prepositions, etc., 764 

Chlorodyne, Comparisons of Ten Formula therefor, . 765 

Patent Medicines, 766 

The Treatment of Poisoning, 767 

Tables of Differential Diagnosis, 773 

Notes on Temperature in Disease, 780 

Clinical Thermometry, 780 



TABLE OF CONTENTS. XI 

Obstetrical Memoranda, 782 

Signs of Pie r r.ancy, 782 

Signs of Labor, 782 

Average Pelvic Diameters, 783 

Development of the Foetus, 783 

Diameters of the Foetal Skull at Term, 784 

Asphyxia and Apncea, 784 

Clinical Examination of the Urine, 786 

Ethics, the Hippocratic Oath, etc., 788 

Notes on Some New Remedies, . . 790 

Table of Specific Gravities and Specific Volumes, . . . 794 

Table of Drops in, and Weights of, a Fluid-drachm of 

Various Liquids, 795 

Table for Converting Apothecaries 1 Weights and Meas- 
ures into Grams, 796 

INDEX, 797 



ERRATA 



Page 25, line 5 from bottom — for " March" read "Marsh." 

P a ge 33, line 8 from bottom — before the word " alkaloids " insert the word 

"uncombined." 
Page 35, line 12 from top — for " Trinitro " read "Trinito." 
Page 36, line 13 from bottom — after " Dose" insert "gr." 
Page 70, line 20 from top — for " Antimonii" read " Antimonium." 
Page 71, line 7 from bottom — for "J" read "^," 
Page 96, line 12 from bottom — for "lessens" read "increases." 
Page 169, line 10 from top — for " is" read "was." 
Page 184, line 11 from bottom — for " membane " read "membrane." 
Page 183, line 3 from top — for "5 per cent." read " 25 per cent." 
Page 222, line 12 from bottom — for " Hydrochoric" read "Hydrochloric." 
Page 306, line 3 from bottom — change the sign 3 to ^. 
Page 334, line 8 from top — after " tr^x — " insert the sign "g." 
Page 340, line 10 from top — strike out " Caryophyllus (cloves). '' 
Page 353, line 4 from top — " Seneg& " should be " Senega." 
Page 384, lines 5 and 6 from top — for " Uva " read " Uvae." 
Page 434, line 15 from bottom — for " Nitrate" read "Nitrite," and after the 

word " Curare " insert the word " Urethran." 
Page 457, last line — for " acids " read " acid." 
Page 458, line 1 — for " Olecium " read " Oleicum." 
Page 460, line 1 1 — for " Resina " read " Resinse." 
Page 460, line 21 from top — for " Massi " read " Massa." 
Page 469, last line — after the word " classes" insert " (See Appendix for a 

fuller Table)." 
Page 476, line 17 from top — after the words " Non Renovatum" insert the 

words " Non Repetatur, etc." 
Page 481, line 6 from top — read "addition of fixed alkalies, their salts, or 

salts which." 
Page 481, line 7 from top — before "alkalies" insert "fixed." 
Page 481, line 14 from top — for " emulsions " read " emulsin." 
Page 485, line 17 from top — for " in emulsions " read " Emulsin." 
Page 485, line 23 from top — for " is " read " are." 
Page 506, line 2 from top — for " Chartulas " read " Chartulae." 
Page 560, line 15 from top— for "(H)" read "(R)." 
Page 744, line 26 from top — for "Creasote" read " Creasoti." 
Page 758, line 3 from top — for " Septima " read " Septim." 



INTRODUCTION. 



Pharmacology, from tpdptiazov, a drug, Myo$, a discourse, 
is a general term which properly includes all matters pertaining 
to the study of medicinal agents in the widest possible sense, 
embracing all of Materia Medica and Pharmacy, with so much 
of Therapeutics as relates to drugs. The term is however fre- 
quently employed in a more restricted sense, including only 
the physiological action of drugs ; a subject to which the title 
Pharmacodynamics is much more appropriately applied. 

Materia Medica is that branch of medical science which 
treats of the substances used as medicines, their origin, com- 
position, physical characteristics, chemical properties, modes of 
preparation and administration, physiological and toxicological 
actions. 

Pharmacodynamics, from (pdpfiaKov, a drug, Svvafug, power, is the proper 
title for that portion of the Materia Medica which relates to the physiological 
action of drugs, that is, the influence of drugs upon the healthy human body 
to modify its physiological activity. 

Toxicology is another subdivision, and includes the effects of drugs when 
administered in poisonous doses, together with the study of the drug-antago- 
nists for the most dangerous symptoms produced, and the appropriate chemi- 
cal antidotes. (See page 433.) 

Pharmacy is the art of preparing medicines for use and 
dispensing them on the order of the therapeutist. It includes 
a knowledge of the Materia Medica, an acquaintance with the 
theories and manipulations of chemistry, and an intimate practi- 
cal knowledge of many special operations peculiar to itself. 

Therapeutics, from Sepaxeuetv, to attend upon, includes all 
that relates to the science and art of healing \ and embraces 
the application, not only of medicines to the alleviation or cure 
of disease, but of all other agents which may aid in the accom- 
plishment of the same result. The operations of Nature herself, 
as well as of the substances described in the Materia Medica, 



XIV INTRODUCTION. 

and those of all other remedial measures, as food, climate, clothing, 
heat, cold, electricity, etc., are all embraced in the term Thera- 
peutics, which may be divided into two grand divisions, viz. : — 

Natural Therapeutics, including the operations of the Vis Medicatrix 
Naturae, — the modes and processes of healing which occur independently of 
Art, for the spontaneous decline and cure of disease. There is no more com- 
pletely established fact in science than that the living organism is in itself 
adequate to the cure of all its curable disorders. This natural law enables 
the homoeopath to relate his sugar cures, aids the medical skeptic to hold to 
his infidelity, and helps all physicians out of more close places than most of 
them are willing to acknowledge before their clientele. This part of the sub- 
ject is not taught in the schools except in connection with pathology, and by 
the chair of Theory and Practice of Medicine. It is deserving of a special 
chair and of more systematic treatment than it receives. 

Applied Therapeutics embraces the application by Art of agents foreign 
to the living organism, for the purpose of aiding Nature to restore the body 
to a healthy condition. This division is the portion of the subject which is 
taught separately and systematically in the schools, and therefore is alone 
considered in the following pages. 

Other divisions of the general subject of Therapeutics employed 
in professional literature and conversation are those entitled 
" Empirical " and " Rational Therapeutics. 7 ' 

Empirical Therapeutics is a term applied to the use of medi- 
cinal or other therapeutical agents for the sole reason that they 
have been tried previously with successful results in cases appa- 
rently identical with the one under treatment. By those who 
advocate this method it is styled the Therapeutics of Experience, 
and claimed to be an accumulation of means of combating dis- 
ease simply by observation and experiment, independently of 
physio-pathological reasoning (Hartshorne). It was necessarily 
the original method in Therapeutics, has conferred many rich 
gifts upon medical science, and has been advocated by many 
great physicians, its latest and ablest expounder being the eminent 
and lamented Niemeyer. 

The use of Opium to relieve pain, — that of Cinchona for malarial fevers, — 
of Colchicum in gout, — of Potassium Iodide in syphilis, — of the Bromides in 
epilepsy, — of Cod-liver Oil in phthisis, — are examples of the empirical use of 
remedies. But, after all has been said for it that can be said, the fact remains 
that it is essentially an unscientific method, a mere elaboration of the prevail- 
ing popular habit of recommending Mrs. A. to use pepper tea, because it cured 
Mrs. B. of " the very same trouble." Permitted to reign supreme it would be 
destructive to all exactness in therapeutical progress. The so-called " expe- 
rience " of one observer is too often overbalanced by the experience of another 
equally competent and trustworthy ; and as few are encouraged to record their 
failures with remedies, there can be no scientific comparison of the failures with 
the reported successes. Yox this reason empirical methods would tend to a 
minimum degree of accuracy in a science which, in the very nature of things, 



INTRODUCTION. XV 

can never be an exact one ; — though undoubtedly such methods will always 
prevail to some extent. 

Rational Therapeutics embraces the use of remedies for 
reasons based on a knowledge (i) of the pathological conditions 
present in the subject, and (2) of the physiological action of the 
agent employed. This method is the very antithesis cf empiri- 
cism, and has been the leading idea in every revolt against em- 
pirical therapeutics in the past. Humoralism, Chemicism, Solid- 
ism, Stimulism, Galenism in the 2d century, Paracelcism in the 
1 6th, and Hahnemannism in the 19th, — all originated in efforts 
to find a more rational system of administering medicines than 
the prevailing empiricism of the day. 

The illustrious Albrecht von Haller, the father of Physiology 
and the author of the doctrine of Irritability, was the real origi- 
nator of modern physiological therapeutics. In the preface to 
his Swiss Pharmacopoeia {circa A.D. 1755), occur the following 
remarkable directions: 

" Nempe primum in corpore sano medela tentanda est, sine peregrina ulla 
miscela: odoreque et sapore ejus exploratis, exigua illius dosis ingerenda et 
ad omnes quae hide coniingunt aftectiones, quis pulsus, quis calor, quae respi- 
ratio, quaenam excretiones, attendendum. Inde adductum phenominorum in 
sano obviorum, transeas ad experimenta in corpore aegroto." 

" In the first place the remedy is to be tried on the healthy body, without any 
foreign substance mixed with it; having been examined as to its odor and 
taste, a small dose is to be taken, and the attention directed to all effects uuhich 
thereupon occur : such as upon the pulse, the temperature, the respiration, the 
excretioJis. Having thereby adduced their obvious phenomena in health, you 
may pass on to experiment upon the sick body" 

Forty or more years after these rules were laid down ex ca- 
thedra by Haller, the central idea contained in them was incor- 
porated, as one of the main pillars, in a medical edifice then 
being erected in Germany. In the course of construction this 
pillar became so buried beneath a superstructure of palpable 
absurdities, that the medical profession, in its anxiety to steer 
clear of the whole mass, almost forgot the humble corner-stone, 
appropriated from the teachings of one of its own greatest chief- 
tains. While, however, the masses of the profession, blinded by 
its prejudices, turned away from everything which savored of 
drug-experimentation, a few in every country were quietly work- 
ing on the lines of the Hallerian dictum ; and as a result of their 
labors, the present generation has seen the development of an 
idea, announced 130 years ago, but now inspiring the minds of 
teachers and students all over the civilized world. Medical Col- 
leges are recognizing physiological drug experimentation as a 



XVI INTRODUCTION. 

part of their regular curricula ; — laboratories are fitted up in 
many of the schools with costly instruments of precision, for the 
more exact prosecution of this study ; — and under the direction 
of such men as Wood, Ringer, Murrell, Brunton, Bartholow, 
Hildebrandt, Liebermeister, Husemann, Schmiedeberg, etc., sys- 
tematic researches are being conducted upon the physiological 
action of every agent hitherto used in medicine. The alkaloids, 
and other component principles of vegetable drugs, are being 
subjected to the same rigid observation, — as also every new com- 
pound which chemistry gives to medicine. Journals, in every 
civilized country, teem with the results of these labors; and no 
medical student is permitted to pass the graduating ordeal until 
he has mastered the essential characteristics of the physiological 
action of the important medicaments. What has hitherto been 
the conviction of but a few, is daily growing into a fixed canon 
of professional belief, viz : — that physiological experimentation 
with drugs must be the basis of their therapeutical employment, 
and that all real advance towards the establishment of Thera- 
peutics as a science, must be made upon the course laid down by 
Haller. Still, in the words of Brown-Sequard, " Therapeutics 
will cease to be empirical, only when this last kind of knowledge 
shall be fully obtained." 



ADMINISTRATION OF MEDICINES. 

Medicines may be introduced into the circulation by various 
routes, as the gastro-intestinal tract, the rectum, the respiratory 
tract, the veins and arteries, the subcutaneous cellular tissue, and 
the integument itself. 

The Gastro-intestinal Route is the one most frequently 
employed, being the most convenient. The remedies, after 
being swallowed, find their way into the current of the circula- 
tion, through the walls of the gastro-intestinal bloodvessels and 
the lacteals. When the stomach is empty and its mucous mem- 
brane healthy, crystalloidal substances in solution pass through 
the walls of its vessels with great rapidity. Colloidal substances 
(fats, albumen, gum, gelatin, etc.) require to be digested and 
emulsified before they can be absorbed. 



INTRODUCTION. XV11 

The Rectum will absorb many substances applied in the 
form of Enemata or Suppositories. Those most suited to this 
route are the salts of the alkaloids in solution, especially those 
of Morphine, Atropine and Strychnine, the latter being absorbed 
more rapidly per rectum than by the stomach. Acid solutions, 
if not too frequently repeated, are also well administered by this 
channel. 

The Respiratory Tract admits of the rapid absorption of 
medicinal substances through its extensive blood-supply. The 
inhalation of vapors or atomized fluids, the insufflation of pow- 
ders into the nares, fauces, larynx, etc., and the use of a medi- 
cated nasal douche, are methods whereby this channel may be 
utilized. 

The Veins are only used as a route of medication in emer- 
gencies, where the other channels are not available, and where 
immediate action is necessary to the preservation of life, the 
operation being a highly dangerous one. The injection intra- 
venously of Saline Solutions in the collapse of cholera, diabetic 
coma, etc., — Blood or Milk as a last resort in excessive hemor- 
rhage, epilepsy, uraemia, the collapse of cholera, etc., — and a 
solution of Ammonia for the bites of venomous reptiles, Hydro- 
cyanic-acid poisoning, Opium narcosis, Chloroform asphyxia, 
etc., are the instances admitted in practice. 

Arterial Transfusion has also been performed successfully in a number of 
cases, and is considered safer than venous transfusion when a large quantity 
of fluid has to be introduced into the circulation. A special apparatus is 
employed for these purposes, known as Aveling's Transfusion Syringe, but 
the ordinary Dieulafoy's aspirator slightly modified, may be used with safety 
and convenience. The danger of the operation lies in the liability of air to 
introduction into the circulation, an occurrence which causes instant death in 
the human subject. 

The Hypodermic Method is the introduction of medicines 
into the organism by injecting them into the subcutaneous areolar 
tissue, from which they are quickly absorbed by the lymphatic 

and capillary vessels. 

The medicines must be in solution, of neutral reaction and freshly prepared, 
the usual menstruum being distilled water ; though spring water filtered will 
answer just as well, and much better than distilled water which has been 
standing several days, and exposed from time to time to the air. The solu- 
tion is to be injected beneath the skin, by a hypodermic syringe, care being 
taken to avoid puncturing a vein. The most suitable localities for the injec- 
tion are the external aspect of the arms and thighs, the abdomen, the back, 



xviii 



INTRODUCTION. 



and the calves of the legs. On the external aspect of the thigh, just in front 
of the great trochanter, there is an area of some two inches square, over which 
the insertion of a fine hypodermic needle is not felt, so barren is the skin in 
that region of sensitive nerve filaments. 

After nearly filling the syringe with the solution to be used, the needle 
should be screwed on tightly ; and with the instrument held in a vertical posi- 
tion, point uppermost, the excess of solution over the amount required should 
be ejected, thus expelling air-bubbles and filling the needle itself. A portion of 
skin should be grasped by the thumb and forefinger at the site selected for 
the injection, into which the needle should then be quickly inserted until its 
point has passed beneath the skin, when the piston may be pressed down 
slowly, delivering the solution so gradually as to avoid rupturing the tissue. 
If the solutions are freshly prepared with clean water, the needles kept clean 
and sharp, and the injection be made beneath the skin not into it, there will 
be no risk of producing abscesses with the agents ordinarily employed. 
Tablets for hypodermic use are prepared by the prominent manufacturers, 
each containing one dose. They may be readily dissolved in a teaspoon at 
the bedside, and are very convenient for the pocket, if put up in a case with a 
good hypodermic syringe, as may be obtained from Parke, Davis and Co., of 
Detroit. Their regular line of Hypodermic Tablets includes the agents 
named in the following list, put up in tubes of 25 each. 



List of Hypodermic Tablets. 



Aconitine ( crystals), . 


gr. 


1 

T2TT 


Apormorphine Muriate, 


• g r - 


1 
10* 


Atropine Sulphate, 


gr. 


1 


Atropine Sulphate, 


■ g r - 


.1 

1 


Cocaine Hydrochlorate, 


g r - 


I 


Conine Hydrobromate, 


■ g r - 


h 


Colchicine, 


g r - 


1 

30- 


Corrosive Sub. and Urea, 


gr. 


1 

2 3"' 


Digitaiin (soluble), 


g r - 


TOO 


Gelsemine Muriate, . 


g r - 


1 

~5~0' 


Hyoscine Hydrobromate, 


• g r - 


T^O 


Hyoscyamine, 


• g r - 


1 
50* 


Morphine Sulphate, . 


• g r - 


4- 



gr. h 



Morphine Sulphate, . 
Morphine & Atropine, No. I 

Morphine Sulph., 

Atropine Sulph., 
Morphine & Atropine, No. 

Morphine Sulph., 

Atropine Sulph., 
Picrotoxin, 

Pilocarpine Hydrochlor., 
Pilocarpine Nitrate, . 
Physostigmine Sulph., 
Sodium Arseniate, 
Strychnine Sulphate, . 
Strychnine Sulphate, . 

[For Formula for Hypodermic Solutions, see Appendix, page 760.] 

Parenchymatous Injection is the delivery of a medicine 
deeply into the tissues, either to affect a muscle itself or to 
locally influence some important nerve-trunk. The principal 
agents used in this manner are Strychnine for palsied muscles, 
Chloroform for sciatic and other neuralgias, and Salts of Cocaine 
for local anaesthesia. 



• gr- 


y f 


• gr- 


2ihj' 


2. 




. gr. 


v f 


. gr. 


T5 0< 


• gr- 


sV 


• g r - 


h 


• g r 


*• 


• g r 


1 

100* 


. gr. 


tV 


• g r - 


1 
5 0"' 


• gr. 


100* 



The Skin is an active absorbent of crystalloidal substances 
when its epidermis or cuticle is removed. By this route there 
are four methods of introducing medicaments into the circula- 



INTRODUCTION. XIX 

tion, viz. — the En epidermic, Epidermic and Endermic Methods, 
and Inoculation. 

The Enepidermic Method consists in placing the medi- 
cine in simple contact with the epidermis, no friction being 
used to hasten its penetration. Chloroform and Oleic Acid 
solutions of the alkaloids pass by osmosis in this manner with 
comparative ease, but aqueous solutions act very slowly and alco- 
holic ones with great difficulty if at all. (See page 34.) 

The Epidermic Method consists in the use of friction to 
promote the passage of the medicament between the cells of the 
epidermis. Mercurial Ointment, Cod-liver Oil, and other fats, 
Oleates, etc., are used in this way for their local and systemic 
effects. 

The Endermic Method obviates the difficulty of absorption 
through the cuticle by removing the latter through the agency 
of a blister, and then powdering the medicament over the surface 
of the denuded derma. 

An ordinary cantharides-plaster, followed by a poultice to raise the blister, 
may be employed ; but a quicker method is to place upon the skin a piece of 
lint soaked in Stronger Water of Ammonia, covering it with a watch glass or 
a piece of oiled silk to prevent evaporation. The blister raises rapidly and 
should then be removed with scissors. Morphine, Atropine, Quinine and 
Strychnine, are the agents generally used in this manner, but the method is 
painful and unpopular. 

Inoculation is the introduction of medicinal agents through 
the scraped or punctured skin by an operation similar to that 
employed for vaccination. 



XX DOSAGE. 



DOSAGE OF MEDICINES. 

The Doses given throughout this book are for adults; for 
children the following rule (Young's) will be found the most 
convenient. Add 12 to the age, and divide by the age, to get 
the denominator of a fraction, the numerator of which is 1. Thus, 
for a child two years old, -+ 12 =7, and the dose is one-seventh 
of that for an adult. Of powerful narcotics scarcely more than 
one-half of this proportion should be used. Of mild cathartics, 
two or even three times the proportion may be employed. 

For Hypodermic Injection, the dose should be two-thirds 
or three-fourths of that used by the mouth; by rectum five- 
fourths of the same. Strychnine acts more actively when given 
per rectum than by the stomach. 

Conditions which modify the action of medicines, and there- 
fore affect their dosage, are — age, body-weight, temperament and 
idiosyncrasy, drug-habits, intervals between doses, time of admin- 
istration, condition of the stomach, temperature of the body, 
cumulative drug-action, mode and form of drug-administration, 
disease, climate, race, etc. 

Children bear Opiates badly (see page 278): — but on the 
other hand they stand comparatively large doses of several other 
drugs; such being Arsenic, Belladonna, Calomel, Ipecacuanha, 
Squill, Rhubarb, and several other purgatives. 



PART I. 

MATERIA MEDICA AND THERAPEUTICS. 



ABRUS, Jeriquity (Unofficial), — is the seed of Abrus pre- 
catorius, or Wild Liquorice, a plant of the nat. ord. Legumi- 
nosse, indigenous in India, but growing wild in most tropical 
countries. The seeds are small, hard, of a bright scarlet color, 
with a black spot around the hilum, and contain an alkaloid, 
some fixed oil, sugar, a principle resembling Glycyrrhizin, and 
A brie Acid, C 12 H 24 N 3 \ but neither of these is believed to be the 
active principle. 

Preparation. 

Infusum Abri, Infusion of Jeriquity (Unofficial), — prepared by macerating 
three powdered seeds in gss of cold water for twelve hours, adding ]|ss of 
boiling water, and filtering when cold. It should be used while fresh, as 
after two or three days it is worthless. 

Another formula contains gr. ix of Jeriquity to the §, with gr. iv of Boric 
Acid to prevent decomposition. 

Physiological Action and Therapeutics. 

Jeriquity seeds, when moistened with water, become highly 
poisonous. If applied to the conjunctiva, a severe inflammation 
is set up, with oedema and false membrane, ulceration of the 
cornea, and extension to the lids, face, neck and submaxillary 
glands. Inserted into a wound in cattle, they cause death in a 
few hours. The irritant action is believed to result from the 
presence in the seeds of some ferment, or perhaps great numbers 
of gonidia, which develop rapidly on a suitable tissue. The in- 
fusion, in a short time, swarms with bacteria. 

Jeriquity is used for the purpose of producing a purulent or 
croupous conjunctivitis, by which to destroy old granulations 
(trachoma) and pannus. A mild infusion is applied to the eye 
two or three times a day for two days, and followed by weak 



1 8 ABSINTHIUM — ACACIA. 

solutions of Alum or Borax. This should be repeated after three 
weeks if necessary. An emulsion of the seeds in water is a useful 
application to unhealthy ulcers and lupus. 



ABSINTHIUM, Wormwood,— the leaves and tops of 
Artemisia Absinthium, a perennial garden herb of the nat. ord. 
Composite, indigenous in Europe, but cultivated in the United 
States. The leaves are about 2 inches long, hoary, silky-pubes- 
cent, petiolate, pinnately two or three-cleft ; heads numerous, 
with small, pale-yellow florets, odor aromatic, taste persistently 
bitter. It contains a volatile oil and a bitter principle, Ab- 
sinthin. Dose, gr. xx-xl, in infusion. There are no official 
preparations, except Vinum Aromaticum (see Alcohol), of which 
Absinthium constitutes one per cent. 

Absinthe, the French liqueur, is an alcoholic solution of the oil, containing 
also extracts of Anise, Marjoram, and Angelica. Its continued use produces 
various nervous symptoms, morning nausea and vomiting, also a tendency 
to epileptiform convulsions. 

Physiological Action and Therapeutics. 

The bitter constituent of Absinthium is stimulant to the di- 
gestive organs, but the oil is a narcotic poison, increases the car- 
diac action, and produces tremor, stupor, epileptiform convul- 
sions, involuntary evacuations, and stertorous breathing. It is 
but little used in medicine, and only as a stomachic tonic in 
dyspepsia. 



ACACIA, Gum Arabic, — is a gummy exudation from Acacia 
Verek, a small tree of the nat. ord. Leguminosse, indigenous 
in Africa — also from other species of Acacia. It occurs in sphe- 
roidal tears of various sizes, breaking with a glassy, sometimes 
iridescent fracture ; insoluble in alcohol, but soluble in water, 
forming a thick and mucilaginous liquid. It consists of Arabin 
or Arabic Acid, Ci 2 H 22 0ii, combined with calcium, potassium, 
and magnesium. 

Preparations. 

MuciLAGO Acaci^E, — has of Acacia 34, Water to 100 parts. It should not 
be prescribed with tinctures or spirits except in very small quantity. Dose, 
indefinite. 

Syrupus Acaci^e, — has of the Mucilage 25, Syrup 75. Should be freshly 
made. Dose, indefinite. 

Acacia enters into the composition of Mistura Amygdalae, Mistura Glycyr- 
rhizae Composita, Pulvis Cretan Compositus, Trochisci Cretae, Trochisci Cu- 
bebae, and Trochisci Glycyrrhizae et Opii. 



ACIDUM ACETICUM. 1 9 

Physiological Action and Therapeutics. 

Gum Arabic has no activity except the negative one of a demul- 
cent, and is chiefly used in coughs, sore throats, catarrhal inflam- 
mation of the stomach and intestines, and irritant poisoning. It 
is much employed in pharmacy to suspend insoluble powders in 
mixtures, for which purpose the mucilage is generally used. 



ACIDUM ACETICUM, Acetic Acid,— is a liquid com- 
posed of 36 per cent, of absolute Acetic Acid, HC 2 H 3 2 , and 64 
per cent, of water. It is a clear, colorless liquid, of a distinctly 
vinegar odor, a purely acid taste, and a strongly acid reaction: 
sp. gr. 1.048 at 59 F. ; miscible in all proportions with water 
and alcohol, and wholly volatilized by heat. It is prepared from 
wood by destructive distillation and purification.. Acetic Acid 
is also official in two other degrees of concentration, viz. — 

Acidum Aceticum Glaciale, Glacial Acetic Acid, HC 2 H 3 2 ,— is nearly or 
quite absolute Acetic Acid, solid below 59 F., above that temperature a 
colorless liquid of sp. gr. 1.056 to 1.058. Is strongly escharotic and only used 
locally. 

Acidum Aceticum Dilutum, Diluted Acetic Acid, — consists of Acetic 
Acid 17, Distilled Water 83 parts, contains 6 per cent, of absolute Acetic 
Acid, and has a sp. gr. of 1.0083. Dose, gj-ij. 

Acktum, Vinegar ^Unofficial), — is an impure diluted Acetic Acid, pro- 
duced by the acetous fermentation of any liquid susceptible of the vinous 
fermentation. 

Diluted Acetic Acid is used in the preparation of the four official Aceta 
(Vinegars). 

Physiological Action. 

Acetic Acid, like the other vegetable acids, in concentrated 
form is escharotic and produces gastro-enteritis if swallowed. 
In dilute form it acts as a refrigerant, diminishing thirst and 
allaying restlessness. It forms salts in the stomach, thus enters 
the blood, and is there oxidized, producing carbonic acid, and 
thereby increases the acidity of the urine. It is also diuretic. 
Long used, it causes emaciation and poverty of the blood, pro- 
ducing a general scorbutic condition. It is hemostatic and 
anthelmintic, and the vapor inhaled causes reflex contraction of 
the vessels and raises the blood-pressure. 

Therapeutics. 

The glacial acid is used as a caustic in many skin affections, as 
warts, condylomata, etc., and to destroy the parasite in ringworm 
and pityriasis. It has been employed locally in carcinoma, with 



20 ACIDUM BORICUM. 

the view of dissolving the supposed cancer-cells. The dilute acid 
is used locally in superficial inflammations of the skin, and may 
be sponged over the body to check perspiration and reduce the 
surface temperature in fevers. It is often administered internally 
to reduce obesity, which it does by impairing digestion. Locally, 
it may be employed to arrest slight hemorrhages, as epistaxis; 
and is occasionally used by enema for the destruction of ascarides. 

ACIDUM BORICUM, Boric or Boracic Acid, H 3 Bo 3 , 
— is a weak acid occurring in transparent, colorless, six-sided 
plates, of unctuous touch, odorless, of a cooling and slightly 
bitter taste, soluble in 25 of water and in 15 of alcohol at 59 F., 
in 3 of boiling water and in 5 of boiling alcohol. It is produced 
from Borax by the action of Sulphuric Acid. Dose, gr. v-xx. 
There is only one official Borate, viz. — 

Sodii Boras, Borate of Sodium, Borax, Na 2 B 4 7 ,ioH 2 0, — 
colorless, transparent prisms, of cooling and sweetish, afterwards 
alkaline taste and alkaline reaction, soluble in 16 of water at 
59 F., and in 0.5 of boiling water; insoluble in alcohol. Oc- 
curs native in ancient lake beds in various parts of the world. 
Dose, gr. v-xl. 

Unofficial Preparations. 

Boro-GLYCERIDE, — is a solid chemical compound, prepared by heating 
together Boracic Acid and Glycerin. It is soluble in water, but is generally 
used in solution of equal parts of pure Glycerin and Boro-glyceride. It com- 
bines readily with Chrysarobin, Carbolic Acid, Atropine, and Morphine, and 
is used as a local application in eye-diseases and skin affections. 

Boracic Ointment, — has of Boracic Acid 1, White Wax 1, Paraffin 2, 
Almond Oil 2, thoroughly mixed together. 

Boracic Lotion, — is a saturated solution of the acid in water. 

Boracic Lint, — prepared by steeping lint in a boiling saturated solution 
and drying. It contains nearly one-half its weight of the acid. 

Magnesii Boro citras, Borocitrnte of Magnesium, — prepared extempora- 
neously thus, — R. Magnesii Carbonatis 7j. Acidi Citrici gij, Sodii Biborat. gij, 
Aquse Bullientis ^viij. A tablespoonful three or four times daily as a solvent 
of uric acid calculi. 

Potassii Tartra boras, Tartraborate of Potassium, — is a better solvent 
of uric acid calculi than the Magnesium salt, and is soluble in 2 parts of cold 
water. Prepared by heating together Boracic Acid I, Potassii Bitartras 4, 
Water 10 parts. Dose, gr. xx, largely diluted with water, three or four times 
a day. 

Physiological Action and Therapeutics. 

Boracic Acid is an efficient antiseptic, disinfectant, and deo- 
dorant, arresting fermentation and putrefaction, and very de- 
structive to low organisms. A solution of 1 in 133 arrests the 
activity of bacteria. It is feebly acid and but slightly irritant, 



ACIDUM CARBOLICUM. 21 

and is used as a surgical dressing for its antiseptic and unirritating 
qualities. Its lotion and ointment have been successfully em- 
ployed in ulcers, eczema, burns and scalds, pruritus ani, fetid 
perspiration, wounds, tinea tonsurans, and tinea circinata. 

The Borate of Sodium is antiseptic and disinfectant, as it 
also destroys low vegetable organisms. It removes the epidermis 
w T hen locally applied, has power to increase uterine contraction, 
and aids the solution of Benzoic Acid. It is employed as a wash 
to remove the epidermis from the skin, and as a lotion in acne, 
freckles, chloasma, leucorrhcea, aphthae, etc., and to allay itching 
in urticaria, psoriasis, impetigo, and in pruritus puclendi, scroti et 
ani. It has been used internally in amenorrhcea, dysmenorrhcea, 
puerperal fever and puerperal convulsions, for its supposed spe- 
cific action on the uterus. 

Boro-glyceride in solution (i to 40) is also a powerful anti- 
septic, and is used as a lotion in purulent ophthalmia and in the 
treatment of wounds, also as a local application to diphtheritic 
membranes. It is an efficient preservative of milk and food 
against putrefactive changes, and is entirely harmless. 

An elegant cosmetic cream maybe made by dissolving Boracic 
Acid in Glycerin, and then incorporating it with White Wax and 
Almond Oil. 



ACIDUM CARBOLICUM, Carbolic Acid, Phenic 
Acid, Phenylic Alcohol, Phenol, C 6 H 5 HO, — is an alcoholic 
product of the distillation of coal-tar between the temperatures of 
356 and 374 F. It occurs in needle-shaped crystals of tarry odor 
and burning taste, is liquefied by about 5 per cent, of water, 
soluble in 20 of water at 59 F., and very soluble in alcohol, 
ether, chloroform, glycerin, oils, etc. Peculiarities about Car- 
bolic Acid are that about 5 per cent, of water liquefies it, a further 
addition of water renders it turbid, until 2000 parts of water to 
100 of the acid have been added, when a stable and clear solution 
is formed. One volume of liquefied Carbolic Acid containing 5 
per cent, of water forms with one volume of Glycerin a clear 
mixture which is not rendered turbid by the addition of three 
volumes of water (absence of Creasote and Cresylic Acid). It 
does not redden bine litmus paper, but combines freely with 
alkalies and other salifiable bases, the products having an alkaline 
reaction and being decomposed by the feeblest acids (carbonic, 
etc.). Dose, gr. %-). 

Acidum Carbolicum Crudum, Impure Carbolic Acid, — is 
obtained as above stated, but at a lower heat (z2>%° t0 374° F.)> 



22 ACIDUM CARBOLICUM. 

and contains Carbolic, Xylic, and Cresylic Acids in varying pro- 
portions, together with other impurities. It is used as a disin- 
fectant. 

Preparations. 

Unguentum Acidi Carbolici, — strength 10 per cent., Ointment 90. 

Glyceritum Acidi Carbolici (Unofficial), — Carbolic Acid 1, Glycerin 4. 

Aqua Acidi Carbolici (Unofficial), — has of the Glycerite 3X to Aquae 
Oj. Dose, ,5J-^ss. 

Carbolic Acid Gauze (Unofficial), — is medicated with Ac. Carbol. 1, 
Resin 5, Paraffin 7 parts. 

Carbolic Acid Plaster (Unofficial), — has of Carbolic Acid 25, Shellac 
75, coated with Gutta-percha dissolved in Carbon Disulphide. 

Carbolic Acid Solutions, for antiseptic surgery, are — 
5 per cent, in Water, as a spray or wash. 
2^2 per cent, in Water, for sponges, hands, or as a lotion. 
5 per cent, or less in Olive Oil, as a special dressing. 

Official Derivative Salts. 

Sodii Sulpho-Carbolas, Sulpho-carbolate of Sodium, NaC 6 H 5 S0 4 .2H 2 0, 
— prepared by dissolving Carbolic Acid I , in strong Sulphuric Acid I , thus form- 
ing Sulpho-carbolic Acid, which is then neutralized with Carbonate of Sodium. 
Transparent, rhombic prisms, soluble in 5 of water at-59 F., less freely in alco- 
hol and glycerin. Dose, gr. x-xxx. 

Analogues. 

Creasotum, Creasote, — is a similar product, obtained from wood-tar, but 
by the action of Nitric Acid it is converted into Oxalic Acid chiefly, while 
by the same reagent Carbolic is converted into Picric Acid. Creasote does 
not coagulate albumen or collodion, Carbolic Acid does. Creasote is described 
under its own title. 

Resorcin (non-official), C 6 H 6 2 , — is also a phenol, obtained from certain 
resins by the action of fusing alkalies. [Described under its own title.] 

Physiological Action. 

Carbolic Acid is a powerful antiseptic and antiferment, being 
destructive to all low forms of life. It is a local anaesthetic and 
a superficial escharotic, coagulating albumen and also the blood 
when out of the body. Taken internally undiluted it produces 
violent gastritis, mvj of the pure acid having caused dangerous 
symptoms. It stimulates the cardiac inhibition, first slowing, 
then depressing, and finally paralyzing the heart. Respiration, at 
first increased, is soon depressed, the pupils are contracted, and 
both brain and spinal cord are directly affected ; stupor, coma, 
suspended reflexes, impaired motility and sensibility being pro- 
duced.' It is rapidly absorbed and diffused, many fatal cases 
having occurred from its external use. It is partly oxidized in 
the blood, and partly eliminated by the lungs and kidneys, im- 
parting to the urine a peculiar olive-green or smoky color. 



ACIDUM CHROMICUM. 23 

Locally applied Carbolic Acid produces on the skin or mucous 
membrane a white superficial eschar which succeeds to burning 
pain of short duration. 

Antidotes and Antagonists. 

Liquor Calcis Saccharatus, or the official Syrupus Calcis, given freely; 
or Sodium Sulphate to form the Sulpho-carbolate of Sodium, are the chemical 
antidotes. Vegetable demulcents (but no oils or glycerin) to protect the 
mucous surfaces. Atropine is a very complete physiological antagonist to 
the systemic symptoms, maintaining the heart and respiration until elimination 
occurs. 

Therapeutics. 

Carbolic Acid owes its prominence to its having been the 
principal agent used in the antiseptic method of treating wounds; 
but lately its employment in that connection has become much 
restricted, and many of the most prominent surgeons have aban- 
doned it altogether in favor of other germicides. For nausea 
and vomiting it is an excellent remedy in ^ grain doses, and in 
many chronic pulmonary affections it is used with benefit by 
spray. It maybe employed locally in acute and chronic catarrhs, 
parasitic skin diseases, uterine and other ulcers, abscesses, boils, 
and carbuncles, endo-metritis, and perhaps in pulmonary phthisis. 
It has proven of temporary benefit in diabetes of hepatic origin. 
It has been injected parenchymatously (2 per cent, solution) in 
erysipelas, pleuro-pneumonia, intermittents, synovitis, lupus, 
chancroid, hydrocele, etc. 

The Sulpho-cakbolates of Sodium, Potassium, Calcium, and 
Magnesium, have been employed advantageously in the septic 
diseases (as the exanthemata, diphtheria, puerperal fever), the 
object being to obtain the antiseptic and antipyretic actions of 
Carbolic Acid without its dangers. They may be used locally 
with good results in aphthae, tonsillitis, otorrhcea, gonorrhoea, 
and inflamed mucous membranes generally. 

ACIDUM CHROMICUM, Chromic Acid, Cr0 3 — is 

obtained by the action of Sulphuric Acid upon Potassium Chro- 
mate, and occurs in small crimson needle-shaped crystals, deli- 
quescent and very soluble in water. Brought in contact with 
alcohol mutual decomposition takes place. A similar result and 
perhaps sudden combustion results when it is placed in contact 
with other easily oxidizable substances, such as Glycerin, Spirit of 
Nitrous Ether, etc. It is not used internally. 

Potassii Bichromas, Bichromate of Potassium, K 2 Cr 2 7 , — large, orange- 
red prisms of disagreeable, metallic taste and acid reaction, soluble in 10 of 



24 ACIDUM CHROMICUM. 

water at 59 F., and in I J of boiling water, insoluble in alcohol. Used locally 
in aqueous solution (gr. v-gj to the J|), and internally in doses of gr. y^-ij in 
trituration. 

Physiological Action and Therapeutics. 

Chromic Acid is a powerful escharotic, penetrating deeply, 
but slow of action and not very painful. It coagulates albumen 
and parts readily with its oxygen, oxidizing organic matter and 
decomposing ammonia and sulphuretted hydrogen. It is there- 
fore an energetic disinfectant and deodorizer. When used as 
a caustic it is mixed with sufficient water to make a paste, which 
may be employed for the destruction of warts, hemorrhoids and 
other superficial growths, the neighboring parts being protected 
by cotton soaked in a strong alkaline solution. For syphilitic 
warts and condylomata, lupus, tinea tonsurans, etc., a solution of 
100 grains to the § of distilled water is generally used. A solu- 
tion of 1 in 40 is an excellent and inexpensive antiseptic lotion 
for putrid sores and wounds, syphilitic affections of the tongue, 
mouth and throat, ozaena, leucorrhoea, and gonorrhoea. In ute- 
rine catarrh and hemorrhages a solution of 120 grains to the § 
has been injected into the uterine cavitywith good results. 

Bichromate of Potassium is a good antiseptic and an escha- 
rotic of milder action than the acid. In doses of 3U -rv ** nas 
proved fatal to life in adults, with symptoms of gastro-enteritis, 
suppression of urine, and cardiac paralysis. It is chiefly employed 
as a local application in saturated solution to warts and venereal 
condylomata; and in dilute solution (gr. j-x to the §) for 
catarrhal conditions of the nasal, buccal, or vaginal mucous mem- 
brane. Internally it has been employed with benefit in locomotor 
ataxia and in dyspepsia simulating gastric cancer; also in chronic 
gastric catarrh, the tongue having a thick yellow coat, in chronic 
diarrhoea from intestinal ulceration, and in chronic ulcers of the 
pharynx and mouth. It is a good remedy in syphilitic sore throat, 
local rheumatism of the fibrous tissues, periosteal and syphilitic 
rheumatism, and acute catarrh and influenza, chronic nasal 
catarrh, chronic laryngitis, and chronic catarrhal affections of the 
bronchial mucous membrane, especially when the expectoration 
is tough and stringy. It has also been used with some success in 
membranous croup and diphtheria. In pharmacy it is employed 
in the preparation of Chromic Acid and Valerianic Acid, and as 
a test solution. Most of the medical galvanic and farad ic bat- 
teries are run by a mixture of this salt with Sulphuric Acid. 
Poisoning by it should be treated as directed for that by mineral 
acids. 



ACIDUM FLUORICUM — ACIDUM GALLICUM. 25 

ACIDUMFLUORICUM, Fluoric Acid,HF (Unofficial), 

— isastrongescharotic, acting deeply and leaving a dry and painful 
slough. The dilute acid (i in 200) is prepared by acting on fluor 
spar by Sulphuric Acid, the resulting gas being dissolved in water. 
Its dose is n# xx-xxx, well diluted. 

Therapeutics. 

Dilute Fluoric Acid has been successfully used as an internal 
remedy in goitre, and the gas has been inhaled with benefit in 
diphtheria and membranous croup. 

ACIDUM GALLICUM, Gallic Acid, HC 7 H 5 5 .H 2 0,— 
is a nearly colorless solid in long needles or triclinic prisms, having 
a slightly acid and astringent taste, soluble in 100 of water and 
in 4^ of alcohol at 59 F., and in 3 of boiling water. It is pre- 
pared from a paste of powdered galls (see Galla), by fermenting 
for six weeks, boiling and reboiling in water, filtering and crys- 
tallizing. According to some authorities the Tannic Acid of the 
galls is split up into Gallic Acid and glucose by fermentation ; 
but according to others the glucose is an impurity and the 
Tannic Acid is simply converted into two parts of Gallic Acid, 
C u H 10 O 9 +H 2 O=(HC 7 H 5 O 5 ) 2 . Dose, gr. v-xv, in solution, pill, 
or powder. 

Acidum Pyrogallicum, Pyrogallic Acid, C 6 H 3 (HO\ (unoffi- 
cial), — is obtained from Gallic or Tannic Acid by careful heating. 
Dose, gr. j-ij. 

Preparations. 

Unguentum Acidi Gallici, — is a 10 per cent, ointment, with a basis of 
Benzoinated Lard. 

Vegetable Astringents depend for their medicinal value upon the Gallic 
and Tannic Acids contained in them. Such are — 

Alnus, Alder Bark. Heuchera, Alum Root. 

Castanea, Chestnut Leaves. Kino, Kino. 

Catechu, Catechu. Krameria, Rhatany. 

Diospyros, Persimmon. Myrica, Wax Myrtle. 

Galla, Nut Galls. Nympham. Pond Lily. 

Geranium, Cranesbill. Quercus Alba, Oak Bark. 

Granatum, Pomegranate. Rosa Gallica, Red Rose. 

Hamamelis, Witch Hazel. Rubus, Blackberry. 

Hsematoxylon, Logwood. Statice, Ma^h Rosemary, 

Physiological Action. 

Gallic Acid, and its congener Tannic Acid, are astringents, 
the former being the more feeble of the two. They differ in that 
Tannic Acid coagulates albumen and gelatin, while Gallic does 



26 ACIDUM HYDROBROMICUM DILUTUM. 

not. Tannic Acid is converted by the organism into Gallic and 
Pyrogallic Acids, in which forms it is absorbed and excreted. 
According to some authorities the difference between Gallic and 
Tannic Acids is one of oxidation, according to others of hydra- 
tion ; the latter assuming Tannic Acid to be simply Gallic Acid 
Anhydride. They constringe the muscular tissue in the walls of 
the minute vessels, thus checking secretion and hemorrhages and 
cutting short local inflammations. Except in enormous doses 
they are harmless. [Compare Acidum Tannicum.] 

Pyrogallic Acid may act as an intense poison, having been 
absorbed from the surface with fatal results, preceded by vomiting 
and diarrhoea, rigors, and fever, black urine full of globulin, and 
disorganization of the blood-corpuscles. It has great affinity for 
oxygen and may be used as an antiseptic and disinfectant in i to 
2*^ per cent, solutions. 

Antagonists a?id Incompatibles. 

Mineral acids, alkalies, per-salts of iron, and salts of antimony, lead, and 
silver are chemically incompatible. 

Therapeutics. 

Gallic Acid is preferred to Tannic Acid when an astringent 
action is desired upon remote parts, as the lungs, kidneys, 
etc., which can only be reached through the circulation. In 
hematuria, distant passive hemorrhages, albuminuria, diabetes 
insipidus, bronchorrhoea, night-sweats, chronic diarrhoea, and 
chronic cystitis, it is a most useful remedy. 

Pyrogallic Acid has been used internally in two-grain doses 
for internal hemorrhages. As an ointment (3J~Ij) it i s next to 
Chrysarobin as an efficient palliative in psoriasis, and has been 
used with good results in lupus and epithelioma, being supposed 
to attack the diseased nodules only, leaving the # adjacent skin 
uninjured. 



ACIDUM HYDROBROMICUM DILUTUM, Di- 
luted Hydrobromic Acid, — is composed of 10 per cent, of 
absolute Hydrobromic Acid (HBr), and 90 per cent, of water. 
It is a clear, colorless, and odorless liquid, of a pungent acid 
taste, produced by decomposing Potassium Bromide by Sulphuric 
Acid and distilling. Dose, nj? xx~3ij. 

Physiological Action and Therapeutics. 

Hydrobromic Acid has identical action on the nervous system 
and circulation with that of the Bromides. Added to a mixture 



ACIDUM HYDROCHLORICUM. 2J 

of Quinine and water (n^ ij to each grain of Quinine) it will 
produce a clear solution. 

In hysteria, congestive headaches, neuralgia, and nervous 
exhaustion, Hydrobromic Acid has been found useful. Used as 
a solvent of Quinine it retards cinchonism, and prevents the 
headache resulting from the full action of Quinine and Iron. As 
a substitute for the Bromides of Sodium and Potassium it is highly 
recommended, being much less depressant. It has been especially 
recommended in tinnitus aurium. Fothergili uses it for coughs 
of reflex or spasmodic nature, also for simple continued fever 
where there is cerebral disturbance. 



ACIDUM HYDROCHLORICUM, Hydrochloric 
Acid, Muriatic Acid, — is a liquid composed of about 32 per 
cent, of absolute Hydrochloric Acid Gas, HC1, and 68 per cent, of 
water. It is colorless and fuming, of specific gravity 1 . 1 60, pungent 
odor, intensely acid reaction and taste, and is obtained by the 
action of Sulphuric Acid upon Sodium Chloride, the resulting gas 
being carried through water which dissolves it. It is sometimes 
used as a caustic. Its union with basic substances forms salts, 
called Hydrochlorates (Muriates), of which four are official, viz. : 
the Hydrochlorates of Apomorphine, Morphine, Pilocarpine, and 
Quinine, described under the titles of their respective bases. 

Preparations. 

Acidum Hydrochloricum Dilutum,— is a io per cent, solution of the 
absolute acid in water. Dose, tt^ iii-x. 

Acidum Nitro-hydrochloricum, — see under Acidum Nitricum. 

Physiological Action of the Mineral Acids. 

The mineral acids (Hydrochloric, Sulphuric, Nitric, Nitro- 
hydrochloric, and Phosphoric) resemble each other in general 
action so closely that they may all be described in this place. 

The strong acids are escharotic, abstracting the water of the 
tissues, combining with the albumen and other bases, and de- 
stroying the protoplasm. They are very diffusible, redestroying 
the albumen after precipitating it (except Nitric Acid). Sulphuric 
and Phosphoric have a strong affinity for water, completely 
decomposing tissues to which they are applied, and are therefore 
the most powerfully escharotic. Nitric Acid does not readily 
redissolve the albumen precipitated by it, which thus forms a bar- 
rier against the deep action of the acid. Sulphuric Acid chars 
or carbonizes the tissues black, while Nitric and Hydrochloric 
tan them yellow. 



28 ACIDUM HYDROCHLORICUM. 

The dilute acids produce a peculiar taste in the mouth and a 
sensation of roughness on the teeth. They stimulate the flow of 
saliva from the parotid and submaxillary glands, but have no 
action on the sympathetic saliva. They promote the alkaline 
intestinal secretions and excite the flow from ducts having an 
alkaline secretion (bile, etc.), but check that from those whose 
•secretion is acid (gastric, etc.). Secretion generally is promoted 
by Nitric Acid, and lessened by Sulphuric, Hydrochloric acting 
between the other two. Given before meals, in small doses, they 
relieve acidity of the stomach by checking the production of the 
acid gastric juice. At first they aid digestion, being synergistic 
to the action of pepsin, but if continued they impair digestion by 
lessening the production of the gastric juice. They check fer- 
mentation and constipate the bowels, except Nitric Acid, which 
relaxes them. They render the urine slightly more acid than its 
normal reaction, but do not acidify alkaline urine as the vegetable 
acids do. They are all astringent to the tissues, Hydrochloric 
being weakest and Sulphuric the strongest in this respect. 

Antagonists and Incotnpatibles. 

Alkalies to neutralize the acid ; oil, albumen, or milk, to protect the 
mucous membrane; stimulants, Opium, Ammonia (intravenously) to combat 
the resulting depression of the vital powers. 

Therapeutics of the Mineral Acids. 

All the members of this group are useful in fevers, if well 
diluted, Hydrochloric being usually preferred, especially in 
typhoid. In atonic dyspepsia, acidity of the stomach, and locally 
in ulcerations of the throat, Hydrochloric Acid is best used. 
Nitric is the acid generally preferred as a caustic, its action being 
effective and superficial. As such it is applied undiluted to 
phagedenic ulcers and sloughs, warty growths, and to the cavity 
of the womb in chronic inflammation thereof. Dilute Nitric Acid 
is used internally in oxaluria and lithemia, intermittent and remit- 
tent fevers, and aphonia of singers. Dilute Nitro-hydrochloric 
is more suitable in chronic hepatic disorders due to malaria; 
Sulphuric in hemorrhages, diarrhoeas, colliquative sweating, and 
as a prophylactic against lead-poisoning. Dilute Sulphuric Acid 
is used as an acid drink in fevers, and before meals in acidity of 
the stomach. It is very doubtful whether the latter has any spe- 
cial influence on the nervous or osseous systems. 

All these acids act injuriously on the teeth, by attacking the 
enamel. They should always be administered largely diluted, 



ACIDUM HYDROCYANICUM DILUTUM. 29 

taken through a straw or glass tube, and the mouth should at once 
be thoroughly rinsed with an alkaline solution. 



ACIDUM HYDROCYANICUM DILUTUM, Di- 
luted Hydrocyanic Acid, Prussic Acid, — is a liquid com- 
posed of 2 per cent, of absolute Hydrocyanic Acid, HCN, and 
98 per cent, of alcohol and water. It is colorless, faintly acid, 
of peculiar odor, and is prepared by distilling solutions of Potas- 
sium Ferrocyanide and Sulphuric Acid together, or extempora- 
neously by adding 6 parts of Cyanide of Silver to a solution of 5 
parts of Hydrochloric Acid in 55 of distilled water, shaking 
together and pouring off the supernatant liquid. irj?xl have 
proved fatal. Dose, "rj-v. 

Preparations containing Hydrocyanic Acid. 

Aqua Laurocerasi, Cherry-laurel Water (Unofficial),— is a water distilled 
from the fresh leaves of Primus laurocerasus, the common Laurel or Cherry 
Laurel, a small tree of the nat. ord. Rosacea?, sub-order Amygdaleae. The 
leaves contain a variable amount of Hydrocyanic Acid and a volatile oil. 
Dose, Tr£ v-xxx, cautiously. 

Scheele's Dilute Hydrocyanic Acid (Unofficial), — is a 4 or 5 per cent, 
solution, and is highly dangerous even by inhalation. 

Amygdala Amara, Bitter Almond (see its title), and its essential oil; 
also, various other members of the sub-order Amygdaleae, including the official 
Prunzts Virginiana, perhaps the unofficial Prunus laurocerasus, and the 
leaves and kernels of the peach and cherry trees, contain a proximate principle 
Amygda/in, and a ferment Emulsin, which in the presence of water react 
with each other, forming Hvdrocyanic Acid, a volatile oil, and glucose. 
C 20 H, 7 NO n (Amygdalin) -f 2H.,0 = C 7 H 6 (Oil of Bitter Almond) -f- HCN 
(Hydrocyanic Acid) -f- 2C 6 H 12 6 (Glucose). 

Other Cyanogen Compounds. 

Potassii Cyanidum, Cyanide of Potassium, KCN, — a white, opaque salt, 
of alkaline reaction, bitter-almond taste and a peculiar odor when moist ; 
soluble in 2 of water at 59 F., sparingly soluble in alcohol. Dose, gr. ^q-2- 
Locally a solution of gr. j-v to the 3. 

Potassii Ferrocyanidum, Ferrocyanide of Potassium, K 4 Fe(CX 6 ^ 6 3H 2 0, 
— large, lemon-yellow prisms or tablets, efflorescent, odorless, of sweetish 
taste and neutral reaction, soluble in 4 of water, insoluble in alcohol. Em- 
ployed in pharmacy as a test solution, and in the preparation of Ferrocyanide 
of Iron, Diluted Hydrocyanic Acid, and the Cyanides of Potassium and Silver. 
Rarely used medicinally. Dose, gr. v-xv. 

Physiological Action. 

Prussic Acid is one of the most powerful and rapid poisons 
known, half a grain having proved fatal. Its action on the 



30 ACIDUM HYDROCYANICUM DILUTUM. 

organism is one peculiar to itself, the inhalation of a strong 
preparation producing rapid insensibility and almost immediate 
exhaustion ; — death from a full dose occurring by sudden paral- 
ysis of the heart, from a less but still a fatal dose, by paralysis of 
respiration. The symptoms are those of sudden and complete 
asphyxia, and some volitional movements may be made before 
death, unless the dose be very large. Cases in which the dose, 
though fatal, permitted of the observance of its effects, they were 
usually divisible into two marked stages, viz. : (i) Dyspnoea, slow 
and full pulse, giddiness, loss of muscular power. (2) Vomiting, 
dilated pupils, unconsciousness, spasms, muscular rigidity, and 
cessation of the heart's action. In poisonous, but not fatal doses, 
the following effects have been observed : feeble pulse, dilated 
pupils, turgid and dusky face, insensibility, convulsions or 
rigidity, but no paralysis. Large medicinal doses may produce 
salivation, irritation of the throat, dizziness, buzzing in the ears, 
headache, numbness, dusky countenance, staggering gait, sense 
of constriction of the chest, palpitation of the heart, a frequent 
or an abnormally slow pulse, a sense of great weariness and 
drowsiness. Post-mortem examination shows usually dilated 
pupils, the eyes having a marked glassy lustre, the cadaveric 
rigidity very great. The blood, in cases which have been rapidly 
fatal, may show the arterial color in both the arterial and the 
venous systems; but in slower cases it is dark and fluid, engorg- 
ing both sides of the heart, the venous trunks, and the cerebral 
sinuses. The paralyzant action of the drug is chiefly exercised 
on the nerve-centres in the medulla; next on the peripheral 
afferent nerves, the spinal cord, the motor nerves, and finally on 
the muscular tissue. It stops the heart by irritation of the vagus- 
roots in the medulla, as well as by paralyzing the cardiac motor 
ganglia. It is said to form with haemoglobin a compound 
(cyan-haemoglobin), which does not readily give up oxygen. 
The odor of the acid is fragrant, resembling that of bitter 
almonds or peaches, and may be detected in the lungs shortly 
after death. The effects of a medicinal dose pass off in an hour 
at farthest. 

Locally applied to the skin, Hydrocyanic Acid penetrates the 
epidermis and paralyzes the end-organs of the sensory nerves in 
the derma. It is rapidly absorbed from mucous surfaces. 

Cyanide of Potassium has similar action, but in addition has 
some tew peculiar to itself. Locally used it produces dermatitis, 
with an eczematous eruption, and if applied to an abraded sur- 
face freely may cause fatal effects. Internally it has proved fatal 
in doses of 3 to 5 grains, with all the symptoms of Prussic Acid 



ACIDUM LACTICUM. 3 I 

poisoning. It is much used in photography, and many cases of 
poisoning by it have occurred in persons employed in that art. 

Antagonists and Antidotes. 

Atropine has antagonistic action, but is too slowly diffused to be of any 
value. Ammonia by inhalation, by the stomach, and by intravenous injection, 
with cold affusion to the spine, and artificial respiration, are the measures most 
likely to avail in cases of poisoning where there is time to do anything. In 
poisoning by Potassium Cyanide give the Sulphate of Iron, producing Fer- 
rocyanide of Iron ( Prussian Blue). Then evacuation of the stomach, artificial 
respiration, and Ammonia by intra-venous injection. 

Therapeutics. 

Hydrocyanic Acid is used for its antispasmodic and sedative 
effects. In vomiting, whooping-cough, and coughs of spasmodic 
character, in asthma and other neuroses of the respiratory organs, 
in affections involving the pneumogastric nerve, vertigo and 
headache from stomachal derangements, gastralgia, painful dys- 
pepsia, vomiting, etc., it is very efficient as a palliative. In acute 
mania and melancholia it has been used with advantage; and in 
various skin diseases, accompanied by itching, tingling, etc., its 
use as a lotion (n^ xxx~3j ad .$j Aquae Rosae) to the unbroken 
surface is prompt in relieving the pruritus and other distressing 
sensations. 

Cyanide of Potassium in ointment (gr. v ad §]) is used to 
allay pruritus, and in solution (gr. iij-v ad gj) is applied locally 
with benefit in reflex headaches, and is used as a wash to remove 
nitrate of silver stains. It has been used internally in doses of 
gr. j for acute articular rheumatism, but such employment of it is 
highly dangerous. 

Ferrocyanide of Potassium has been used in doses of 8 to 15 
grains as an astringent and anodyne, but it is seldom employed 
in medicine. 

Cherry-laurel Water has been extensively used as a flavoring 
agent, having a very agreeable taste. It is official in the British 
Pharmacopoeia, and is supposed to be a rather elegant mode of 
administering Prussic Acid ; but the uncertainty of its strength 
is such that it should never be used internally, except in very 
small quantities. It has been employed as an anaesthetic injection 
into the urethra prior to catheterization, and was formerly em- 
ployed by ophthalmologists as an eye-wash in painful affections of 
that organ. 

ACIDUM LACTICUM, Lactic Acid,— is a liquid com- 
posed of 75 per cent, of absolute Lactic Acid (HC 3 H 5 3 ) and 25 



32 ACIDUM NITRICUM. 

per cent, of water ; nearly colorless, syrupy, odorless, of acid taste 
and reaction, freely miscible with water, alcohol, and ether, but 
nearly insoluble in chloroform. It is produced by the fermenta- 
tion of sugar of milk, has a sp. gr. of 1.212, and is difficult to 
obtain pure. It enters into Syrupus Calcii Lactophosphatis. 
Dose, 5ss-^ss, well diluted. 

Physiological Action. 

Lactic Acid is found in the stomach as a product of the food, 
and combines with bases in the blood, forming lactates, which, 
being oxidized, are converted into carbonates. It aids digestion, 
and promotes the appetite, but, in large doses, causes flatulence 
and much epigastric pain. Injected into the peritoneal cavity of 
animals, it excites endocarditis, and given in diabetes, it has pro- 
duced acute rheumatism and rheumatic endocarditis. Hence 
its supposed causation of acute rheumatism when in excess and 
free in the blood. It dissolves false membranes and the phosphate 
of calcium. 

Therapeutics, 

It is used with benefit in diabetes, atonic dyspepsia, oxaluria, 
and in the lithic and phosphatic diatheses when due to imperfect 
digestion and assimilation. As a solvent of false membrane in 
croup and diphtheria it is unquestionably of great service. In 
chronic cystitis it arrests the ammoniacal decomposition of the 
urine. As the acid found in the shops is generally of poor quality, 
disappointment in its use may be expected. 



ACIDUM NITRICUM, Nitric Acid,— is a liquid com- 
posed of 69.4 per cent, of absolute Nitric Acid, HN0 3 , and 30.6 
per cent, of water. It is colorless, fuming, very caustic and corro- 
sive, of sp. gr. 1.420, strongly acid in reaction, and is obtained by 
the action of Sulphuric Acid on Nitrate of Potassium. Is only used 
externally as a caustic. 

Preparations. 

Acidum NITRICUM DiLUTUM, Diluted Nitric Acid, — has of the above 1 
part in 6 of Distilled Water, and contains 10 per cent, of absolute Nitric Acid. 
Dose, n£iij-xv, well diluted. 

Acidum Nitrohydrochloricum, Nitrohydrochloric Acid, Nitromuriatic 
Acid, Aqua Regia, — a golden-yellow, fuming, corrosive liquid, composed of 
Nitric Acid 4 parts, Hydrochloric Acid 15 parts. Is wholly volatilized by heat, 
readily dissolves gold-leaf, and a drop added to test-solution of Potassium 
Iodide liberates Iodine in abundance. Dose, tr^j-viij, well diluted. 

Acidum Nitrohydrochloricum Dilutum, Diluted Nitrohydrochloric 
Acid, — consists of Nitric Acid 4, Hydrochloric Acid 15, Water 76 parts. Dose, 
ir^v-xx, well diluted. 



ACIDUM OLEICUM. 33 

Physiological Action and Therapeutics. 

The action and uses of these agents are herein described with 
those of the other mineral acids, under the title Acidum Hydro- 
chloricum (see ante, page 28). Some special properties are as 
follows : 

Nitric Acid is an exceedingly powerful escharotic, but, as it 
coagulates and does not redissolve the albumen of the tissues, it 
forms a barrier to its excessive action. The vapor may cause 
oedema of the glottis, intense bronchitis, etc., and death from 
suffocation. It is used for the destruction of chancres, warts, 
hemorrhoids, phagedenic ulcers, etc. ; and internally in dilute 
form for bilious affections, as it is supposed to have a selective 
action on the liver. It also lessens phosphatic deposits in the 
urine, and acts as an astringent in the system, diminishing pro- 
fuse secretion in bronchorrhcea and phthisis. 

Nitrohydrochloric Acid is also supposed to specially affect 
the liver. It is usefully employed in jaundice, dyspepsia, and the 
so-called bilious condition ; also in frontal headache, situated 
just above the eyebrows, when unaccompanied by constipation, 
and in acidity of the stomach. In hepatic disorders it may be 
used in dilute form as baths, or applied to the hepatic region on 
compresses. The official dilute acid is of little use therapeutically, 
as it rapidly deteriorates, and the same may be said of the strong 
acid when standing long enough for the color to change to a 
lemon-yellow. The most efficient preparation is the strong acid 
freshly prepared, when it is of an orange-red color. This should 
be properly diluted when required for use, and should be con- 
stantly protected from light. 

ACIDUM OLEICUM, Oleic Acid, HC 18 H 33 2 ,— is one of 

the constituent acids of oils and fats, obtained commercially as a 
secondary product in the manufacture of stearin candles. It is a 
yellowish oily liquid, semi-solid at 57 F., odorless, tasteless, and 
of neutral reaction, insoluble in water but soluble in alcohol, 
chloroform, benzol, benzin, turpentine, and jfhe feed oils. It 
dissolves most of the metallic oxides ^a^^Jalkaiora^^ forming 
the so-called Oleates, which, however, are not pure chemical com- 
pounds, but merely compounds of the oxides or alkaloids, as the 
case may be, with oleic acid, dissolved in a great excess of the 
latter. Two of these are official, viz. — 

Preparations. 

Oleatum Hydrargyri, Oleate of Mercury — has 10 per cent, of the Yel- 
low Oxide of Mercury, with 90 of Oleic Acid. 

3 



34 ACIDUM PHOSPHORICUM. 

Oleatum Veratrine, Oleate of Veratrine — has 2 per cent, of Veratrine 
in 90 of Oleic Acid. 

Unofficial Preparations. 

Oleates (Oleata) of Aconitine (2 per cent.), Atropine (2 per cent.), 
Morphine (10 per cent.), Morphine and Mercury (2 per cent, morphine 
and 20 per cent, mercuric oxide), Quinine (25 per cent.), Strychnine (2 
per cent.), Arsenic (gr. xx of oleate of arsenic to the 5j), Aluminium, Bis- 
muth, Copper, Iron, Lead, Silver. Zinc, etc., are prepared by the manu- 
facturing pharmacists, and are to be obtained in the shops. Most of them 
answer to the description given above, but several are Oleo-palmitates, or 
double salts of Oleic and Palmitic Acids, being prepared from oils which 
yield the latter acid in considerable quantity. Drs. Shoemaker and Wolff, of 
Philadelphia, have introduced, under the above names, several solid or semi- 
solid preparations, which they claim to be chemically true oleates, salts having 
no excess of either their acid or basic radicals. They are produced by the 
double decomposition of sodium oleate with solutions of neutral salts, the pre- 
cipitates, washed and dried, being the oleates required. These oleates are 
claimed to be more stable than the official oleic solutions, and using less oleic 
acid are much less costly. Many of them may be used as dusting powders, 
or mixed with oil or lard to form ointments. 

Physiological Action a?id Therapeutics. 

Oleic Acid is only used in making the Oleates, which were 
introduced by Marshall, in 1872, as substitutes for ointments, 
being cleaner, more elegant, and more penetrating, but decidedly 
more irritating if applied with friction. Their medicinal prop- 
erties depend upon the bases employed, hence their actions and 
uses will be described under the corresponding basic heads. They 
should usually be diluted with an equal bulk of vaseline or olive 
oil before being rubbed into the skin, or they may produce a 
cutaneous eruption or even pustulation. As a rule they should 
be lightly spread over the surface with the finger or a brush. As 
parasiticides, the Oleates of Copper and Mercury are most efficient, 
and in skin diseases generally these preparations are rapidly com- 
ing into favor. 

ACIDUM PHOSPHORICUM, Phosphoric Acid,— is 

a liquid composed of 50 per cent, of Orthophosphoric Acid, H 3 P0 4 , 
and 50 per cent, of water, and is obtained by oxidizing Phosphorus 
by Nitric Acid. It is strongly acid, odorless, colorless, and of sp. 
gr. I-347- 

Preparations. 

Acidum Phosphortcum Dilutum, Diluted Phosphoric Acid, — has of 
Phosphoric Acid 20 parts in 80 of Distilled Water, sp. gr. 1.057, and contains 
10 per cent, of Orthophosphoric Acid. Dose, tt£v-xxx, in sufficient water. 

Phosphates of Ammonium, Ferrum, and Sodium, and the Syrupus Ferri, 
Quininae et Strychninae Phosphatum, are described under Phosphorus. 



ACIDUM PICRICUM — ACIDUM SULPHURICUM. 35 

Physiological Action and Therapeutics. 

The action and uses of Phosphoric Acid are described with 
those of the other Mineral Acids under Acidum Hydrochloricum 
(see ante, page 28). It may be given in larger doses than the 
other acids without deranging digestion, and is therefore preferred 
in cases requiring acid treatment for a long period, as in diabetes, 
etc. It is considered of especial value in strumous affections, and 
is thought to diminish the growth of osseous tumors, and to dis- 
solve phosphatic deposits. As it contains no free phosphorus, it 
cannot be used to obtain the effects of that drug. 



ACIDUM PICRICUM, Picric Acid, Carbazotic Acid, 
Trinit/ophenol, C 6 H 3 < N0 2 \ 3 I Unofficial), — is obtained by the 
action of Nitric Acid on "Carbolic Acid, or many other sub- 
stances. It has recently been introduced as a test for albumen 
and sugar in the urine. A saturated aqueous solution has been 
used locally in erysipelas with some advantage. Some of its 
salts (Picrates of Ammonium, Iron, etc.) have been tried thera- 
peutically, without any particular results. Powers as an antipe- 
riodic and anthelmintic and against trichinae have been urged for 
it, but experience has not supported these claims. Dose, gr. v- 
xv per diem. 



ACIDUM SULPHURICUM, Sulphuric Acid,— is a 
strongly caustic and corrosive liquid, oily, inodorous, of strong 
acid reaction, composed of not less than 96 per cent, of absolute 
Sulphuric Acid (H 2 S0 4 1 and 4 per cent, of water. It is obtained 
by the combustion of Sulphur and its oxidation by nitrous fumes. 
Its specific gravity should not be below 1.840, and it is miscible 
in all proportions with water and alcohol, with evolution of heat. 
Occasionally used as a caustic. 

Preparations. 

Acidum Suiphuricum Dilutum, Diluted Sulphuric Acid, — has of the 
strong acid 1 part to 9 of distilled water. Dose, rrvv-xv, well diluted. 

Acidum SULPHURICUM Aromaticum, Aromatic Sulphuric Acid, Elixir of 
Vitriol, — is Sulphuric Acid 20 per cent., diluted with Alcohol and flavored 
with Cinnamon and Ginger. It is not an acid, but rather an ether formed by 
reaction between the acid and the alcohol. Dose, "niv-xv, well diluted. 

Physiological Action and Therapeutics. 

The action and uses of Sulphuric Acid generally are described 
with those of the other Mineral Acids under Acidum Hydrochlo- 



$6 ACIDUM SULPHUROSUM. 

ricum (see ante, page 28). Its chief use internally is in lead- 
poisoning, to form the insoluble sulphate, and as a remote astrin- 
gent in diarrhoea, hemorrhoids, hemorrhages, night -sweats, and 
mucous discharges. In choleraic diarrhoea and lead-poisoning it 
is generally administered in combination with Opium. . The 
hemorrhages in which it is efficient are only those from mucous 
surfaces. It is exerted chiefly by the kidneys, part escaping by 
the bowels as sulphates, part also by the skin. Like the other 
mineral acids, it does not increase the acidity of the urine to 
any considerable extent. 



ACIDUM SULPHUROSUM, Sulphurous Acid,— is a 

colorless liquid, of sulphurous taste and very acid reaction, com- 
posed of about 3*^ per cent, of Sulphurous Acid Gas (S0 2 ) and 
96^ per cent, of water. It is prepared by heating Sulphuric 
Acid with charcoal and dissolving the gas produced in distilled 
water. Dose, ""IV-3J, largely diluted with water. 

Preparations. 

Potassii Sulphis, Sulphite of Potassium, K 2 S0 3 .2H 2 0,— white, opaque, 
octahedral crystals, or a crystalline powder, somewhat deliquescent, of bitter, 
saline, and sulphurous taste, and a neutral or feebly alkaline reaction ; soluble 
in 4 of water at 59 F., and in 5 of boiling water ; sparingly soluble in alcohol. 
Dose, gr. iij-x. 

Sodii Sulphis, Sulphite of Sodium, Na 2 S0 3 .7H 2 0, — colorless, transparent, 
monoclinic prisms, efflorescent in dry air, of cooling, saline, and sulphurous 
taste, and neutral or feebly alkaline reaction; soluble in 4 of water at 59 
F., and in 0.9 of boiling water, very slightly soluble in alcohol. Dose, gr. v 
-xx. 

Sodii Bisulphis, Bisulphite of Sodium, NaHS0 3 , — opaque, "prismatic crys- 
tals, or a crystalline or granular powder, slowly oxidized in the air; of faint, 
sulphurous odor, a disagreeable taste, and an acid reaction; soluble in 4 of 
water and in 72 of alcohol at 59 F., in 2 of boiling water, and in 49 of boiling 
alcohol. By strong heat it is converted into sulphur and sulphate of sodium. 
Dosfcx. 

Sodii Hyposulphis, Hyposulphite of Sodium, Na 2 S 2 3> 5H 2 0,— large, col- 
orless, monoclinic prisms or plates, efflorescent in dry air, of cooling and bitter 
taste, and neutral or faintly alkaline reaction; soluble in 1.5 of w T ater at 59 
F., and in 0.5 of boiling water, which partially decomposes it ; insoluble in 
alcohol. Dose, gr. v-xx. 

Magnesii Sulphis, Sulphite of Magnesium, Mg,S0 3 .6H 2 0, — a white, crys- 
talline powder, gradually oxidized in the air, of bitter and sulphurous taste, 
and neutral or slightly alkaline reaction ; soluble in 20 of water at 59 F., and 
in 19 of boiling water; insoluble in alcohol. Dose, gr. v-xxx. 

Antagonists and Incompatibles. 

All oxidizing substances change the Sulphites into Sulphates, and the 
mineral acids decompose them, 



ACIDUM TANNICUM. 37 

Physiological Action. 

Sulphurous Acid has great affinity for oxygen, and is a pow- 
erful disinfectant and deodorizer, and very destructive to all plant 
life. The gas inhaled is irritant to the glottis, and may produce 
dangerous inflammation of the respiratory passages. 

The Sulphites and Hyposulphites are partly decomposed by 
the acid of the stomach, sulphurous acid being given off, and the 
balance being converted into sulphates act as purgatives, and are 
absorbed, undergoing elimination as sulphates by the kidneys and 
bowels. They were formerly supposed to enter the blood and 
tissues as sulphites, and to arrest morbid processes of the zymotic 
character, but both these assumptions have proven erroneous. 

Therapeutics. 

Sulphurous Acid Gas (Sulphurous Anhydride) is extensively 
used as a disinfectant, being the most powerful and convenient 
agent for this purpose. Sulphur is burned on a shovel or plate in 
the room to be fumigated, all outlets having been carefully closed. 
It is injurious to many fabrics. 

Sulphurous Acid is used locally in many throat affections as 
a spray or by a mop. In diphtheria, stomatitis, aphthae, ulcers of 
the tonsils, syphilitic, and tuberculous laryngitis, chronic bron- 
chitis, etc., it may be thus applied with great benefit. Morbid 
fermentation in the stomach wiih growth of penicillium and 
sarcinae is quickly stopped by 5 to 60-minim doses in water, or by 
the sulphites in 20-grain doses. In parasitic skin diseases and 
foul wounds these agents are extremely useful as local applica- 
tions. 

The Sulphites were used in zymotic and septic fevers as 
internal antiseptics on theoretical grounds, but their supposed 
value has not been realized. 



ACIDUM TANNICUM, Tannic Acid, Tannin, C u H 10 O 9 , 

— is a solid body in light-yellowish scales, of strongly astringent 
taste and acid reaction, obtained from powdered galls (see Galla), 
by exposure for three days in a damp atmosphere, then macer- 
ating with ether, pressing, and drying the liquid portion. It is 
soluble in 6 parts of water, in 0.6 of alcohol, and in 6 of glycerin 
at 59 F. Dose, gr. j-xx in water, pill or capsule. 

Preparations. 

Unguentum Acidi Tannici, — is a 10 per cent, ointment made with Ben- 
zoinated Lard. 



38 ACIDUM TANNICUM. 

Trochisci Acidi Tannicl, — each troche contains one grain of Tannic 
Acid. 

Collodium Stypticum, Styptic Collodion, — has of Tannin 20, Alcohol 5, 
Ether 20, Collodion 55 parts. 

Suppositoria Acidi Tannici (Unofficial), — have Tannin 1 part to 5 of 
Cacao Butter. 

Glyceritum Acidi Tannici (Unofficial), — has Tannin 1 part in 4 of 
Glycerin. 

Vegetable Astringents contain some form of tannic acid, as Querci- 
tannic Acid from Oak-bark, Rhatania-tannic Acid in Rhatany, etc. 
(For list, see page 25.) The official acid is Gallo-tannic Acid, being that 
produced from Galls. 

Antagonists and Incompatibles. 

Mineral acids, alkalies, persalts of iron, and salts of antimony, lead and 
silver, are chemically incompatible. Vegetable alkaloids and gelatin form 
insoluble precipitates with Tannic Acid. 

Physiological Action. 

Tannic Acid is a powerful astringent. It precipitates pepsin 
and coagulates albumen, impairs digestion, stops peristalsis, and 
causes constipation. A part of that taken into the stomach 
unites with the pepsin and albumen, while a part is converted 
into Gallic and Pyro-gallic Acids, and in this form is both 
absorbed and excreted. It is a crystalloidal body, but combines 
with colloids, and is a valuable antidote in poisoning by the alka- 
loids and tartar emetic, with which it forms tannates which are 
nearly insoluble. Its continued use disorders digestion, irritates 
the mucous membranes, and produces emaciation. Injected into 
the veins it forms emboli and thus may cause death, but by the 
stomach it is non-toxic. Some authorities hold that Tannic Acid 
is merely Gallic Acid Anhydride ; others believe that the differ- 
ence between them is one of oxidation. Gallic Acid does not 
coagulate albumen or gelatin, while Tannic Acid does. 

Therapeutics. 

Tannic Acid is a more powerful astringent than Gallic Acid, 
and hence is preferred for local use and for astringent effect on 
the intestinal canal. It is well employed in hemorrhoids and 
hemorrhages from the lower bowel, in hematemesis, epistaxis, 
rectal ulcers or fissures, catarrhs and chronic affections of the 
mucous membranes, endocervicitis, conjunctivitis, dysentery and 
diarrhoeas, eczema, impetigo and other forms of skin-disease, 
otorrhoea, bed-sores, prolapsus ani, and many other affections. 

Styptic Collodion is used to stanch the bleeding from an 



ACIDUM TARTARICUM — ACONITUM. 39 

open wound, to unite and protect incised or lacerated wounds, 
and to cover and change the character of foul ulcers. 

ACIDUM TARTARICUM, Tartaric Acid, H 2 C 4 H 4 6 , 

— is a crystalline acid, prepared from Acid Tartrate of Potassium 
(Cream of Tartar), by neutralizing a solution thereof with Chalk 
and Calcium Chloride, then decomposing the Tartrate of Lime 
thus formed by Sulphuric Acid, evaporating and purifying. It 
occurs in colorless, transparent prisms, which are odorless, of acid 
taste and reaction, and soluble in 0.7 of water and in 2^ of 
alcohol at 59 F. Twenty grains exactly neutralize 27 of Potas- 
sium Bicarbonate, 22 of Sodium Bicarbonate, or 15^ of Am- 
monium Carbonate. Dose, gr. x-xxx. 

Preparations. 

Tartaric Acid is an ingredient of the Effervescing Powders (see under Po- 
tassium), and is used in making all the preparations of Aconite. Five Tar- 
trates are official (see Index). 

Physiological Action and Therapeutics. 

The actions and uses of Tartaric Acid are similar to those of 
the other Vegetable Acids, as described under Acidum Aceticum 
{ante, page 19). It is chiefly employed in preparing refrigerant 
drinks. 



ACONITUM, Aconite, — is the tuberous root of Aconitum 
Napellus, a perennial plant of the nat. ord. Ranunculacese, found 
in mountainous regions of Europe, Asia and N. America. The 
plant has deep-blue, helmet-shaped flowers, and leaves which 
have deeply-cut, wedge-shaped segments, exciting slowly when 
chewed a sensation of tingling in the tongue and lips. The root 
is conical and tapering, from 2 to 3 inches long, dark-brown 
externally, whitish internally, having a thick bark enclosing a 
seven-rayed, star-shaped pith, odorless, taste sweetish at first, soon 
becoming acrid. A minute portion, cautiously chewed, causes 
prolonged tingling and numbness. Its active principle is the 
alkaloid Aconitine (see below), which it contains in the propor- 
tion of .03 per cent. It also contains gum, sugar, Aconitic Acid, 
and several other principles, viz. — Aconine, Napelline, Pseudaco- 
nitine, Lyctonine, etc., concerning which there is much diversity 
of opinion. Dose, gr. J^-ij. 

Other aconite-roots are those of A. Cammarum, A.ferox, and 
the Chinese or Japanese Aconite, A. Chinense vet Japonicum. 
From the latter an alkaloid is obtained, named Japaconitine> 



40 ACONITUM. 

which is even more poisonous than aconitine. The Indian variety 
(A.ferox) contains pseudaconitine, but does not yield aconitine. 

Preparations. 

Abstractum Aconiti, — is twice the strength of the powdered drug or its 
fluid extract. Dose, gr. %-). 

Extractum Aconiti, — is at least four times as strong as the extract official 
in the U. S. P. 1870, which was prepared from the leaves, and is yet to be 
found in the shops. Dose, gr. ^-^. 

Extractum Aconiti Fluidum, — each drop represents nearly one grain of 
the powdered drug: an alcoholic preparation. Dose, "EJ^-ij. 

Tinctura Aconiti, — Aconite 40, Tartaric Acid 0.4, Alcohol to 100 parts. 
Is about twenty-eight times as strong as the former tincture of the leaf. Dose, 
ngj^-iv. 

Tinctures of Aconite root vary greatly in strength. In Fleming's Tincture 
79 parts of aconite are used in preparing 100 of the tincture, in that of the 
Br. P. 16, the French 20, the German 10, while the Linimentum Aconiti 
(B. P.) is really a very strong tincture, of the strength of I to 1^. Probably 
the best and safest preparation for ordinary use is a 10 per cent, tincture, of 
which the maximum single dose for an adult is stated in the P. Ger. at trj£ ix, 
and the maximum daily dose at *% xxxv. 

The best rule for the administration of aconite preparations is to give the 
minimum dose at intervals of 15 to 20 minutes, until the desired effect is pro- 
duced. 

Unofficial Preparations. 

Aconitina, Aconitine, C 3 3H 43 N0 12 , — a white, and usually amorphous solid, 
of alkaline reaction, soluble in 150 of cold and in 50 of hot water; much 
more soluble in alcohol and ether. Is difficult to obtain of constant strength, 
some samples being all but inert, others extremely active. As obtained in the 
shops it is usually a mixture of several alkaloids. The Aconitine crystalisee 
of Duquesnel, which, according to Squibb, is a nitrate of aconitine, is consid- 
ered to be the most active of those in the market. Dose, gr. -^fa - ■£$. 

Oleatum Aconitine,— is a 2 per cent, solution in Oleic Acid, for external 
use. Duquesnel's crystals will not dissolve in Oleic Acid (Squibb). 

Napellina, Napelline, — is weaker than Aconitine, and has been used in 
doses of gr. |--f. It has lately been studied by Laborde, who claims for it 
most valuable hypnotic properties, and proposes to use it as a substitute for 
opium and chloral. 

St. Jacob's Oil (a patent medicine), — is a weak Aconite Liniment, which 
also contains Ether, Alcohol, Turpentine, red coloring matter and water 
(Squibb). 

Physiological Action. 

Aconite is a powerful depressant of the heart, the respiration 
and the spinal system. It is also antipyretic, diaphoretic and 
diuretic. It paralyzes both the sensory and motor nerves — the 
sensory being affected first and from the periphery inwards, while 
the motor nerves are affected from the centres outwards. It re- 
laxes the inhibitory apparatus of the heart, and paralyzes the 
cardiac muscle and its contained ganglia, the respiratory centres, 



ACONITUM. 41 

and the spinal cord in all its functions — sensory, reflex and 
motor; but does not affect the cerebrum. 

Its taste is bitter, acrid and pungent. Soon after the ingestion 
of even a small quantity, a sensation of numbness and a persistent 
tingling are felt in the tongue and lips. Full medicinal doses 
cause a sense of constriction in the fauces, irritation of the gas- 
trointestinal mucous membrane with increased secretion ; some- 
times nausea and vomiting, and severe pains in the joints and 
muscles; always more or less salivation, diaphoresis and diuresis; 
reduced respiratory power, cardiac rate and force ; lowered 
arterial tension and temperature. 

A lethal dose produces great muscular weakness, dim sight, 
dilated (sometimes contracted) pupils; shallow, irregular, and 
labored respiration, slow and weak pulse, cold surface, clammy 
sweat, great anxiety, numbness and tingling in the extremities, 
lowered body-temperature (2 to 3 ), abolished sensation, im- 
paired reflexes and motility, and finally death from paralysis of 
the heart and respiration, with or without convulsions, conscious- 
ness being preserved until near the end, when C0 2 narcosis sets in. 

Aconite is rapidly diffused and slowly excreted, the effects of a 
full medicinal dose continuing for three or four hours. Applied 
externally, it paralyzes the sensory nerves of the part, producing 
its characteristic numbness and tingling. 

Antagonists. 

Atropine, Morphine and Ammonia antagonize its effects on the heart 
and respiration. Digitalis counteracts its heart action and the relaxation of 
cardiac inhibition. In Aconite poisoning, the stomach should be evacuated, 
warmth applied to the extremities, stimulants administered, artificial respira- 
tion if necessary, and the recumbent posture strictly maintained. 

Therapeutics. 

Aconite antagonizes the fever process, and rightly used is 
therefore one of the most valuable drugs we possess. It has well 
been called the " therapeutic lancet," and is certainly responsible 
to a great extent for the disuse of venesection. Its power over 
the circulation, respiration and transpiration renders it of the 
greatest value in all affections characterized by high resisting 
pulse, dry hot skin, and elevated body-temperature. It is espe- 
cially useful in acute throat affections, the early stage of acute 
inflammations of the respiratory organs, catarrhal croup, acute 
pleuritis and peritonitis before the stage of effusion, simple and 
eruptive fevers, puerperal and surgical fevers, facial erysipelas, 
acute rheumatism, cardiac affections with overaction or hyper- 
trophy and without valvular lesion, diarrhoea and dysentery from 

4 



42 ADEPS — .ETHER. 

cold or exposure, menstrual suppression from chill, and neuralgia 
of the 5th (externally and internally), it having a selective influ- 
ence on that nerve. It is also highly recommended in otitis, 
nervous palpitations, restlessness, and sick headache, as also in 
the acute stage of gonorrhoea. 

Aconite is best administered in small doses frequently repeated ; 
from half a drop to a drop of the tincture every fifteen minutes 
in a teaspoon ful of water giving as a rule better results than a pro- 
portional quantity at longer intervals. 

Aconitine has been remarkably efficient in trigeminal neuralgia, 
and Napelline in the same affection, and as an hypnotic. 

ADEPS, Lard, — is the prepared internal fat of the abdomen 
of Sus scrofa (Pig), purified by washing, melting and straining. 
A soft, white, unctuous solid, of bland taste and neutral reaction, 
entirely soluble in ether, benzin, and bisulphide of carbon; com- 
posed of 38 per cent, of stearin and margarin, and 62 per cent, 
of olein. Lard forms 70 per cent, of Ceratum, and 80 per cent, 
of Unguentum, and enters into the composition of several of the 
official cerates. 

Preparations. 

Adeps Benzoinatus, Benzoinated Lard, — has 2 per cent, of Benzoin in 
powder incorporated by stirring. 

Oleum Adipis, Lard Oil, — is a fixed oil expressed from lard at a low tem- 
perature. 

Physiological Action. 

The actions of the Oils and Fats will be described under Mor- 
RHUiE Oleum (which see). 

Therapeutics. 

Lard is only used as an ingredient of ointments and cerates. 
Lard Oil is used in making the Unguentum Hydrargyri Nitratis, 
but has been proposed as an inferior substitute for Cod -liver Oil 
in cases where the taste of the latter is particularly offensive. 

AETHER, Ether, Ethyl Oxide (C 2 H 5 \0,— in its absolute 
form is not official, the strongest preparation containing 6 per 
cent, of alcohol and some water. Considered as a generic term, 
an ether is analogous to a salt, as an alcohol is to a metallic hy- 
drate. The particular ether officially so named is Ethyl Oxide, 
prepared from Ethyl Hydrate (Ethylic Alcohol) by a dehydrating 
agent with the aid of heat, and then purified by various processes. 
The agent used is Sulphuric Acid, hence this ether is improperly 



iETHER. 43 

called " Sulphuric Ether/' but the acid simply dehydrates the 
alcohol and remains in the retort, becoming constantly more 
diluted by the abstraction of water from the alcohol. Conse- 
quently H 2 is the difference between Alcohol and Ether. 
(C 2 H 6 0) 2 — H 2 = (C 2 H 5 ) 2 0. The official ethers are the three 
following, viz. — 

^Ether, Ether, — is a liquid composed of about 74 per cent, 
of Ethyl Oxide, and about 26 per cent, of Alcohol containing 
a little water; an inflammable, thin, very diffusive, clear and 
colorless liquid, having a burning, sweetish taste, and a neutral 
reaction, of sp. gr. about 0.750 at 59 F. Its vapor is heavier 
than air and forms therewith a highly explosive mixture. Ether 
is freely soluble in alcohol, chloroform, benzol, oils, and in 8 
volumes of water at 59 F. It boils at the temperature of the 
body (98. 6°), and is a solvent of oils, fats, resins, caoutchouc, 
gutta-percha, and many other substances. It has chiefly a phar- 
maceutical value. 

JEther Fortior, Stronger Ether, — is a liquid composed of 
about 94 per cent, of Ethyl Oxide, and about 6 per cent, of 
Alcohol containing a little water. Sp. gr. not above 0.725 at 
59 F. It is the preparation employed for anaesthetic use, and 
is generally though improperly called " Sulphuric Ether/' a 
term which belongs to Ethyl Sulphate (C 4 H 10 SO 4 ). The dose of 
JEther Fortior for internal administration is ^x-^j, in syrup. 

JEther Aceticus, Acetic Ether, Acetate of Ethyl, C 2 H 5 C 2 H 3 0, 
— is an inflammable liquid, transparent and colorless, of ethereal 
and acetous odor, soluble in alcohol, ether, chloroform, and 17 
of water. Sp. gr. 0.889 t0 0-897. Is a constituent of Sp. Odor- 
atus and Tr. Ferri Acetatis. Dose, tn? x-Jj. 

Hydrobromic Ether, Ethyl Bromide, C 2 H 5 Br (Unofficial), — 
is not inflammable. Dose, internally and hypodermically, it^ x~3J. 

Hydriodic Ether, Ethyl Iodide, C 2 H 5 I (Unofficial), — is a 
colorless liquid, non-inflammable, and insoluble in water. Dose, 
inhaled, rrg xv. 

[For the chlorinated Ethers see under Chloroform.] 

Preparations. 

Oleum ^Ethereum, Ethereal Oil, — is a volatile liquid, consisting of equal 
volumes of heavy Oil of Wine and Stronger Ether. Used to prepare the Spt. 
^Etheris Comp., and as it occurs in commerce is usually a worthless preparation. 

Spiritus ^Etheris, Spirit of Ether, — has of Stronger Ether 30 parts, Alco- 
hol 70. Dose, n^x-^j. 

Spiritus ^Etheris Compositus, Hoffman's Anodyne, — contains Stronger 
Ether 30, Alcohol 67, Ethereal Oil 3 parts. Dose, ^v-^j. 

Spiritus ^Etheris Nitrosi, Spirit of Nitrous Ether, Sweet Spirit of Nitre, 
— is an alcoholic solution of Ethyl Nitrite, C 2 H 5 N0 2 , containing 5 per cent, of 



44 iETHER. 

the crude ether. It turns acid with age, and should not be kept long. It is a 
constituent of Mist. Glycyrrhizae Co. (3 per cent.). Dose, ^ss-^ss. Its in- 
compatibles are Potassic Iodide, Ferric Sulphate, Tr. Guaiaci, Tannic and 
Gallic Acids. 

Anesthetic Mixtures. 

Nussbaum's has — Ether 3 parts, Chloroform 1, Alcohol I. 
Vienna General Hospital uses — Ether 9, Chloroform 30, Alcohol 9. 
The "Vienna Mixture," — Ether 3, Chloroform 1. 
Committee of Medico-Chirurgical Society of London (1864) pro- 
posed — Ether 3, Chloroform 2, Alcohol I. 

Physiological Action of Ether. 

Ether is anodyne, antispasmodic, diaphoretic and anthel- 
mintic ; a cardiac and cerebral stimulant, an anaesthetic, and a 
narcotic poison. Given internally, it stimulates the secretions 
of the stomach, salivary glands and pancreas. On the cerebrum 
and the motor and sensory nerves its action is similar to that of 
alcohol, but more prompt and less protracted. It is eliminated 
rapidly, chiefly by the lungs. Externally it is a powerful refrigerant 
and local anaesthetic; also rubefacient when rubbed into the skin. 

Inhaled Ether produces at first faucial irritation, a sense of 
strangulation and cough; then a stage of excitement (cerebral 
intoxication), in which the face is flushed and the respiration and 
pulse are accelerated. A tetanic convulsive s' jge generally fol- 
lows, the face being cyanosed, the muscles rigid, and the respira- 
tion stertorous. This soon subsides, and complete insensibility is 
established, the muscles being then relaxed, the reflexes abolished, 
and the cerebral functions suspended, the lower centres in the 
medulla carrying on the processes of respiration and circula- 
tion. If the inhalation be continued, these also become paralyzed, 
death usually resulting from slow paralysis of respiration, the heart 
pulsating long after breathing has ceased. [Chloroform usually 
paralyzes the heart.] If the inhalation be discontinued before 
the lower centres are affected, the patient gradually emerges from 
the condition of insensib'lity, and, as the narcosis subsides, 
vomiting is usually experienced. 

Compared with Chloroform. 

Ether is less irritant than Chloroform to the mucous membranes 
when swallowed, but its vapor is more irritant to the air-passages. 
It is more of a general stimulant, and less depressant to the heart 
and circulation. It does not clot the blood. Its vapor is very 
inflammable, less pleasant to inhale, slower in action, has a longer 
stage of excitement, and a less profound narcosis, and causes a 
greater degree of vomiting. It is much less dangerous than 



iETHER. 45 

Chloroform, death from the inhalation of Ether occurring slowly 
and usually by paralysis of respiration — from Chloroform it is 
almost always sudden, and by paralysis of the heart. Ether has 
undoubtedly caused a number of deaths, besides several which 
occurred some hours after the anaesthesia. The reported cases of 
fatal Chloroform narcosis number about 500, those from Ether 
about 20. 

Modes of Dying from Ancesthetics. 

(1.) From sudden paralysis of the cardiac ganglia, early in the inhalation, by 
reflex action proceeding from some peripheral injury before complete anaesthe- 
sia is produced. Thus, in the extraction of teeth, a small quantity of Chloroform 
having been administered, the heart is enfeebled, and the cerebral hemispheres 
paralyzed, but not the basal or medullary ganglia. If at this stage the 5th 
nerve be irritated, by the intimate relation of its nucleus with that of the 
pneumogastric reflex inhibition may be transmitted over the latter, arresting 
the cardiac ganglia. The stage of incomplete anaesthesia is always a dangerous 
one in which to perform any operation. 

(2.) In the stage of rigidity, from tetanic fixation of the respiratory muscles, 
the blood backing up on the venous side, and the arresting of the heart's 
action, respiration ceasing before the cardiac action is stopped. 

(3.) In the stage of complete relaxation, by paralysis of respiration; or by 
paralysis of the tongue, causing obstructed respiration. 

(4.) In the same stage, by paralysis of the motor ganglia of the heart. 

(5.) From depression of the functions by chloroform narcosis, and from 
shock, — and may occur in the anaesthetic state, or afterward. 

Contraindications for Anesthesia are — fatty degeneration 
or dilatation of the heart, renal and pulmonary disease, enlarged 
tonsils, cerebral tumor, and chronic alcoholism — particularly the 
first and last named. 

Dangerous Symptoms should be met by withdrawing the vapor 
and inverting the patient head downwards, drawing the tongue 
forwards, and applying a cold douche to the face and chest. 
Atropine hypodermically is an agent of great value in combat- 
ing the cardiac failure, — artificial respiration and faradization of 
the respiratory muscles if breathing ceases. Amy I Nitrite by 
inhalation, or Ammonia hypodermically. Heat to the body 
and limbs. 

Notes on Other Ancesthetics. 

A comparison of these agents in respect to their safety has been lately made 
by Dr. Richardson, who considers Methylic Ether to be the safest of all, and 
the others as follows : 

Safe are — Ethyl Bromide, Ethyl Chloride, Ether, Ethene folefiant gas), 
Ethene Chloride, Methyl Bromide, Methyl Chloride, Methyl Ether, Methene 
Chloride, Methane (marsh gas), Nitrous Oxide. 

Of doubtful value are — Amylene, Amyl Chloride, Butyl Chloride, Ben- 
zene (benzol), Carbon Disulphide, Carbon Dioxide, Carbon Tetrachloride, 
Methyl Alcohol, Methylal, Spirits of Turpentine. 



46 iETHER. 

Dangerous are— Amyl Hydride, Butyl Hydride, Carbon Monoxide, Ethyl 
Hydride. Chloroform and Ethene Dichloride are considered useful, but 
requiring care. 

Physiological Action of Other Ethers, 

Hydriodic Ether is an antispasmodic and a general stimu- 
lant ; also an anaesthetic if inhaled for a sufficiently long time. Its 
use as a medicinal agent is chiefly to bring the system rapidly 
under the influence of iodine. It increases appetite, stimulates 
the action of the heart, gives vivacity to the general feelings and 
activity to the intellect. 

Hydrobromic Ether has a not unpleasant odor, produces but 
little irritation of the air-passages, has very brief stages of excite- 
ment and rigidity, and but a short stage of insensibility, with 
prompt awakening and but little of the mental confusion and 
excitement consequent on the use of the other anaesthetics. It is 
not inflammable, acts quickly, and is a good local anaesthetic. 
Its actions in other respects correspond with those of Ether. 

Nitrous Ether is a mild diaphoretic, a diffusible stimulant, 
a carminative, and an efficient diuretic. On the blood it acts simi- 
larly to Amyl Nitrite, diminishing oxygenation, relaxing the peri- 
pheral vessels, accelerating the heart's action, and thus lowering 
arterial tension. Relaxing the renal and cutaneous vessels, it is 
diuretic and diaphoretic. 

Acetic Ether has a pleasant odor and taste, forming agree- 
able combinations with other carminatives as a stimulant and 
antispasmodic. 

Therapeutics. 

When diluted with alcohol Ether mixes readily with water, and 
may be administered internally with advantage in indigestion of 
fats, and to aid the digestion of Cod-liver Oil. It is also 
given in hysteria to relieve the paroxysm and flatulence, and 
in hepatic colic from calculi, Ether with Turpentine (Durande's 
solvent remedy), which acts only as an anodyne and antispas- 
modic, is considered by some as of great value. 

Subcutaneously Ether is used in the algid stage of cholera, 
sudden cardiac depression, neuralgia, and in the adynamia of 
hemmorrhage, pneumonia and the eruptive fevers. 

Local anaesthesia by the Ether-spray affords great relief in 
neuralgia of superficial nerves, lumbago, chorea, and spinal irrita- 
tion. In minor surgical operations it is a valuable method. 

As an Anaesthetic the vapor of Ether is less prompt than that 
of Chloroform, but is equally efficient and much safer. It should 



AGARICUS ALBUS. 47 

be inhaled in as concentrated a form as possible, and will then 
produce insensibility in from 5 to 10 minutes. If a light be in the 
room it should be high above the patient. A grate-fire or gas- 
stove in the vicinity is very dangerous. [Compare Chloroform.] 
Besides its surgical uses ether-anaesthesia is employed in neuralgia, 
cancer, tetanus, chorea, colic, delirium, puerperal mania and con- 
vulsions, infantile convulsions, hystero-epilepsy, epileptic seizures, 
laryngismus stridulus, whooping-cough, and asthma. The un- 
pleasant after-effects may be greatly modified if not entirely pre- 
vented by the previous administration of Morphine (gr. xs) and 
Atropine (gr. T ^) subcutaneously. 

Hydrobromic Ether had a short period of popularity as an 
anaesthetic, but fell into disrepute after a few cases of death under its 
influence, which were probably not due to the agent used (Levis 7 
and Sims 7 cases). Its action is less prolonged than that of 
Ether, but it has many advantages, requiring only 3j to %\] rap- 
idly given, and being uninflammable. Its inhalation has been of 
especial value in hysteria, epilepsy, chorea and other spasmodic 
disorders. 

The Compound Spirit of Ether (Hoffman's Anodyne) is an 
admirable agent in gastralgia, colic, flatulence, syncope, etc., also 
in the various manifestations of the hysterical paroxysm. In 
combination with the camphorated tincture of Opium it is often 
remarkably efficient in checking the diarrhoea of hot weather. 

Spirit of Nitrous Ether is used as a diaphoretic, a diuretic 
and a carminative ; also in expectorant mixtures, as an antipyretic 
in febrile affections, and to relieve pain in angina pectoris, dys- 
menorrhcea and asthma. 

Hydrobromic Ether has been employed subcutaneously in 
place of Ether in the treatment of such spasmodic affections as 
whooping-cough, chorea, etc. Its place as an anaesthetic is not 
determined, having caused two deaths at the very outset of its 
career. 

Hydriodic Ether may be obtained in glass capsules con- 
taining five minims each, and is used by inhalation in chronic 
pulmonary disorders, cardiac dyspnoea, spasmodic affections of 
the bronchi and larynx, asthma, and in catarrhal laryngitis with 
dyspnoea. It is not employed as an anaesthetic. 



AGARICUS ALBUS, Purging Agaric (Unofficial),— is 
a fungus, occurring in large white spongy pieces, obtained from 
the European larch. It contains Agaricin, a crystalline sub- 
stance, and Agaric Acid ; also from 40 to 70 per cent, of resins. 



48 AGARICUS CHIRURGORUM AGARICUS MUSCARIUS. 

Physiological Action. 
The taste of Purging Agaric is first sweetish, then becoming very 
acrid and bitter. The powder inhaled causes violent sneezing, 
and taken internally in full doses it produces watery stools. 
Small doses check diarrhoea and dysentery, and diminish the 
secretions of the bronchi and mammae. 

Therapeutics. 

Agaricus Albus was formerly employed as a drastic purgative, 
in doses of gr. xxx to 3J- It has lately been used, with much 
success, in 15-grain doses of the powder, or 3 grains of the alco- 
holic extract, to check the night-sweats of phthisis. 



AGARICUS CHIRURGORUM, Surgeon's Agaric 

(Unofficial), — is the interior portion of the fungus Polyporus 
fomentarius, which grows on the trunks of beeches, birches, and 
oaks in Europe. It is prepared for use by boiling in weak lye and 
beating with mallets, and then occurs in light, thin, yellowish- 
brown pieces, soft and pliable, without odor or taste. It is 
almost pure cellulose. It was formerly used as a mechanical 
hemostatic, and for the purpose of moxa. When soaked in a 
strong solution of Potassium Nitrate or Potassium Chlorate and 
dried, it is very inflammable, and is then called Spunk. 



AGARICUS MUSCARIUS, Amanita Muscaria, Fly- 
Agaric (Unofficial), — is a poisonous mushroom, of a disagree- 
able odor and a burning, acrid taste, used in infusion with milk 
for poisoning flies, and used by the Tartars as an intoxicant. It 
contains an actively toxic alkaloid, Muscarine, C 5 H 13 N0 2 , of 
syrupy consistence, odorless and tasteless, soluble in water and 
alcohol, and readily dissolved out by water and dilute acetic acid, 
so that a doubtful mushroom may be easily rendered innocuous. 
It may also be produced synthetically, but it is doubtful whether 
the article so prepared is as active as the natural product. 

Preparations. 

Muscarina, Muscarine (Unofficial), — Dose, gr. f-gr. ij. It may be used 
hypodermically in watery solution. 

Muscarine Nitras, Nitrate of Muscarine (Unofficial), — may be used hypo- 
dermically in doses of from gr. ^ to gr. |. 

Physiological Actio?i. 
Muscarine is a powerful respiratory and cardiac depressant, 
paralyzing the respiratory centre and arresting the heart in dias- 



AILANTHUS. 49 

tole by paralyzing its motor ganglia while stimulating its inhibi- 
tory apparatus. It lowers the arterial tension, produces profound 
salivation, lachrymation and sweating, contracts the pulmonary 
vessels, causing intense dyspnoea, and increases the intestinal, 
hepatic and pancreatic secretions, but markedly diminishes the 
renal. It disturbs the gastro-intestinal tract, causing tetanic 
intestinal contractions, severe colic, vomiting and purging. It 
produces spasm of the accommodation, marked myosis and con- 
traction of the pupil when given internally, but dilates the pupil 
widely when locally applied. [Gelsemium does so also.] Under its 
action the body temperature is decidedly reduced, and the excre- 
tion of waste-products is lessened. It is eliminated unchanged 
by the kidneys. 

Agaricus acts as an intoxicant to the cerebrum, producing more 
vertigo and delirium than Alcohol, followed by profound sopor 
with lowered reflexes, perhaps coma and death. 

Antagonists. 
Atropine exactly opposes Muscarine, and vice versa ; no example of physio- 
logical antagonism being so complete in all particulars. When a frog's heart 
is arretted by the topical action of a minute quantity of Muscarine, the appli- 
cation of a little Atropine will immediately paralyze the inhibition and restore 
the pulsations. An equally prompt antagonism runs through their entire 
spheres of action. Digitalme is to some extent antagonistic ; so also is 
Eserine. 

Therapeutics. 

Muscarine has been as yet little used in medicine, but it will 
probably prove to be a valuable drug. It has been long used, 
with marked benefit, in the night-sweats of phthisis. A tincture 
of Agaricus has been found beneficial in ataxic typhus, chorea, 
and chilblains. Muscarine promises to be of great value in inflam- 
mations characterized by copious exudation, especially eye-in- 
flammations, catarrhal jaundice, recent hemorrhoids, acute bron- 
chitis, pulmonary hemorrhage, incipient pulmonary congestion, 
diabetes of both forms, and in constipation due to intestinal 
torpor and deficient secretion, accompanied by a torpid liver 
and difficult digestion of fats. In the latter affection it should 
be given in small doses, gr. gV, thrice daily. 



AILANTHUS, Tree of Heaven (Unofficial),— is the bark 
of Ailanthus glandulosa, a well-known shade tree, of the nat. ord. 
Simarubacese, indigenous to China, but cultivated elsewhere. It 
contains an oleo-resin and a volatile oil, on which its properties 
probably depend. Dose, gr. x— 3j- 



50 ALCOHOL, 



Pi'eparations. 



Extractum Ailanthus Fluidum (Unofficial), — Dose, ttgx-^j. 
Tinctura Ailanthus (Unofficial), — Dose, tr^x-^ij. 

Physiological Action. 

Ailanthus is a decided nauseant, and a drastic purgative, caus- 
ing also vertigo, weakness, cold sweats, dull headache, pains in 
the back, numbness and tingling in the limbs. It paralyzes the 
cerebrum and spinal cord of animals, impairment of motility 
beginning in their hind extremities. The cardiac action, at first 
increased, soon slows, the pulse becoming small and weak, and 
the respiration depressed, death occurring from paralysis of res- 
piration. It is a good taeniafuge. 

Therapeutics. 

Ailanthus is used against tapeworm, a decoction of the fresh 
bark (3j ad 3i y )> or tne oleo-resin in drachm doses, being very 
efficient. It has also been well employed in malignant scarlatina, 
with dark and partial eruption, insensibility, delirium, and other 
cerebral symptoms. 



ALCOHOL, — is a liquid composed of 91 per cent, by weight 
(94 per cent, by volume) of Ethyl Ale oho I > C 2 H 5 HO, and 9 per 
cent, by weight (6 per cent, by volume) of water. Sp. gr. 0.820 
at 6o° F., and 0.812 at 7 7 F. An inflammable, transparent, 
colorless, mobile and volatile liquid, of agreeable odor and burn- 
ing taste. Obtained by the distillation of fermented saccharine 
fluids. Used in making all the Tinctures and Spirits ; also in 
some of the Liniments, Liquors and Mixtures. 

Prepa?'atio7is. 

Alcohol Dilutum, Diluted Alcohol, — consists of Alcohol and Distilled 
Water, equal parts of each. Sp. gr. 0.928 at 6o° F. 

Spiritus Frumenti, Whiskey, — obtained from the distillation of fermented 
grain, rye or corn (U. S.), barley (Scotch), and at least two years old. Sp. gr. 
0.917 to 0.930. Has an alcoholic strength of 44 to 50 per cent, by weight; 
also Ethers developed by the action of acetic and butyric acids on the alcohol, 
and traces of Amy lie Alcohol (fusil-oil) even in the best. 

Spiritus Vini Gallici, Brandy, — obtained from the distillation of fer- 
mented grapes, and at least four years old. Sp. gr. 0.925 to 0.941. Has an 
alcoholic strength of 39 to 47 per cent, by weight, and CEnanthic and other 
Ethers developed by age. Pale Brandy is colored by the cask, the dark has 
caramel to color it. Is often prepared artificially by adding to high wines 
Acetic or Nitric Ether, Caramel, and Logwood or Catechu for astringency. 

Spiritus Odoratus, Perfumed Spirit, Cologne-water, — prepared by adding 



ALCOHOL. 5 1 

to 800 parts of Alcohol, Water 158, Acetic Ether 2, Oil of Bergamot 16, Oil of 
Lemon 8, Oil of Rosemary 8, Oil of Lavender Flowers 4, and Oil of Orange 
Flowers 4 parts. A perfume or ingredient of lotions. 

Vinum Album, White Wine, — should contain from 10 to 12 per cent, by 
weight of absolute alcohol, and is made by fermenting the unmodified juice of 
the grape, freed from seeds, stems and skins. 

VoiUM Album Fortius, Stronger White Wine, — should contain 20 to 25 
per cent, by weight of absolute alcohol, and is made by adding 1 part of 
Alcohol to 7 of Vinum Album. Is simply a formal recognition of the fact 
that the stronger sherries are artificially made. L'sed to prepare the official 
Vina (Wines). 

Vinum Rubrum, Red Wine, — should contain from 10 to 12 per cent, by 
weight of absolute alcohol, and is made by fermenting the juice of colored 
grapes in presence of their skins. 

Vinum Aromaticum, Aromatic Wine,— consists of Stronger White Wine 
' 94 per cent., with Lavender, Origanum, Peppermint, Rosemary, Sage and 
Wormwood, of each 1 per cent. 

Unofficial Alcoholic Preparat. 

Rectified Spirit, sp. gr. 0.835, — nas 85 P er cent - by weight of absolute 
alcohol, and no fusil oil. Is often spoken of as " 56 over proof," meaning 
that to reduce 100 volumes of it to the strength of proof spirit, requires 56 vol- 
umes of water. 

Proof Spifit, sp. gr. 0.920, — contains 49 per cent, by weight of absolute 
alcohol, with a peculiar oil and other foreign matters. 

Rum, — is obtained from the distillation of fermented molasses, and has about 
42 per cent, by weight of alcohol. 

Gin, — has about the same alcoholic strength as rum, and approaches very 
nearly to the official Spiritus Junipen Compositus. It is usually distilled from 
rye or barley, and flavored, in Holland, with juniper berries and hops, in 
England, often with oil of turpentine, various cheap aromatics, acetate of lead, 
sulphate of zinc, cayenne pepper, etc. Pure gin is slightly diuretic, from the 
oil of juniper contained in it. 

Vinum Portense, Port Wine, — is not a natural wine, spirit being added 
during the process of manufacture, and the alcoholic strength raised to 30 or 
40 per cent. 

Vinum Xericum. Sherry Wine, — a dry, spirituous white wine, generally 
made to order by the dealers, and having from 20 to 35 per cent, of alcohol. 

Sparkling Wines, as Champagne, Hock, Catawba, —are more or less 
sweet, and charged with carbonic acid, being bottled before fermentation is 
completed and the grape-sugar all converted into alcohol. They contain 8 to 
10 per cent, of absolute alcohol. 

Sweet Wines, as Burgundy, Tokay, Muscatel, Malaga, Angelica, Madeira, 
etc., — are of low alcoholic strength, 6 to 7 per cent., unless fortified. 

Light Red Wines, as Claret, Red Rhine, Concord, — have 5 to 7 per cent, 
alcohol,- tannic acid, grape coloring matter, etc. 

Dry Acid Wines, as Rhine and Moselle wines, California Hock, Ohio, 
and Kelley-Island Catawba, — in these fermentation is complete, and the alco- 
holic strength from 5 to 7 per cent. 

Beer, Ale, and Porter, — are fermented liquors, made from malted grain, 
with hops and other bitters added. Beer is made by slow fermentation, the 
yeast sinking; Ale by rapid fermentation, the yeast floating. Their alcoholic 
strength is from 2 to 3 per cent, in beer, to 4 to 6 per cent, in ale and porter, 



52 ALCOHOL. 

— and they also contain malt extract, carbonic acid, lactic acid, various aro- 
matics, potassium and sodium salts, etc. 

Koumiss, — is obtained by the fermentation of milk, that of the mare being 
used in Tartary, where it is largely employed as a food. It contains from I 
to 3 per cent, of alcohol, sugar, lactic acid, casein, fat, salts, carbonic acid 
and ethers. 

Principal Alcohols. 

Ethylic Alcohol, Ethyl Hydrate, C 2 H e O, — Grain-spirit. 

Methylic Alcohol, Methyl Hydrate", CH 4 0, — Wood-spirit. 

Amylic Alcohol, Amyl Hydrate, C 5 H 12 0, — Potato-spirit, 
Fusil Oil. Occurs also in the excessive distillation of fermented 
grain, after the ethylic alcohol has distilled over. 

Phenylic Alcohol, Phenol, Carbolic Acid, C 6 H 6 0, — from 
coal-tar (see page 21). 

Composition, etc., of Alcohols. 

An Alcohol is a volatile organic compound, which contains no N, has a 
great affinity for water, and reacts with acids, forming H 2 and ethers. Alco- 
hols are therefore analogous to the metallic hydrates, and Ethers to salts. 
They are obtained by distillation from the fermented product of grape-sugar, 
or some substance (as starch) easily converted into grape-sugar, which, in the 
presence of certain low vegetable organisms (as the yeast-plant), splits up into 
Alcohol and C0 2 ; and may be made synthetically by snaking Olefiant gas 
(C 2 H 4 ) with strong Sulphuric Acid, then diluting and distilling. C 2 H 4 4~ H 2 
= C 2 H 6 0, Ethylic Alcohol. Absolute Ethylic Alcohol, which is only used 
for chemical testing, is made by shaking Rectified Spirit with Potassium Car- 
bonate, decanting, and distilling with slaked lime. 

Alcohol very slowly oxidized forms Aldehyde (C 2 H 4 0\ if less slowly, 
Acetic acid (C 2 H 4 2 ), if quickly as in burning, C0 2 and H 2 0, which are in 
all cases the ultimate products of its continued oxidation. 

Physiological Action. 

Alcohol is a cerebral excitant and depressant and a narcotic 
poison. It is anaesthetic, antiseptic, and antiparasitic, a mild 
counter-irritant, and it coagulates albumen by abstracting its 
water. It is very diffusible, and is partly oxidized by the organism, 
part being excreted unchanged. 

In small doses, Alcohol relaxes the vessels, stimulates the gastric 
glands, promotes appetite and digestion, lessens the elimination 
of waste-products (urea and C0 2 ), causes a subjective sensation 
of heat, and slightly raises the body temperature. It briefly 
stimulates the heart, prolonging its systole and reducing the 
length of the diastole, and increases the functional activity of all 
the organs. A portion is oxidized by the organism (about §jss in ■ 
twenty- four hours), yielding force which is utilized as nervous, 
muscular and glandular power. 

The continued use of small or moderate doses congests the 



ALCOHOL. 53 

stomach and liver, over-stimulating the gastric glands and the 
hepatic cells to the production of pathological secretions, causing 
gastric catarrh and morning-vomiting of mucus, and impairing 
digestion. By irritation it sets up hyperplasia of the submucous 
connective tissue (sclerosis), especially in the stomach, brain, 
kidneys and liver (cirrhosis) ; produces fatty degeneration (stea- 
tosis) of the blood, the arterial walls, and the various organs, and 
depresses the heart and the arterial tension. Epilepsy, paraplegia, 
amaurosis and insanity may result from the long-continued use of 
spirits, alcohol having an especial affinity for the nervous system. 
The malt liquors (beer, ale, etc.) are less prone than the spirituous 
to affect the brain, but are even more apt to set up fatty degen- 
eration of the liver and heart. 

In large doses Alcohol precipitates pepsin and destroys its 
activity as a ferment, arrests digestion, produces exhilaration, in- 
toxication, hallucinations, delirium, muscular incoordination, 
depression of the heart, lowered arterial tension and body tem- 
perature, abolished reflexes and coma. 

A toxic dose, after a very brief period of excitement, produces 
insensibility, stertorous breathing, dilated or contracted pupils, 
complete muscular resolution, and death by paralysis of the 
heart and respiration. 

Acute Alcoholism may be confounded with apoplexy, opium 
narcosis, concussion of the brain, and even acute pneumonia, — 
the differential diagnosis being impossible to make in the stage 
of deep coma. The pupils are not a trustworthy indication, as 
in alcoholism they may be either dilated or contracted. 

Alcohol is a food within narrow limits, §jss per diem being the 
probable quantity which the adult organism can oxidize, more 
than this being probably poisonous, as it sets up structural 
changes in the various organs, and lowers the power of resistance 
to morbific influences. It has frequently caused an intractable 
form of phthisis. The very young and the very old stand more 
alcohol relatively than the adult. It has been proven to exist 
normally in the human organism. 

Treatment of Acute Alcoholism. 

The stomach should be evacuated, Ammonia by inhalation cautiously, 
warmth applied to the extremities, cold affusion to the head, faradism of the 
muscles of respiration. Milk, mucilaginous drinks, black coffee are useful 
afterwards. Lupuline as a substitute stimulant, Chloral (cautiously) to secure 
sleep, but is dangerous in old topers. Capsicum is excellent for the same 
purpose in 20- to 30-grain doses. Nutritious, digestible diet in fluid form 
and small quantity frequently repeated. 



54 ALLIUM. 

Therapeutics. 

Though Alcohol is decidedly injurious in health, in disease it 
is a most useful agent. It is invaluable in diphtheria, poisoning 
by cardiac depressants and snake-venom, adynamic fevers and 
cardiac failure from any cause. It is an excellent dressing to 
wounds and bed-sores, may prevent colds from exposure by relax- 
ing the peripheral vessels and restoring the balance of the circu- 
lation, and in phthisis it does good if it promotes digestion and 
assimilation. In atonic indigestion of nervous and depressed 
subjects, cholera infantum, diarrhoea, etc., brandy is universally 
found to be beneficial. In the vomiting of yellow fever or of 
sea-sickness iced champagne is very efficient. In anaemia and 
chlorosis good red wines are almost indispensable, as also in 
convalescence from acute diseases, sudden and profuse hemor- 
rhage, and in many other morbid conditions. 

Koumiss is an excellent food and stimulant in feeble digestion, 
phthisis, chronic bronchitis, and in all adynamic states in which 
the effects of alcohol and nutrients are indicated. The stomach 
is very tolerant of koumiss even when it will bear nothing else, 
and as it increases the body nutrition remarkably it is of great 
value in the treatment of all the cachexias. Each quart is esti- 
mated to contain 4 ounces of solid food, besides 1 to 3 per cent, 
of alcohol. 



ALLIUM, Garlic, — is the bulb of Allium sativum, a plant 
of the nat. ord. Liliaceae, indigenous to Asia, but cultivated in 
Europe and America. It is sub-globular and compound, consist- 
ing of eight bulblets, covered by dry, membranous scales. Its 
odor is pungent and disagreeable and its taste is warm and acrid. 
It contains a Volatile Oil, which consists mainly of the Sulphide 
of Allyl (C 3 H 5 \S, on which its qualities depend. Allied species 
are Allium Cepa, the Onion, and Allium Porrum, the Leek. 

Preparation. 

Syrupus Allii, — contains 15 per cent, of Garlic, Sugar 60, Dilute Acetic 
Acid 40 parts. Dose, 3J-iv, according to age. 

Physiological Action and Therapeutics. 

Garlic, Leeks and Onions are stimulant to the digestion and 
to the nervous system, and are supposed to have a special influ- 
ence upon the bronchial secretion. Garlic is also thought to be 
emmenagogue and anthelmintic. It promotes diaphoresis and 



ALNUS — ALOE. 5 5 

diuresis, and acts as a tonic and carminative. Many persons use 
it as a condiment. Large doses will often produce gastric irrita- 
tion, flatulence, hemorrhoids, headache and fever. In domestic 
practice it is frequently employed as an external application in 
the cutaneous eruptions of children, and as a poultice or liniment 
in infantile disorders of many kinds. Internally it is of real 
benefit in feeble digestion and flatulence, chronic catarrhal affec- 
tions of children, in nervous and spasmodic coughs and in ner- 
vous vomiting. 



ALNUS, Alder-Bark (Unofficial), — is the bark of Alnus ser- 
rulata. the common American Alder, a small tree of the nat. ord. 
Betulacese. It has similar properties to those of A. glutinosa, the 
European Alder, and A. urcana, the Tag Alder, and contains a 
tannic acid, an oil and a resin. The bark and leaves are astrin- 
gent and bitter, and are chiefly used as gargles for the throat, as 
local applications to wounds and ulcers, and to restrain the secre- 
tion of milk. Dose of the powdered bark gr. x, in decoction or 
infusion, several times a day. The Tag Alder is highly recom- 
mended as a hemostatic. 



ALOE, Aloes, — is the inspissated juice of the leaves of Aloe 
socotrina, a plant of the nat. ord. Liliacese, inhabiting the island 
of Socotra and the eastern coast of Africa near the southern shore 
of the Red Sea. It has orange-colored flowers and resembles in 
appearance the American aloe or century-plant (Agave ameri- 
cand). It occurs in soft masses, hard exteriorly, of a yellowish- 
brown color, fragrant odor and bitter taste, soluble in alcohol 
and in boiling water, and containing a peculiar volatile oil, a 
resin and Soaloin, C 15 H 16 7 . a variety of the principle A loin, 
which is common to all varieties of aloes, — also Aloetic and 
Chrysammic Acids. Dose, gr.j-v. 

Other varieties are Aloe Barbadensis, Barbadoes Aloes, from 
Aloe vulgaris; and Aloe Capensis, Cape Aloes, from Aloe ferox, 
the first of which is official in the Br. Phar. 

Preparations. 

Aloe Purificata, Purified Aloes, — prepared by heating with alcohol, 
straining and evaporating. Is almost entirely soluble in alcohol. Dose, gr. j-v. 

Extractum Aloes Aquosum, — prepared by mixing 1 with 10 parts of 
Boiling Distilled Water, standing 12 hours, decanting, straining and evapo- 
rating. Dose, gr. ss-v. 



56 ALOE. 

Tinctura Aloes, — has of Aloes 10, extract of Glycyrrhiza 10, Diluted 
Alcohol to ioo parts. Dose, ^ss-ij. 

Tinctura Aloes et Myrrhs, — Aloes 10, Myrrh 10, Alcohol to ioo parts. 
Dose, £ss-ij. 

Vinum Aloes, — has of Aloes 6, Cardamom i, Ginger I, Stronger White 
Wine to ioo parts. Dose, ^j-iv. 

Pilule Aloes, — each has of Aloes gr. ij with the same quantity of Soap. 

Pilul^e Aloes et Asafetid^, — each contains gr. ij^ of each ingre- 
dient. 

Pilul^e Aloes et Ferri, — each pill contains gr. j each of Aloes, Sulphate 
of Iron and Aromatic Powder, with Confection of Rose. 

Pilule Aloes et Mastiches, Lady Webster's Pill, — each has of Aloes 
gr. ij, Mastic gr. ss, Red Rose gr. ss. 

Pilule Aloes et Myrrhs, — each contains of Aloes gr. ij, Myrrh gr. j, 
Aromatic Powder gr. ss, mixed with Syrup. 

Pulvis Aloes et Canell^: (Unofficial),— contains the powdered bark of 
Canella alba. Dose, gr. v-xx. 

Aloes is also a constituent of Pilulae Rhei Compositae and Tinctura Ben- 
zoini Composita — (which see.) 

Physiological Action. 

Aloes is a tonic-astringent and resin-bearing purgative, an em- 
menagogue and an anthelmintic against the thread-worm. As a 
cathartic it acts chiefly on the lower half of the large intestine, in 
doses of gr. j-iv producing in about 10 hours copious soft evacu- 
ations with some griping pain. This effect is produced whether 
the drug be taken internally or absorbed from an exposed surface, 
so that it probably diffuses into the blood and is eliminated by 
the mucous membrane of the colon. It is a stomachic tonic in 
small doses, a stimulant of the hepatic functions, and an excitant 
of the pelvic circulation. It may cause abortion in the female 
and priapism in the male, and is said to have frequently produced 
hemorrhoids, which if existing it will certainly aggravate. Given 
to nursing mothers it imparts a purgative quality to their milk. 

Therapeutics. 

Aloes is chiefly used in combination with Iron, Myrrh, Nux- 
vomica, etc., for amenorrhcea and chronic constipation with 
atonic dyspepsia and hypochondriasis. It is curative in certain 
forms of hemorrhoids, especially those occurring after delivery 
and where the condition is not one of active pelvic congestion. 
It is also used internally and as an injection in gonorrhoea, and for 
simple atonic jaundice. It must be avoided in irritable rectum, 
hemorrhoids of active form, menorrhagia and pregnancy, unless 
given in small doses and with care. The Pil. Aloes et Ferri is 
perhaps the most generally useful agent in anaemia, amenorrhcea 
and constipation of girls at the period of puberty. 



ALTHAEA — ALUMEN. 57 

ALTHiEA, Marsh-mallow, — is the peeled root of Althcea 
officinalis, a European plant of the nat. ord. Malvaceae, occurring 
in dry cylindrical pieces, of white color, without pith, of faintly 
aromatic odor and sweetish mucilaginous taste. It contains about 
35 per cent, each of vegetable mucus and starch, with 2 percent, of 
Asparagin, also pectous matter, sugar, fixed oil, but no tannin. 
It is a constituent of Massa Hydrargyri and Pilulae Phosphori, 
and is much used as an excipient in extemporaneous phar- 
macy. Dose, indefinite. 

Preparation. 

Syrupus Alth^e^, — has of Althaea 4 per cent., and should be freshly 
made. Dose, indefinite. 

Physiological Action and Therapeutics. 

Althaea is one of the best mucilaginous drugs, but has no 
active medicinal properties. It is used in Europe to make pec- 
toral teas and syrups, and is extensively employed as a mucilagi- 
nous demulcent. The powdered root makes a good emollient 
poultice. In the German Pharmacopoeia a Compound Althaea Tea 
is official, which under the common name, " German Breast Tea," 
is a popular demulcent drink in bronchial affections, coughs, 
colds, etc. 

Asparagin is an organic principle, occurring in large rhombic 
crystals, and found in many other plants, as in the shoots of 
asparagus, vetches, potatoes, liquorice, the sweet almond, the root 
of the locust, etc. It is considered a derivative of Succinic Acid, 
and has diuretic properties, besides being sedative to the circula- 
tion. It may be used in ascites, especially in children, in the 
anasarca of Bright's disease, and in gout. Dose, gr. ij-iij, in 
water. 



ALUMEN, ALUM, Potassa-alum — is the Sulphate of 
Potassium and Aluminium, K 2 A1 2 (S0 4 ) 4 .24H 2 0, which, when the 
24 molecules of water are driven off, becomes Alurnen Exsiccatum, 
Dried Alum, K 2 Al 2 (S0 4 ) r Alum occurs in large, octahedral 
crystals, or cubes, of sweetish astringent taste and acid reaction. 
It is soluble in ioj^ parts of water at 59 F., and in 0.3 part of 
boiling water, but is insoluble in alcohol. The Ammonia-alum 
(Aluminii et Ammonii Sulphas) was formerly official, and is still 
sold and dispensed as "Alum." Dose, gr. x-xx, as an emetic 
3j for a child. 

5 



58 ALUMINIUM. 

Preparation. 
Alumen Exsiccatum, Dried Alum, — is a white, granular powder, slowly 
soluble in 20 parts of water at 59 F., and quickly soluble in 0.7 of boiling 
water. Dose, gr. x-xx. (See above.) 

Physiological Action. 

Alum is an astringent, coagulating albumen and stimulating 
muscular contraction. At first it excites the flow of saliva and 
then markedly diminishes it. It coagulates pepsin and arrests 
digestion, stops peristalsis, and usually causes constipation, 
though sometimes inducing diarrhoea. Although coagulating 
albumen, even in weak solution, it enters the blood, constricts 
the capillaries, arrests secretions, especially those of mucous sur- 
faces, and stops capillary hemorrhage. 

In teaspoonful doses Alum is an efficient and non-depressant 
emetic. In large doses it is a gastro-intestinal irritant, gj^ of 
dried Alum having caused the death of an adult in 8 hours. 

Therapeutics. 

Alum is used locally as an astringent in chronic catarrhs, leu- 
chorrhcea, gonorrhoea, hemorrhoids, bed-sores, ulcers, relaxed 
throat, colliquative sweats, catarrhal ophthalmia and granular 
lids. The dried powder is escharotic, destroying granulations 
and warty growths, and is used by insufflation in chronic nasal 
catarrh. 

Internally it is beneficial in gastric catarrh, gastralgia, enteralgia, 
passive hemorrhages, lead colic and constipation. As an emetic it 
is employed in croup, and it is a good antidote in lead-poisoning. 

Alum is best administered alone, as it forms precipitates with 
a large number of drugs. 



ALUMINIUM, — This metal is not official, though of its 
salts two are, besides Alum. They are — 

Aluminii Hydras, Hydrate of Aluminium, Hydrated Alumina, A1 2 H0 6 , — 
is a white, light, amorphous, tasteless powder, insoluble in water or alcohol, 
but soluble in strong alkaline or acid solutions. Dose, gr. iij-xx, in powder 
or mixture. 

Aluminii Sulphas, Sulphate of Aluminium, Al 2 (S0 4 ) 3 .i8H 2 0, — is a white 
crystalline powder, soluble in 1.2 of water at 59 F., almost insoluble in alco- 
hol. Used locally. 

Physiological Action and Therapeutics. 

The Hydrate is a feebly astringent and desiccant powder, 
occasionally used in inflammatory skin affections as a local appli- 
cation, and internally in diarrhoea. 



AMMONIACUM AMMONIUM. 59 

The Sulphate is antiseptic and astringent. It has been used 
internally in diarrhoeas, but is chiefly employed in a 5 per cent, 
solution locally to ulcers, or in stronger solution (5iij ad gvi) 
in foul discharges from mucous surfaces. A saturated solution is 
a mild caustic, and may be used daily a%a local application to 
enlarged tonsils, nasal polypi, ulceration of the os uteri, and 
various chronic enlargements. The Benzoinated Solution of 
Alumina is an unofficial preparation used for the same purposes. 



AMMONIACUM, Ammoniac, — is a gum-resin, obtained 
from Dorema Ammoniacum, a Persian plant of the nat. ord. Um- 
belliferse, occurring in yellowish-brown tears of peculiar odor, and 
bitter, acrid and nauseous taste. When triturated with water it 
readily yields a milk-white emulsion, and contains a Volatile Oil, 
which differs from that of Asafcetida in that it is neither sulphur- 
etted nor phosphoretted. It also contains resin, gum, gluten, 
etc. Dose, gr. x-xxx. 

Preparations. 

Mistura Ammoniaci, — is an emulsion with water of 4 per cent, strength, 
the resin being suspended by the contained gum. Dose, ^ss-j. 

Emplastrum AMMONIACI, — Ammoniac 100 parts, digested with 140 of 
Dilute Acetic Acid until emulsionized, then strained and evaporated. 

Emplastrum Ammoniaci cum Hydra rgyro, — Ammoniac 72, Mercury 
18 per cent., and contains also Lead-plaster, Sulphur, Olive Oil, and Dilute 
Acetic Acid. 

Physiological Action a?id Therapeutics. 

Ammoniac is a stimulating expectorant and a laxative, and has 
a mildly irritant action on the skin. Its actions are similar to those 
of Asafcetida, but much less powerful. It is not much used, but 
may be employed with benefit in chronic bronchial affections, 
especially of the aged, the mixture with the Chloride or Car- 
bonate of Ammonium facilitating expectoration and lessening 
wheezing. It is also recommended in asthma, and in glandular 
enlargements and indolent swellings the plasters are employed as 
stimulating alteratives and resolvents. 



AMMONIUM, NH 4 , — is a hypothetical compound radical, 
which does not exist in the free state, but which in combination 
with acids forms salts which closely resemble those of the ele- 
ments Potassium and Sodium. Many of its salts are official, as 
well as the aqueous solutions of the gas Ammonia, NH 3 , which is 
produced during the putrefaction of all organisms and of many 
organic nitrogenous compounds existing in the air and in the 



60 AMMONIUM. 

soil in the free state. The chief commercial source of Ammo- 
nium salts is the ammoniacal liquor from gas-works and bones. 

Preparations of Ammonia, 

Aqua Ammonia, Watei^pf Ammonia, — is an aqueous solution of Ammo- 
nia, containing -^th by weight of the gas. It is a colorless liquid, of pungent 
odor, acrid taste and strongly alkaline reaction. Sp. gr. 0.959 at 59 F. 
Dose, 1*1 v-£ss, well diluted. 

Aqua Ammonia Fortior, Stronger Water of Ammonia, — contains 28 per 
cent, by weight of the gas. Sp. gr. 0.900 at 59 F. 

Spiritus Ammonite, — is a 10 per cent, solution of the gas in alcohol. Sp. 
gr. about 0.810. Dose, ril x -gj, diluted. 

Spiritus Ammonite Aromaticus, — contains Ammonium Carbonate, Aqua 
Ammoniae, Oils of Lemon, Lavender, and Pimenta, Alcohol and Water. 
Used in the Tinct. Guaiaci Ammoniata and the Tinct. Valerianae Ammoniata. 
Dose, ^ss-ij. 

Linimentum Ammonite, Ammonia Liniment, — has of Aqua Ammonise 30 
parts, Cotton-seed Oil 70. 

Ammonium Salts and their Preparations, 

Liquor Ammonii Acetatis, Solution of the Acetate of Ammonium, Spirit 
of Mindererus, — is prepared by neutralizing Dilute Acetic Acid with Carbonate 
of Ammonium, and contains about "]]/ 2 per cent, of the Acetate. It should be 
freshly made. Used in Mistura Ferri et Ammonii Acetatis. Dose, 5J-§j. 

Ammonii Benzoas, Benzoate of Ammonium, NH 4 C 7 H 5 2 , — in minute four- 
sided laminar crystals, soluble in 5 of water and 28 of alcohol at 59 F. Dose, 
gr. v-xv. 

Ammonii Bromidum, Bromide of Ammonium, NH 4 Br, — in prismatic crys- 
tals or as a granular salt, soluble in 1^ of water and 150 of alcohol at 59 F. 
Dose gr. x-gss, well diluted. 

Ammonii* Carbonas, Carbonate of Ammonium, NH 4 HC0 3 .NH 4 NH 2 C0 2 , 
— occurs in white masses consisting of both the bicarbonate and carbonate, 
which on exposure to air becomes a white powder (acid carbonate). Soluble 
in 4 parts of water at 59 F. Dose, gr. v-x. 

Ammonii Chloridum, Chloride of Ammonium, Sal-ammoniac, HN 4 C1, — a 
white, crystalline powder, of saline taste, and slightly acid reaction ; soluble 
in 3 of water and very sparingly in alcohol. Dose, gr. j-xx. 

Trochisci Ammonii Chloridi, Troches of Chloride of Ammonium, — each 
contains 2 grains of the chloride. 

Ammonii Iodidum, Iodide of Ammonium, NH 4 I, — a deliquescent, gran- 
ular, white salt, soluble in 1 of water and 9 of alcohol at 59 F. Dose, gr. 
ij-x. 

Ammonii Nitras, Nitrate of Ammonium, NH 4 N0 3 , — in colorless crystals 
or fused masses, soluble in 0.5 of water and 20 of alcohol at 59 F. Only 
used to prepare Nitrous Oxide Gas by heating to 365 F., for anaesthesia. 

Ammonii Phosphas, Phosphate of Ammonium (NH 4 ) 2 HP0 4 , — in colorless 
prisms, soluble in 4 of water, insoluble in alcohol. Dose, gr. v-xx. 

Ammonii Sulphas, Sulphate of Ammonium (NH 4 ) 2 S0 4 ,— is only used for 
the preparation of other ammonium salts. 

Ammonii Valerian as, Valerianate of Ammonium, NH 4 C 5 H 9 2 , — in 
white, quadrangular plates, deliquescent ; very soluble in water and alcohol. 
Dose, gr. j-v. 



AMMONIUM. 6 1 

Raspatl's Eau Sedatif (Unofficial), — consists of Aqua Ammonise ]|ij, 
Sodii Chloridum ^ij, Spiritus Vini Camphorat. giij, Aqua ^xxxij. For local 
use. 

Physiological Action. 

The gas Ammonia is intensely alkaline and irritant to mucous 
membranes \ inhaled producing spasmodic cough and a sense of 
suffocation. Its prolonged inhalation will induce violent inflam- 
mation of the air-passages and oedema of the glottis. It stimu- 
lates the nasal branch of the fifth nerve, exciting the vaso- motor 
centre by reflex action, and thus raising the arterial tension. 
Applied to the skin and allowed to evaporate, it has a slight rube- 
facient effect, but if evaporation be prevented it penetrates the 
epidermis and has a powerfully vesicant action. The Aqua, 
swallowed undiluted, may cause death quickly by suffocation from 
the action of its vapor upon the air-passages ; if not, it may 
excite gastro-enteritis accompanied by coma, differing in the 
latter respect from potassium or sodium poisoning. After absorp- 
tion it stimulates both the respiration and the circulation by 
direct action on their respective nerve-centres. Ammonia exists 
normally in the circulation, where it keeps the fibrin in solution 
and thus maintains the fluidity of the blood. It increases the 
glycogenic function of the liver, and is converted finally into 
urea. It is a powerful irritant to muscular tissue, causing tetanic 
contraction and subsequent rigor mortis when directly applied. 

Ammonium Salts all stimulate and finally paralyze the spinal 
cord, motor nerves and muscles, in animals, but the order and 
readiness of the action vary with the salt employed, some having 
a predominating influence on the cord, others on the motor 
nerves. In general they may be said to form a series, of which 
the members at one end stimulate the cord, and those at the 
other paralyze both the cord and the motor nerves. At the stimu- 
lant end are Ammonia and the Chloride ; at the paralyzant end 
the Iodide; the Bromide, Phosphate and Sulphate lying between 
(Brunton). In medicinal doses they act on man as stimulating 
expectorants, in large quantity they injure the structure of the 
red blood-corpuscles, and if long-continued they produce rapid 
emaciation by impairing digestion and increasing tissue-waste. 

The Chloride has decided cholagogue powers, increases the 
excretion of urea, in 20-grain doses is purgative, and is consid- 
ered to have a selective action upon the gastric mucous membrane. 
The Carbonate is a powerful and very diffusible stimulant ; when 
administered internally in moderate doses, it is probably decom- 
posed by the HC1 of the gastric juice, nascent ammonia being 
set free and absorbed. It stimulates the respiratory centre, acts as 



62 AMMONIUM. 

a stimulating expectorant, and in very small doses stimulates the 
secretion of the gastric juice. It is also emetic, and has been 
supposed to prevent iodism when administered conjointly with 
Iodide of Potassium. The Solution of the Acetate is an ac- 
tive diaphoretic if the body be warm, or a diuretic if it be cool. 
In wineglassful-doses it will counteract many of the immediate 
effects of alcohol. The Phosphate is diuretic, and is believed to 
decompose the insoluble Urate of Sodium in the blood, convert- 
ing it into the soluble salts Urate of Ammonium and Phosphate of 
Sodium, and thus promoting its elimination. The Benzoate is 
also diuretic, and like Benzoic Acid passes out of the system in 
the urine as Hippuric Acid. It acidifies the urine where there 
is phosphatic tendency of the same. The Nitrate and Sulphate 
are only used for the preparation of other salts, while the Iodide, 
Bromide and Valerianate correspond in action to that of their 
titular bases, and are described under their respective titles, 
Iodum, Bromum and Valeriana. 

Antagonists to Ai?imonia. 

When inhaled, give HC1 vapors by inhalation to form the chloride ; if taken 
in solution, give Vegetable Acids, and demulcents to protect the mucous 
surfaces. Its physiological antagonists are the cardiac sedatives, Aconite, 
Digitalis, Veratrum, etc. 

Therapeutics, 

The strong solution of Ammonia may be used as a rubefacient 
and vesicant, and its vapor, by cautious inhalation, in syncope 
and the results of shock. Locally, it is a good application to 
bites of the less venomous reptiles and to the stings of insects. 
The Carbonate is used internally in the eruptive fevers, delirium 
tremens, continued fevers, pneumonia, etc., where much depres- 
sion exists; as a stimulating expectorant in chronic bronchitis, 
in the broncho-pneumonia of children, and in cardiac asthma. 
It is highly recommended in scarlet fever in doses of 3 to 5 grains 
every one, two or three hours, all acid drinks or fruits being pro- 
hibited while it is being administered. With ten-minim doses 
of tincture of capsicum in an ounce of some bitter infusion it is 
exceedingly efficient, in 5-10-grain doses, for the sinking sensa- 
tions and craving for stimulants experienced by subjects of alco- 
holism. It may be used as an emetic in bronchitis, when the 
tubes are choked with mucus and the circulation of the patient 
is weak. It may also be employed by inhalation, and adminis- 
tered internally, for similar purposes as Liquor Ammonise. The 
Chloride has a high repute in catarrh of the stomach, with ano- 
rexia, bad taste in the mouth, flatulence, coated tongue, etc., in 



AMYGDALA. 63 

short, the symptoms of so called " biliousness ;" also, in chronic 
congestion of the liver, jaundice from catarrh of the bile-ducts, 
nervous and sick-headaches, myalgia, amenorrhcea, muscular 
rheumatism, and neuralgia. In the latter affection it should be 
given in 30-grain doses several times a day. It is also efficient 
in bronchial catarrh without fever, and in chronic bronchitis when 
the secretion is scanty and tough. Locally, in solution, it has 
been well employed in inflammatory swellings, as sprains, inflamed 
joints, orchitis, etc., as a lotion ; also, to allay itching in prurigo, 
to remove ecchymoses and glandular enlargements. Eau Seda- 
tif is often a good local application in headaches. 

The Solution of the Acetate is especially beneficial in the 
exanthemata, influenza, coryza, anomalous febrile conditions of 
children, acidity and vomiting; also, in erysipelas when there is 
feeble circulation, cyanosis and delirium. It is frequently com- 
bined with Spirit of Nitrous Ether, as a diuretic and diaphoretic 
in febrile affections. The Phosphate is particularly applicable 
to gout and lithaemia, and is a very efficient cholagogue. The 
Benzoate is useful in cystitis with alkaline urine and phosphatic 
deposits, as it acidulates the urine, at the same time stimulating 
and disinfecting the mucous coat of the bladder. 

Aqua Ammonia has been administered by intra-venous injec- 
tion, with efficacy and safety, in sudden or threatened throm- 
bosis, cardiac paralysis from Chloroform, and in poisoning by 
Hydrocyanic Acid and other cardiac depressants. In the same 
manner, it has been employed, but unsuccessfully, in poisoning 
by the bite of venomous reptiles. Ten drops of the strong Liquor 
are diluted with three parts of water, and carefully injected into a 
vein, all air being rigorously excluded from entrance thereinto. 

The therapeutics of the Iodide, Bromide and Valerianate 
are enumerated under the titles Iodum, Bromum and Valeriana 
respectively. 



AMYGDALA, Almond, — the seeds of two varieties of 
Amygdalus communis (nat. ord. Rosacese), namely Amygdala 
amara and Amygdala dulcis, are official, together with several 
preparations, some prepared from one variety, some from another, 
while one is from either and one from both. An important point 
is the reaction between Amygdalin and Emulsin in the presence of 
water, producing Hydrocyanic Acid (see ante, page 29). Amyg- 
dalin, C 20 H 27 NO n , is a crystalline glucoside, existing in Amygdala 
amara but not in Amydala dulcis ; while the ferment Emulsin is 
common to both varieties. 



64 AMYGDALA. 

Amygdala Amara, Bitter Almond, — is the seed of Amygdalus 
communis, var. a??iara, a tree of the nat. ord. Rosaceae, indigenous 
to Western Asia, but cultivated in many other parts of the world. 
The seed is lanceolate in shape, brownish in color, about an inch 
long, having a white, oily embryo of bitter taste, which, when 
triturated with water, emits an odor of Hydrocyanic Acid. Cul- 
tivated chiefly in Spain and the Balearic Islands. 

Amygdala Dulcis, Sweet Almond, — is the seed of Amygdalus 
communis, var. dulcis, a tree of the nat. ord. Rosaceae. The bitter 
and sweet almond trees are identical botanically, and the fruits 
and seeds of the two varieties resemble each other closely, only 
differing in taste and the presence of Amygdalin (see above). 
The sweet almond is largely cultivated about Malaga and in Cali- 
fornia. 

Preparations. 

Aqua Amygdala Amar^e, — is a weak solution of the Oil of Bitter Almond 
in Distilled Water (1 in 1000). Is only a flavored water. Dose, indefinite. 

Oleum Amygdalae Amar^e, — is a volatile oil, of peculiar and aromatic 
odor, bitter, burning taste, and neutral reaction; soluble in 300 of water, but 
freely in alcohol and ether. Dose, wr^-j, in mixture. 

This essential oil, one of the products of the reaction between Amygdalin 
and Emulsin (see a?ite, p. 29), contains a varying quantity of Hydrocyanic Acid 
(3 to 14 per cent.), which may be removed by distillation with caustic potash. 
Nitrobenzol, or " Oil of Mirbane," closely resembles the oil of bitter almond, 
and like it is used for flavoring. It contains no Hydrocyanic Acid, but is a 
dangerous poison, producing toxic effects when inhaled, even in small doses. 

Syrupus Amygdala, — has of Bitter Almond 3 per cent., of Sweet Almond 
10. Dose, indefinite. 

Mistura Amygdalae, — made of Sweet Almond 6 per cent., with Acacia, 
Sugar and Water. A demulcent drink, used as a vehicle for cough mixtures. 
Dose, ^ij-gss. 

Oleum Amygdala Expressum, — is the fixed oil which is expressed from 
either Bitter or Sweet Almond. Used in Unguentum Aquae Rosae, and as a 
bland local application in skin affections. 

Physiological Action. 

The bitter and sweet varieties of the species Amygdalus com- 
munis differ in action only through the agency of the principle 
Amygdalin contained in the former. The Sweet Almond is de- 
mulcent and nutritive, while the fixed oil expressed from either 
variety is a bland application, having the same action as Olive 
Oil. The action of the Bitter Almond and its oil is due to the 
Hydrocyanic Acid contained in them (see ante, p. 29). 

Therapeutics. 

Expressed Oil of Almond is demulcent, and in doses of 
5j-ij a mild laxative. It is used externally for excoriations, 



AMYL NITRIS. 65 

chapped hands, and inflammatory skin affections, and is applied 
to the ear in earache. The cake remaining after the expression 
of the fixed oil from the sweet almond is ground into flour, and 
used in the form of biscuits for diabetics as a substitute for bread, 
as it contains no starch. 

The Oil of Bitter Almond is used as a flavoring agent, and 
may be employed locally or internally in lieu of Hydrocyanic 
Acid. The Syrup is somewhat sedative, but is generally used 
as a demulcent or for flavoring purposes. The Mixture is used 
in catarrhal affections and as a vehicle for cough-mixtures. The 
poisonous character of the Bitter Almond and its essential oil 
(Oleum Amygdalae Amarae) should be kept in mind. 



AMYL NITRIS, Nitrite of Amyl, C 5 H n N0 2 ,— is a clear, 
yellowish liquid, of ethereal and fruity odor, aromatic taste, and 
neutral or slightly acid reaction, extremely volatile, insoluble in 
water but freely soluble in alcohol, ether, chloroform and benzin. 
It is produced by the action of Nitric or Nitrous Acid upon 
Amylic Alcohol, and when impure may have Nitric or Hydro- 
cyanic Acid in it. Dose internally ^l%-) dissolved in alcohol, — 
by inhalation i»lij— vj but larger doses are probably safe. 

Unofficial Analogue, 

Nitroglycerin™, Nitroglycerin, Glonoin, Trinitrate of Glyceryl, 
C 3 H 5 (N0 3 ) 3 , — is a clear, oily liquid, insoluble in water, but soluble in alcohol, 
ether, oils, etc., produced by the action of nitric and sulphuric acids upon gly- 
cerin. Is a dangerous explosive, and should not be kept in stronger solution 
than I per cent. Dose rri 200 to 3V or more > according to susceptibility. 

Unofficial Preparations of Nitroglycerin. 

Tinctura Nitroglycerins, — a one per cent, solution in alcohol. Dose, 
rtj^-x. The strong tincture sold by the homoeopathic pharmaceutists and 
official in their American Pharmacopoeia is a ten per cent, solution, or ten 
times the strength of the above. It is an extremely dangerous preparation, 
both as an explosive and as a medicine. (See American Homoeopathic Phar- 
macopoeia, 2d ed., Boericke & Tafel, 1883, page 235.) 

Tabell^e Nitroglycerini, B. P. — are tablets of chocolate, each contain- 
ing gr. j^-q of pure Nitroglycerin. Dose, j-ij. 

Other Nitrites. 

Sodii Nitris, Nitrite of Sodium, and Potassii Nitris, Nitrite of Potas- 
sium (both unofficial), are used as substitutes for Amyl Nitrite and Nitro- 
glycerin. The former is a white, granular powder, deliquescent, with a cool, 
saline taste, very soluble in water, is made by heating Sodium Nitrate, and 
has the formula NaN0 2 . Dose, gr. ^-v, according to individual suscep- 
tibility. 

6 



66 AMYL NITRIS. 

Ethyl Nitrite, C 2 H 5 N0 2 , — constitutes 5 per cent, of Spiritus ^Etheris 
Nitrosi. (See ante, page 43.) 

Physiological Action. 

Nitrite of Amyl and the other Nitrites agree closely in 
their general action, producing great vascular dilatation by para- 
lyzing either the sympathetic system, the vaso-motor centre or 
the muscular coat of the arterioles, — which, is yet undecided. 
They cause tumultuous action of the heart by relaxing its inhibi- 
tion ; — lowered respiration, from paralysis of the respiratory mus- 
cles and impairment of the ozonizing function of the blood ; — 
diminution of sensation, motility and reflexes; — a sense of heat, 
but lowered body-temperature ; also throbbing pain in the head, 
beating carotids, quickened pulse, flushed face and vertigo. 

The effect of an ordinary inhalation of Amyl Nitrite on man is 
very transitory, excepting the headache, which may last several 
hours. Of the nitrites it is the most prompt but least enduring 
in action, and is best administered by inhalation. It causes sugar 
to appear in the urine and increases the quantity voided. Mixed 
with blood it forms methaemoglobin which is not so readily deoxi- 
dized as haemoglobin, and under its influence the blood in the 
body becomes of a dark chocolate color both in the arteries and 
in the veins. 

Nitroglycerin acts similarly, but less promptly, and its action 
is more enduring. Its headache is of intensely frontal character, 
and persists for hours after the other effects have passed off. It 
is more suitable for internal administration. 

Nitrite of Sodium is also slower in action than Amyl Nitrite, 
and does not cause so much throbbing headache as Nitroglycerin. 
It may be given in solution with water. 

The action of all these agents is probably due to the Nitrous 
Acid contained in them. 

Antagonists. 

Ergot, Belladonna, Strychnine, Brucine, Digitalis, Picrotoxin, and all other 
agents which increase the functional activity of the spinal cord and sympa- 
thetic are antagonistic, though by reason of their slower rate of diffusion the 
antagonism may not be always available. Stimulants, artificial respiration, 
the alternate cold and hot douche, with cold to the head, and Ergotin or 
Atropine subcutaneously, are the best means to be used in cases of poisoning 
by the Nitrites. 

Therapeutics. 

The inhalation of Amyl Nitrite is a useful palliative in angina 
pectoris, epilepsy, tetanus, and many of the respiratory neuroses, 
as spasmodic asthma, whooping-cough, laryngismus stridulus, etc. 



AMYLUM. 67 

It is also indicated in migraine of the pale-face form, and in the 
cold stage of intermittents and pernicious remittents to prevent 
internal congestion, — also in convulsions of various kinds, in- 
cluding the puerperal. It has been sometimes used in threatened 
death from chloroform anaesthesia, and in poisoning by strychnine. 

Nitroglycerin has been used with benefit in neuralgic dys- 
menorrhcea, sea-sickness, and in chronic interstitial nephritis by 
redistributing to the kidneys their blood-supply cut off by de- 
generation of the renal ganglionic centres. It promptly relieves 
hiccough, migraine of spasmodic character, and has afforded 
immediate relief in neuralgia of the fifth. Its administration in 
angina pectoris, though not producing such prompt results as 
that of Amyl Nitrite, gives excellent and much more lasting 
effects. It is useful in the weak heart of the aged, or that from 
fatty degeneration, or when, as in Bright's disease, the arterial 
tension is above normal. 

Nitrite of Sodium has been successfully employed in angina 
pectoris, hemicrania, and in asthma of purely bronchial and neu- 
rotic origin. It has also proved decidedly beneficial in the abnor- 
mally high arterial tension of chronic desquamative nephritis, 
especially when complicated with a weakened and dilated heart. 



AMYLUM, Starch, C 6 H 10 O 5 ,— is the fecula of the seed of 
Triticum vulgar e, common wheat, a plant of the nat. ord. Grami- 
nacese. Though wheat-starch is the official kind, any other might 
be properly used, as the starch occurring in barley, oats, arrow- 
root, sago and tapioca, all of which foods were official in the U. 
S. P. of 1870. The last three are entirely composed of starch ; 
wheat contains about 70 per cent., and rice 90 per cent. 

Starch is a carbo-hydrate, and occurs in distinct grains, forming irregular, 
angular masses, white, inodorous and tasteless, easily pulverized, of neutral 
reaction, and insoluble in alcohol, ether or cold water. Under the microscope 
the granules are seen to be lenticular in form and concentrically striated. When 
boiled with water it yields a whitish jelly of bluish tinge, which when cool 
gives a deep blue color with test-solution of iodine, the color disappearing on 
warming and returning on cooling. 

By boiling with dilute mineral acids starch is converted into 
glucose, dextrin being formed as an intermediate product. Hot 
concentrated nitric acid converts it into oxalic acid, but cold 
fuming nitric acid dissolves it, forming an explosive compound. 
Diastase, ptyalin and pancreatin convert it into glucose. [For 
Glycogen, Dextrin, Cellulose and other allied substances see the 
article Saccharum in the following pages.] 



68 ANISUM ANTHEMIS. 

Preparations. 

Amylum Iodatum, Iodized Starch, — has of Starch 95 parts, Iodine 5, tritu- 
rated with distilled water and dried. Used as a method of giving Iodine [see 
Iodum). Dose, 3J — gss. 

Glyceritum Amyli, Glycerite of Starch, — has of Starch 10 parts, Glycerin 
90, triturated and heated to a transparent jelly. Used as a vehicle for exter- 
nal applications. 

Physiological Action and Therapeutics. 

Starch, though a nutritive of the first order, may be regarded 
as inert medicinally. It serves as a protective and absorbent if 
dusted over the skin, as a vehicle for enemata, and as an antidote 
in iodine-poisoning. Mixed with glue it makes an excellent stiff 
bandage for surgical purposes. 



ANISUM, Anise, — is the fruit of Pimpinella Anisum, & 
European plant of the nat. ord. Um belli ferae. It occurs in ovate 
bodies, \ inch long, hairy, of grayish color, aromatic odor, and 
sweet, spicy taste, resembling conium fruit in appearance. Dose, 
gr. x-xx. 

Preparations. 

Oleum Anisi, — is a volatile oil distilled from Anise or from Illicium ani- 
sattim (the star-anise), and represents the medicinal qualities of the plant. 
That from Anise congeals at 50 to 59 F., and is soluble in an equal part of 
alcohol. That from Illicium congeals at about 35^2° F. The oil is an in- 
gredient of Tinctura Opii Camphorata, Trochisci Glycyrrhizae et Opii, and of 
the two following preparations. Dose, mj-v. 

Aqua Anisi, — has in 500 parts 1 of Oil of Anise mixed with distilled water 
by the aid of cotton. Dose, indefinite. 

Spiritus Anisi,— is a 10 per cent, solution of the oil in alcohol. Dose, ^j-ij. 

Physiological Action and Therapeutics. 

The Volatile Oil is the active constituent of Anise. It has a 
slightly stimulant action on the heart and the digestive organs, 
and liquefies the bronchial secretion, being probably in part ex- 
creted by the bronchial mucous membrane. It is a favorite flavor- 
ing ingredient of cough-mixtures, and relieves slight intestinal 
colic and flatulence in children. In full doses it has a weak nar- 
cotic power. 



ANTHEMIS, Chamomile, — the flower-heads of Anthemis 
nobilis, a European perennial of the nat. ord. Compositse, col- 
lected from cultivated plants. Chamomile-flowers are subglobu- 
lar, about ^ inch broad, having numerous white, three-toothed 



ANTIMONIUM. 69 

florets on a conical, solid receptacle, a strong but agreeable odor, 
and an aromatic, bitter taste ; and contain a volatile oil, a cam- 
phor and a bitter principle but no alkaloid. There are no official 
preparations. An infusion (5* v t0 Oj ' may be given in doses of 

Oleum Anthemidis, Chamomile Oil (Unofficial), — the volatile oil, is of a 
dark blue or green color, and is composed of various ethers, the Angelates 
and Valerianates of Butyl predominating. Dose, tit. ij-x, on sugar. 

Physiological Action. 

Chamomile is a stomachic tonic. It improves the appetite and 
aids digestion by increasing the vascularity of the gastric mucous 
membrane. In large doses the warm infusion is emetic, and per- 
haps diaphoretic, though the latter action is chiefly due to the 
hot water. The oil is remarkably efficient in reducing reflex ex- 
citability in frogs, even after its excitation by Strychnine or Bru- 
cine. 

Therapeutics. 

Chamomile is popular in domestic practice. An infusion is 
used by nurses for many infantile complaints, and externally as 

a fomentation to relieve pain, as in colic, etc. The oil is very 
efficient in reflex cough, pulmonary catarrh, acute dyspepsia, 
diarrhoea of children, spasmodic asthma, whooping-cough, colic, 
and the spasmodic and pseudo-neuralgic affections of hysterical 
women. It should prove extremely useful in poisoning by Strych- 
nine from its power over reflex excitability. 

The Chamomile of the homoeopaths is the Matricaria Chamo- 
mi//a, or German Chamomile, official in the U. S. Pharmacopoeia 
as " Matricaria," which see. 



ANTIMONIUM, Antimony, Sb. — Metallic Antimony is 
not official, nor is it used in medicine. It is represented, how- 
ever, by the following official salts and preparations, viz. : 

Compounds of Antimony and their Preparations. 

Antimonii et Potassii Tartras, Tartrate of Antimony and Potassium, 
Tartar Emetic, 2KSbOC 4 H 4 O r HaO, — small white crystals or a granular 
powder, of sweet, disagreeable metallic taste, soluble in 17 of water at 59 F., 
and in 3 of boiling water, insoluble in alcohol. Dose, gr. T ^ \, but after 

tolerance is established as high as gr. ij may be given. Is an ingredient of the 
two following, viz. : 

Vinum Antimonii, Wine of Antimony, — has of Tartar Emetic 4, Boiling 
Distilled Water 60, Stronger White Wine to 1000 parts. Contains about 2 



yO ANTIMONIUM. 

grains of Tartar Emetic to the g, and is an ingredient of Mistura Glycyrrhizse 
Composita. Dose, as a febrifuge and expectorant, TU v-xv. 

Syrupus Scill^: Compositus, Cox's Hive Mixture, Hive Syrup (see under 
Scill^e), — contains about ^ grain of Tartar Emetic to the g, or more accu- 
rately 3 parts in 2000, with Squill, Senega, etc. Dose, TTt v-^j, cautiously in 
children. 

Antimonii Oxidum, Oxide of Antimony, Sb 2 3 , — a heavy, gray powder, 
insoluble in water or alcohol, but readily and wholly soluble in Hydrochloric 
or Tartaric Acids. Dose, gr. j-iij. It constitutes i^d of — 

Pulvis Antimonialis, — Antimonial or James' Powder, — consists of the 
Oxide of Antimony 2>Z parts, with 67 of Calcium Phosphate. Dose, gr. 
iij-viij, every 3 hours as a diaphoretic, larger doses for emetic and cathartic 
effects. 

Antimonii Sulphidum, Sulphide of Antimony, Sb 2 S 3 ,— is the native sul- 
phide, purified by fusion, and as nearly free from Arsenic as possible, — steel-gray 
masses, or a black, lustreless powder, insoluble in water or alcohol. Dose, 

g r - X-J- 

Antimonii Sulphidum Purificatum, Sb 2 S 3 , — is purified by maceration in 
Aq. Ammonite. joshing and drying. Dose, gr. }(.-). 

ANTiMONi(,feuuPHURATUM, Sulphurated Antimony, — is chiefly Sb 2 S 3 , with 
a very small *amount of Sb 2 3 . A reddish-brown, odorless and tasteless 
powder, insoluble in water or alcohol. Is a constituent of Pil. Antimonii 
Composite Dose, gr. j-v. 

Pilul^e Antimonii Composite, Plummer's Pills, — each pill contains gr. 
j4 each of Calomel and Sulphurated Antimony. 

Physiological Action. 

Tartar Emetic in its action represents the other official 
antimonial preparations, being a cardiac, arterial and general 
depressant, a protoplasmic poison, a systemic and local emetic, 
a specific gastrointestinal irritant, an expectorant and a diapho- 
retic. Like Aconite, Arsenic, Hydrocyanic Acid and Potassium, 
it is destructive to protoplasm, destroying function in all nitro- 
genous tissue, and paralyzing the spinal cord, the motor nerves, 
the muscles and the sensory nerve terminations. It is especially 
depressant to the heart-muscle and the cardiac motor ganglia; it 
combines with the red blood-corpuscles, lessening their oxidizing 
power, lowering the blood-pressure and reducing the body-tem- 
perature. Its taste is styptic and one of its earliest effects is the 
production of constriction of the fauces. It promotes waste and 
rapid excretion of waste-products, carbonic acid and urea being 
especially increased. Being eliminated by all the excretory 
organs, including the skin, it excites follicular inflammation at 
the points of elimination \ resulting in an eruption which is pap- 
ular at first, then becomes vesicular, and finally pustular, the 
pustules being umbilicated, like those of variola. This same 
eruption is also produced by the application of the drug to the 
skin with friction. Aphthous ulcerations, extending from the 



ANTIMONIUM. J\ 

mouth to the stomach, with salivation and painful deglutition, 
may also result from its continued use. 

In small doses Tartar Emetic stimulates secretion in the 
bronchial and salivary glands, the stomach, intestinal canal, liver 
and pancreas. In larger doses it excites nausea, vomiting and 
purging, with evacuations like the "rice-water discharges" of 
cholera, and great prostration of the vital powers. Toxic doses 
produce similar symptoms, besides epigastric pain, cyanosis, deli- 
rium, cramps, motor and sensory paralysis, suppression of urine 
and collapse, — much the same phenomena as observed in Asiatic 
cholera. 

The Sulphide occurs native, and is the source from which the 
other compounds are prepared. It seems to be inert medicinally. 
Sulphurated Antimony owes its efficacy to the small quantity 
of the Oxide contained in it, and as this is variable, the action of 
the preparation is uncertain. The Oxide has a similar action 
to that of Tartar Emetic, but being insoluble in water, it is of 
much less certain activity. 

Antidotes and Antagonists. 

Tannic Acid, or any substance containing it, is the antidote, forming the 
insoluble tannate. Opium, Alcohol, Ether, and other antispasmodics are 
physiological antagonists. Demulcent drinks should be freely administered 
to protect the mucous membranes. Alkalies and Salts of Lead decompose 
Tartar Emetic. 

Therapeutics. 

Tartar Emetic was formerly much employed as an antiphlo- 
gistic on account of its power to cut short acute inflammations of 
sthenic type, and its use was very much abused, so that it has 
now gone out of fashion as a remedy. The contra-stimulant 
treatment of pneumonia and other inflammatory diseases by large 
doses of this salt after tolerance was established, is only worthy 
of reference as an historical fact. The same may be said of its 
external use as a counter-irritant as well as of its employment 
as an emetic, in both of which capacities it is too severe, while 
its emesis is too tardy in action to be of any value in poisoning. 
It is, however, a very efficient agent in many grave affections, if 
used in small doses (gr. ^V^o) > being highly recommended in 
acute inflammatory affections of the respiratory tract, especially 
pneumonia, broncho-pneumonia, acute oedema of the lungs, 
feverish and catarrhal colds, bronchitis, laryngitis and tonsillitis. 
In many respects it acts like Aconite in these and kindred affec- 
tions, producing copious diaphoresis, slowing the pulse and allay- 
ing restlessness. It is considered a good remedy in puerperal 



72 ANTIPYRINA. 

peritonitis, mammitis and orchitis, in lumbago and other muscular 
rheumatisms, also in photophobia and in gastric indigestion after 
beer-drinking. In still smaller doses (gr. T J^ hourly) it is par- 
ticularly efficient in catarrhal inflammations of the respiratory 
mucous membrane in children, accompanied by rattling breathing 
and much mucus, which is expelled with difficulty. Such cases 
often simulate asthma, the attacks being marked by cough, 
wheezing, and difficult respiration, also sibilant rales in the 
chest, and usually follow on severe colds or on measles. The 
Compound Syrup of Squill is commonly used as an expectorant 
and nauseant in the treatment of bronchitis and croup. The 
quantity of Tartar Emetic in it (gr. y^ to the §) should be remem- 
bered in administering it to children. (See Scilla.) 

The Oxide is chiefly employed in the form of James* Powder 
(Pulvis Antimonialis) for its mild diaphoretic qualities. The 
Sulphide is not used in medicine. Sulphurated Antimony is 
very uncertain in action and is but little used. The Compound 
Pill of Antimony (Plummer's Pill) was devised to obtain mercu- 
rial results without writing Hydrargyrum on a prescription. 



ANTIPYRINA, Antipyrine, Dimethyl-oxy-chinicine, 

C 20 H 18 N 4 O 2 (Unofficial), — is an alkaloidal product of the destruc- 
tive distillation of Coal-tar (compare Chinolina), and prepared 
by a patented and complicated process. It may also be obtained 
synthetically by heating Methyl-oxy-chinicine with Phenyl-hy- 
dracine, and collecting the powder. It is a grayish or reddish- 
white crystalline powder, of slightly bitter taste, soluble freely in 
cold water, also but to a less degree in alcohol, chloroform and 
ether. It gives an intense red color with Ferric Chloride, and a 
beautiful green with Nitric Acid. Dose, for an adult gr. xxx every 
hour for two or three hours, for a child gr. jss for each year of 
age for three successive hourly doses, in sweetened peppermint 
water. If vomiting is produced, it may be dissolved in half its 
weight of water and injected subcutaneously. 

Physiological Action. 

Antipyrin reduces the temperature 3 to 5 degrees in fevers, 
for several hours, slightly increases the blood-pressure, has no 
action on the respiration, but causes profuse sweating, which may 
however be prevented by a small dose of Atropine or Agaricine 
previously administered. It occasionally produces vomiting and 
a peculiar eruption on the skin, rarely slight collapse has been 
observed from it, but as yet no serious result has followed its use. 



apiol. 73 

Its antipyretic influence lasts from five to twenty hours, and the 
after-rise of temperature is not generally accompanied by rigor as 
is the rule with Kairine. It dilates the pupil, and is eliminated 
by the kidneys, appearing in the urine about three hours after its 
ingestion. It is a powerful antiseptic and disinfectant, and is 
said to have hemostatic qualities superior to those of Ergotine. 
Symptoms, occurring after its administration in health, are slight 
nausea, singing in the ears, and reduction of body temperature 
about ^ of a degree. The fall in fever is usually from three to 
five degrees, but one instance of twelve degrees has been recorded. 
When administered with Kairine, the mixed drugs produced a 
greater fall of temperature with longer continuance than when an 
equal quantity of either was given alone. 

Therapeutics. 

Antipyrin is probably the most powerful and least unpleasant 
of the many organic compounds which possess antipyretic quali- 
ties. (See under the title Cinchona.) It has been used very 
extensively in every form of febrile disease, and often with the 
most strikingly beneficial results, the unpleasant effects being ob- 
served only in a few instances. It is especially useful in typhoid 
fever, phthisis, erysipelas and rheumatism, also in the febrile dis- 
eases of children and surgical fever. It is not so satisfactory in 
pneumonia or in pleurisy. In phthisis it may produce consid- 
erable depression, and in typhus fever it has caused serious col- 
lapse, but in the other affections noted it is an agent of great 
value, and almost free from danger. 

APIOL (Unofficial), — is a non-volatile, oily liquid, of acid 
reaction and pungent taste, soluble in alcohol, ether, chloroform, 
and in glacial acetic acid. It is extracted from the fruit of Petro- 
selinum sativum (Parsley), a biennial plant of the nat. ord. Um- 
belliferse, which also contains a gelatinous substance named Apiin, 
and a Volatile Oil which is by some considered to be the true 
emmenagogue principle of the plant. Apiol is probably a mixture 
of several substances, and as found in commerce is often an 
impure oleoresin. Dose, trj^iij— x in capsule two or three times a 
day ; as an emmenagogue, TTj£xv in one daily dose. 

Physiological Action and Therapeutics. 

In small doses (n^iij-v) Apiol is carmina f ive, diuretic, dia- 
phoretic, expectorant, and stimulant to the circulation. In full 
doses (njjxv) it is decidedly emmenagogue and feebly anti peri- 
odic, producing headache, tinnitus aurium, intoxication, giddi- 



74 APOCYNUM APOMORPHINA. 

p 

ness, etc., its action generally resembling that of Quinine. Large 
doses (mxxx-3j) are decidedly narcotic. 

It has had some reputation in intermittents and in malarial 
neuralgiae, but is most frequently employed in amenorrhcea and 
dysmenorrhea, being of especial advantage in the amenorrhcea 
of anaemia, also when the menstrual discharge is fetid. It is 
becoming fashionable as a supposed abortifacient, but is useless 
for this purpose, and if freely used may produce decided nar- 
cotism, especially if the preparation employed should happen to 
be an active one. The capsules of Apiol put up in France arfd 
sold in this country over the counters of drug-stores to any appli- 
cant are generally inert ; hence cases of poisoning by this drug 
are seldom observed. They are however an important source of 
revenue to the retailers, as, being "imported" preparations, 
they command a high price, which is readily paid by gullible 
women who wish to " bring around their courses." 

APOCYNUM, Canadian Hemp, — is the root of Apocynum 
cannabinum, an indigenous perennial plant of the nat. ord. Apo- 
cynaceae, and inodorous but of bitter, disagreeable taste. It con- 
tains a peculiar active principle, Apocynin, also tannic and gallic 
acids, resin, wax, caoutchouc, etc. Dose of the powdered root, 
gr. v-xxx. A decoction (§ss to the pint) may be given in doses 
of §j-ij thrice daily. 

Physiological Action and Therapeutics. 

Apocynum is powerfully emetic and cathartic in full doses, 
also diaphoretic, expectorant and sometimes actively diuretic. 
It lowers the pulse-rate, produces much nausea, and induces 
drowsiness. It should not be confounded with Indian or Amer- 
ican Hemp (Cannabis sativa), which have entirely different 
qualities. 

The only condition in which Apocynum has proven of much 
value is dropsy, especially the anasarca of Bright' s disease and 
ascites, in which 15-grain doses are indicated. The active prin- 
ciple, Apocynin y is a good expectorant, in doses of gr. % to gr. y 2 . 

APOMORPHINA HYDROCHLORAS, C 17 H 17 N0 2 - 
HC1, — is the Hydrochlorate of an artificial alkaloid, Apomor- 
phine, prepared from Morphine or Codeine by the action of 
strong acids or zinc chloride. It occurs in minute, colorless crys- 
tals, odorless, of bitter taste, and neutral or faintly acid reac- 
tion ; soluble in 7 of water and 50 of alcohol at 59 F., almost 



AQUA. 75 

insoluble in ether or chloroform ; decomposed by boiling water 
or boiling alcohol. Dose, gr. ^ to T ^ hypodermically, gr. -^ 
to -J by the mouth. For young children, gr. g 1 ^- to 3^ should not 
be exceeded. Solutions should be fresh when used. 

Physiological Action. 

Apomorphine is a systemic emetic, acting directly on the 
vomiting centre, and is the quickest, most certain and least irri- 
tating of all emetics, acting in from five to twenty minutes with 
but moderate nausea. In large dose it is very depressant to the 
heart (gr. y 1 ^ having caused death in a weak adult by cardiac fail- 
ure), and produces paralysis of the motor and sensory nerves, 
delirium, convulsions, and depression of respiratory power. 
Small doses (gr. -^) are expectorant 

Therapeutics. 

The Hydrochlorate is usually employed, and is the only official 
preparation. It is the best emetic to use in many cases of poi- 
soning, particularly when swallowing is difficult, but is useless in 
narcotic poisoning after narcosis has blunted the vagus centre. 
It is a very desirable agent in any case where time is of great 
importance. 

As an expectorant it is highly recommended but has not yet 
been much used. In catarrhs the ^ of a grain every 3 hours 
will prove of great advantage, but it must be used with caution 
especially in young children who bear this remedy very badly. 



AQUA, Water, H 2 0, — is natural water in its purest attain- 
able state, a colorless, limpid liquid, devoid of odor or taste, of 
neutral reaction, and containing not more than 1 part of fixed 
impurities in 10,000 parts. Besides entering into the composition 
of most of the official extracts, fluid extracts, and many other phar- 
maceutical preparations, from it are prepared the 13 official Waters 
(Aquae), and also the official — 

Aqua Destillata, Distilled Water, H 2 0, — 1000 parts of water 
are distilled, the first 50 parts obtained being thrown away, 800 
parts are preserved. It is as near chemically pure water as can 
be obtained. 

Nomenclature. 
Aqua Fluvialis, River-water. Aqua Destillata, Distilled Water. 

Aqua Pluvialis, Rain-water. Aqua Bulliens, Boiling Water. 

Aqua Fontana, Spring or Well-water. Aqua Fervens, Hot Water. 
Aqua Marina, Sea- water. Aqua Communis, Common Water. 

Balneum Maris, Warm -water Bath. 

Balneum Vaporis, Vapor Bath. 



?6 AQUA. 

Mineral Waters. 

Natural Water differs from Distilled in containing saline and 
other constituents in varying proportions, — from common water 
(Aq. Communis), in which they are so small in quantity as not 
to alter the taste, color, etc., up to the Sea-water, having 3^ per 
cent., and that of the Dead Sea with 26^ per cent. Spring 
waters, impregnated with foreign substances so as to have a de- 
cided taste and a marked action on the human system, are called 
Mineral Waters, which may be subdivided into various groups, 
according to their prevailing constituents, as Carbonated, Alka- 
line, Saline, Sulphuretted, Silicious, etc. Full analyses of all the 
principal mineral waters of Europe and America are given in the 
United States Dispensatory, 15th edition, but a few of the most 
prominent will be mentioned here. 

Carbonated Mineral Waters. 

. Selters, Nassau, Germany, 30 cubic inches 

Apollinaris, Nuenahr, Prussia, ... 47 " of C0 2 

Old Sweet Spring, West Virginia, ..11 " [to the pint. 

Sweet Chalybeate Spring, Virginia, . . 13 " 

These waters are cold, contain generally Carbonates of Calcium, Magnesium 
and Sodium (in some, Iron), which are held in solution by the excess of Car- 
bonic Acid, also Chlorides of Sodium and Potassium, Sulphates, Phosphates, 
etc. 

Alkaline Mineral Waters. 

Ems, Germany. Perry Spring, Ills. 

Salzbrunn, Germany. St. Louis Spring, Mich. 

Gleickenberg, Austria. Buffalo Lithia Spring, Va. 

Vichy, France. Hot Spring, Va. 

Vals, France. Warm Spring, Va. 

Bladon Spring, Ala. Berkeley Spring, Va. 

Congress Spring, Cal. Bethesda Spring, Wis. 

Seltzer Spring, Cal. Gettysburg Spring, Pa. 

These waters are generally cold, those of Vichy and Ems being warm. 
They contain a considerable amount of Sodium Carbonate, also Sodium Chlo- 
ride and Sulphate, and various other Chlorides, Carbonates and Sulphates, 
with Carbonic Acid gas in varying quantity. Vichy and Vals waters depend 
for their efficacy almost wholly on the quantity of Sodium Carbonate contained 
in them, which is for Vichy from 26 to 50 grains and for Vals about 60 grains 
to the pint. 

Saline Mineral Waters. 

Friedrichshall, Germany. Cheltenham, England. 

Hunyadi Janos, Hungary. Kissengen, Bavaria. 

Baden-Baden, Germany. Reichenhall, Bavaria. 

Wiesbaden, Germany. Adelheidsquelle, Bavaria. 

Carlsbad, Bohemia. Kreutznach, Prussia. 

Pullna, Bohemia. Saratoga Springs, N. Y. 

Seidlitz, Bohemia. Ballston, N. Y. 

Marienbad, Bohemia. Hot Springs, Arkansas. 



AQUA. y^ 

These waters are of more complex composition, the various waters of Sara- 
toga containing more than thirty constituent salts. Those usually present are 
the Sulphates and Carbonates of Sodium, Calcium, Magnesium, etc. {Mag- 
nesian waters) ; Chlorides of Sodium, Potassium and Lithium ( Chlorinated 
waters), Ferrous salts {Chalybeate waters), with Iodine, Bromine, Manganese 
salts, and Phosphates in some few. Carbonic Acid gas is present in all. Most of 
them are purgative, some are considered alterative, and many are warm (ioo°— 
160 ). 

The most powerful member of the saline group is Hunyadi yanos, which 
contains about 150 grains each of Magnesium and Sodium Sulphates to the 
pint, and is, therefore, effectively purgative. Nearly as strong is Pullna water, 
with 124 grains of Sodium Sulphate and 93 grains of Magnesium Sulphate 
to the pint. Friedrichshall is less powerful, but perhaps a better aperient 
water in doses of 6 to 10 fluid ounces. Marienbad contains no Magnesium 
Sulphate, but has 36 grains of Sodium Sulphate, 9 of Sodium Carbonate, 1 1 
of Sodium Chloride, and a small quantity of Ferrous Carbonate to the pint ; 
in transportation, however, it loses its Carbonic Acid and deposits the Iron. 
It is not aperient in ordinary doses. Carlsbad water contains 20 grains of 
Sodium Sulphate and 9 each of Sodium Carbonate and Chloride to the pint. 
The so-called " Carlsbad Salt " is simply Sodium Sulphate with a trace of the 
Carbonate. Hartnack gives the following formula for its artificial preparation : 
Sodium Sulphate 100 parts, Sodium Bicarb. 80, Sodium Chloride 40; a des- 
sertspoonful in water as a mild saline purgative. These waters are imported 
into the United States in large quantities, and may be ordered through any 
druggist. 

Sulphurous Mineral Waters. 

Aix-la-Chapelle, Prussia. Blue Lick Spring, Ky. 

Bareges, S. France. Sharon Spring, N. Y. 

Eux-Bonnes, S. France. Yellow Sulphur Spring, Va. 

Llandrindod, Wales. White Sulphur Spring, W. Va. 

Harrowgate, England. Salt Lake Warm Springs, Utah. 

These waters all contain Sulphuretted Hydrogen gas, also Carbonic Acid 
gas and Carbonates, Chlorides and Sulphates of Sodium, Potassium, Mag- 
nesium and Calcium ; sometimes Carbonate and Oxide of Iron, Iodide and 
Bromide of Sodium. 

Silicious Mineral Waters. 

Hot Springs, Iceland. Geysers of Yellowstone Park. 

The constituents of these waters are chiefly alkaline Silicates. 

Pnysiological Action. 

Water is an essential constituent of all the tissues of the body, 
forming from 0.2 per cent, of the enamel of the teeth to 77 per 
cent, of the ligaments. In the liquids of the organism it is con- 
tained in the proportions of 78 per cent, of the blood to 93 per 
cent, of the urine, and 99 per cent, of the tears. In moderate 
quantity it is necessary to digestion, but in large amount it 
weakens digestion by diluting the gastric juice. Ice-cold water, 
if freely used, suspends the action of the pepsin, depresses the 



78 AQUA. 

nerves of the stomach, and lowers its blood-supply. The free 
use of water internally produces increased cutaneous and renal 
excretion, and promotes the elimination of some of the products 
of tissue-change, as urea, phosphoric acid, etc. In some subjects 
it favors the deposition of fat. 

Cold Water applied externally, as by a bath (4o°-6o°F.), 
abstracts a portion of the body-heat, lowering the surface tem- 
perature and depressing the cutaneous nerves, producing spas- 
modic breathing and a quickened pulse. If the temperature of 
the water is not too low and the bodily vigor is good, reaction 
soon occurs, and the general effect is tonic to the muscular 
power, circulation and respiration. If this does not take place 
a secondary chill occurs, and serious depression may result. 

Warm Water (95°-ioo°F.) applied to the surface of the 
body, as by baths of water or steam, packing, etc., acts in the 
opposite manner at first, increasing the circulation in the skin, 
the rapidity of the pulse and respiration, and the body tempera- 
ture. Rapid tissue-change occurs, the waste products being 
eliminated chiefly by the skin and the pulmonary mucous mem- 
brane. If long-continued, precordial oppression, giddiness and 
muscular debility are experienced. 

Hot Water (iio°-ii2° F.) at first dilates the vessels of the 
part to which it is applied, and soon afterwards contracts them. 
It is a valuable means of relieving congestion and inflammation, 
and is a most effective hemostatic when the bleeding is from small 
vessels or of capillary character. Whether generally or locally 
applied it is one of the most reliable means of relieving spasm. 

Hot Vapor applied to the surface accelerates the circulation 
and produces profuse sweating. Its general action is similar to 
that of warm water. 

Mineral Waters taken internally act chiefly by virtue of 
the water, partly in accordance with the effects of their various 
constituents. As baths their action is doubtless entirely due to 
their temperature. 

Therapeutics of Water, 

Cold Water or Ice has many external applications of value 
in the treatment of disease. As a wet pack it is used in tonsillitis, 
diphtheria and croup. Cold baths are the most effective anti- 
pyretic in the high temperature of fevers, and the cold wet pack 
is used for the same purpose. Ice or cold water is applied to the 
head in acute cerebral congestion, and to the spine in chorea, 
etc. ; also locally in hemorrhoids, bubo, orchitis, and to the 
uterus in post-partum hemorrhage. Cold affusion to the body 



AQUA. 79 

is employed as a preventive of spasmodic croup, as well as to 
lessen the tendency to taking cold. 

Hot Water externally, as fomentations, hot wet pack, baths, 
etc., is most effective in reducing local congestion and setting 
up resolution of local inflammation. Hot fomentations to the 
renal region are useful in functional inactivity of the kidneys. 
The hot spinal douche is used in affections of the spinal cord 
and meninges, and in the backache of women. The hot wet 
pack is highly esteemed in inflammations of the chest organs, 
and hot injections for chronic inflammation of the uterus. Hot 
water dressings for wounds are strongly recommended by many 
high surgical authorities. Vapor and Turkish baths are used as 
diaphoretics in advanced kidney disease, in acute and chronic 
rheumatism, mineral poisoning, and syphilis. Warm baths, with 
cold applications to the head, are esteemed as of value in infantile 
convulsions and chorea. 

Internally, water is chiefly of value as a diuretic, and if hot as 
a diaphoretic. A glass of cold water before breakfast daily is 
often an effective means of overcoming constipation, while the 
drinking of hot water an hour before each meal has been of great 
value to many dyspeptics. The value of the popular teas in 
chronic diseases is almost entirely due to the diluent, diuretic 
and diaphoretic actions of the hot water used. 

Therapeutics of the Mineral Waters. 

An undue value is placed by the laity and interested proprietors 
on the medicinal value of mineral waters, causing the various 
localities of the best advertised springs to become resorts for 
invalids and idlers from every civilized country. The benefit 
derived is in most instances due to the change of climate and 
scene, freedom from home cares and business worry, regularity 
of life and diet, drinking of water in quantity, and in many 
cases the substitution of water for alcoholic beverages. In order 
to get the worth of their money, people will gladly submit to 
rigid hygienic and dietetic restrictions at a watering-place which 
they would totally ignore at home. The same may be said of 
the treatment at the so-called " hydropathic " or ' ' water-cure ' ' 
establishments. As a rule, those springs will prove of most value 
which are furthest removed from the patient's residence, for " dis- 
tance lends enchantment M in these matters as well as in many 
others. Invalids whose homes are in the vicinity of some won- 
der-working spring will not usually derive any benefit from its 
water, but will by that of another spring, similar in constituents, 
but located several hundred miles away. 



80 ARGENTUM. 

The principal affections in which mineral waters are esteemed 
most highly are the following : dyspepsia, cirrhosis of the liver, 
gout, rheumatism, lithiasis, diabetes of hepatic origin, constipa- 
tion, strumous disorders, obesity, plethora of the pelvic organs, 
hypochondriasis, skin diseases, especially those depending on 
gastric derangement, phthisis, constitutional syphilis, metallic 
poisoning, etc., in all of which the influences above mentioned 
are especially efficacious, and are no doubt the chief factors in 
producing any benefit which may be attainable. 

The special therapeutics of mineral waters are to be found 
in this volume under the heads of their principal constituents, 
as Sodium Chloride, Sodium Sulphate, Magnesium Sulphate, 
etc., also in the therapeutical part of the work. Aperient and 
purgative waters are useful in many cases where a prejudice 
exists against purgative medicine, but none against the same 
agents in a natural water. The strong saline-aperient waters, as 
Carlsbad, Hunyadi, Friedrichshall, etc., have considerable re- 
pute in the treatment of the uric-acid diathesis and calculous 
affections. 



ARGENTUM, Silver, Ag,— is represented by the follow- 
ing four official salts, viz. — 

Co??ipounds of Silver and their Preparations. 

Argenti Nitras, Nitrate of Silver, AgN0 3 , — occurs in colorless rhombic 
crystals, of bitter caustic taste and neutral reaction, soluble in 0.8 of water and 
26 of alcohol at 59 F. Is best given in pill or distilled water; never with 
tannin or a vegetable extract, lest an explosive compound result. Dose, gr. \- 
y 2 , — if watched up to gr. j may be given. When melted with 4 per cent, of 
Hydrochloric Acid it makes — 

Argenti Nitras Fusus, Moulded Nitrate of Silver, Lunar Caustic, — for 
local use as a mild caustic and an astringent. Argenti Nitras Dilutus, 
Diluted Nitrate of Silver, Mitigated Stick, — is the same melted with an equal 
weight of Potassium Nitrate. Is used locally by ophthalmologists. 

Argenti Cyanidum, Cyanide of Silver, AgCN, — has no medicinal use 
except for the extemporaneous preparation of Hydrocyanic Acid. (See ante, 
page 29.) 

Argenti Iodidum, Iodide of Silver, Agl, — a greenish-yellow powder in- 
soluble in water or alcohol. Is used instead of the nitrate internally, as it is 
supposed not to discolor the skin. Dose, gr. ^-j in pill. 

Argenti Oxidum, Oxide of Silver, Ag 2 0— a brownish-black powder, 
nearly insoluble in water and insoluble in alcohol. It should not be triturated 
with readily oxidizable or combustible substances, and should not be brought 
into contact with ammonia. Dose, gr. %-\) in pill. Is not dangerous. 

All the silver salts should be protected from light in dark amber-colored 
vials. 



ARGENTUM. 8 1 

Physiological Action. 

Nitrate of Silver is a powerful astringent and a limited 
escharotic. Applied to the skin or mucous membrane it com- 
bines with the albumen of the tissue, excites superficial inflamma- 
tion, which is soon followed by an altered condition of the part, 
and stains the same black under the influence of light. The 
stains may be removed by washing with a strong solution of Po- 
tassium Cyanide. Given internally in small doses it increases 
secretion, stimulates the heart, promotes nutrition, and acts as a 
nerve tonic. Its continued use produces symptoms which are 
collectively termed Argyria, and are as follows : gastro-intestinal 
catarrh, tissue waste, uraemia, albuminuria, fatty degeneration of 
the heart, liver and kidneys, hemorrhages, fluidity of the blood, 
a slate-colored line along the margin of the gums, and a similar 
discoloration of the skin and mucous membranes, with centric 
impairment of the nervous system producing paralysis on a large 
scale, loss of coordination power, convulsions, and finally death 
by paralysis of respiration. Large doses produce violent gastro- 
enteritis, also ulcer of the stomach from thrombosis of its veins, 
and destruction of the gastro-intestinal mucous membrane. 

The Iodide and Oxide are sometimes used to produce the 
same constitutional effects, they being supposed not to discolor 
the skin, but this has been found to be fallacious. The oxide is 
much the least irritant of the silver salts. 

Antagonists and Incompatibles. 

Common Salt freely used is the antidote, precipitating the insoluble chlo- 
ride of silver and acting as an emetic. The nitrate is exceedingly sensitive to 
organic material and light, which decompose it readily. Incompatibles are 
all the soluble chlorides (hence it should be used in distilled water), most of 
the mineral acids and their salts, alkalies and their carbonates, limewater and 
astringent infusions. 

A course of silver medication should be regulated by suspending the remedy 
after 5 or 6 weeks' use, and then promoting elimination by purgatives, diu- 
retics and baths. To prevent the general discoloration Potassic Iodide should 
be given conjointly with the silver, and baths of Sodium Hyposulphite used 
frequently. 

Therapeutics. 

Locally the Nitrate is much used as a stimulant application, 
an astringent, a caustic, an alterative and an antiphlogistic. To 
ulcers and in throat affections the solid stick may be used, but 
solutions of various strengths from gr. j to gr. xl to the ^ are 
much better. The mildest solutions are employed in conjunc- 
tivitis (never over the cornea), the stronger in throat and mouth 



82 ARNICA. 

affections, and the strongest in lupus, erysipelas and other skin 
diseases. A solution in Nitrous Ether (gr. xl to the g) is said to 
abort superficial inflammations if applied early to the neigh- 
boring integument, and in erysipelas a solution of gr. xx to the % 
is often used over the inflamed surface and beyond, after careful 
washing and drying, in the hope of preventing the extension of 
the disease, which it will not do. The mucous membranes of 
the conjunctiva, fauces, larynx, urethra, bladder, uterus, vagina 
and rectum, have all been subjected to the local action of this 
salt. 

Internally the silver salts are used in dyspepsia with vomiting 
of yeasty fluid, chronic gastritis and gastric ulcer, dysentery 
of chronic type especially if rectal ulcer (the Nitrate internally 
and by enema), the diarrhoea of phthisis and typhoid fever 
(Nitrate with Opium), chronic spinal inflammations causing loco- 
motor ataxia or paraplegia, and epilepsy, in the latter affection 
the Nitrate having occasionally given good results. 

The Oxide has been used internally for gastric neuralgia, irri- 
tative dyspepsia, pyrosis, gastric and pulmonary hemorrhages, 
and menorrhagia. The Iodide is used to obtain the constitu- 
tional effects of silver, but has no advantage over the other 
preparations. 

ARNICA, — is the plant Arnica montana or Leopard's Bane, a 
perennial of the nat. ord. Compositae, indigenous to the moun- 
tains of Northern Europe and Siberia, and said to have been also 
found in the mountains about the headwaters of the Missouri and 
Columbia rivers. It has large orange-yellow flowers, and a 
small, curved rhizome with several rootlets. Both the flowers and 
the root are official. Its most important constituent is Trimethy- 
lamine, C 3 H 9 N, an ammoniacal alkaloidal principle which is 
probably the active ingredient. It also contains Arnicin, Inulin, 
Capronic and Caprylic Acids, tannin, mucilage, resins, and two 
essential oils, one of which exists in the flowers, the other in the 
root. 

Arnica Flores, Arnica Flowers, — the flower-heads of Arnica 
montana, large, yellow, having 14 to 16 strap-shaped florets in 
the ray, twice as long as the disk, which consists of numerous 
tubular florets. The odor is feebly aromatic, the taste bitter and 
acrid. Used in Tincture and Infusion. 

Arnica Radix, Arnica Root, — the rhizome and rootlets of 
Arnica montana, is about 2 inches long and }£ to *4 inch thick, 
externally brown and rough from leaf-scars ; internally whitish, 
with a thick bark containing a circle of resin-cells and a large, 



ARNICA. 83 

spongy pith. Odor somewhat aromatic, taste pungent, aromatic 
and bitter. Resembles Valerian, which is distinguished by its 
smell; Serpentaria, which has many contorted rootlets; and Vera- 
triim Viride, which has thicker rootlets. Dose, gr. v-xx. 

Preparations of the Flowers. 

Tinctura Arnica Florum, — 20 per cent. Dose, ""l v -xxx. 

Infusum Arnica (Unofficial), — Arnica flowers 20 in 100 parts of water, is 
thought by many observers to be the best form for local use, as it does not excite 
dermatitis, probably from containing none of the Volatile Oil, or the insoluble 
principle Arnicin. 

Preparations of the Root. 

Extractum Arnica Radicis, — Dose, gr. j-iij. 
Extractum Arnic^e Radicis Fluidum, — Dose, "HI v-xx. 
Tinctura Arnica Radicis, — 10 per cent. Dose, ^U v-xxx. 
Emplastrum Arnica, — contains Extract of Arnica Root 50 parts to 100 
of Lead Plaster. 

Derivative. 

Trimethylamina, Trimethylamine, C 3 H 9 N (Unofficial), — is a thin, color- 
less, strongly alkaline liquid, boiling at 50 F.,and at ordinary temperatures is 
a colorless, inflammable gas. The Hydrochlorate is the most stable salt, crys- 
tallizing in white or colorless prisms, nearly odorless, of pungent taste, very 
deliquescent, and freely soluble in water and in alcohol. Dose, gr. ij-iij in 
syrup every 2 hours. 

Trimethylamine has been obtained from Arnica flowers and those of several 
other plants, from Ergot, Hops, Codeine, Cod-liver Oil, human urine, herring- 
pickle, and the residue left in making sugar from beets. It is sometimes 
incorrectly named Propylamine, a term also applied to an impure trimethyla- 
mine, but in reality an allied and isomeric compound. 

Physiological Action. 

Arnica is irritant, stimulant, depressant, antipyretic, diuretic 
and vulnerary. It irritates the gastro-intestinal tract, and in some 
persons the local use of an alcoholic preparation of the flowers 
will excite erysipelatous inflammation of the skin, though those 
of the root have not been observed to do so- In small doses 
internally it increases the action of the heart, raises the arterial 
tension and stimulates the action of the skin and the kidneys. 
Large doses produce a transient excitement, followed by depres- 
sion of the circulation, respiration, and nerve-centres; head- 
ache, unconsciousness, and even convulsions being induced, the 
body-temperature lowered, the pupils dilated, and muscular 
paresis produced. A toxic dose paralyzes the nervous systems of 
animal and organic life, causing collapse and death. 

Trimethylamine is an active escharotic and a gastro-intestinal 
irritant. It lowers the rate and force of the heart, decreases the 



84 ARSENIUM. 

body-temperature, and diminishes (though sometimes increases) 
the excretion of urea. The Hydrochlorate is a powerful anti- 
pyretic in doses of gr. ij every 3 hours. 

Therapeutics. 

Arnica is a popular remedy with those who patronize the 
so-called homoeopathic school of practice, but, like many other 
agents which the homceopathists claim to have given to medicine, 
it is a remedy much older than homoeopathy, and was investi- 
gated originally by regular physicians, notably by Van der Kolk 
in the sphere of mental affections. 

Externally, the tincture in water has a popular reputation in 
sprains, bruises, etc., though an infusion is better for local use. 
Ecchymoses are rapidly dispersed by its administration internally 
as well as externally; and, in internal bruises from shocks or con- 
cussions, its internal use has proven very efficacious. The aqueous 
preparation locally promotes the rapid union of cut surfaces. 

Internally, besides its value as noted above, Arnica is un- 
doubtedly effectively employed in typhus and typhoid fevers as 
a stimulant and antipyretic, also in delirium tremens, rheuma- 
tism and rheumatic gout, hemorrhages, epistaxis, hemoptysis, 
amaurosis, concussion of the brain, chronic dysentery, and par- 
alysis of the bladder. 

In idiopathic mania, after the first excitement has diminished, 
Arnica, in aqueous preparation internally, has given great satis- 
faction. It has often checked an exhausting diarrhoea after many 
other remedies have failed. 

Trimethylamine has been found useful in acute rheumatism 
and gout, relieving pain, reducing temperature, and diminishing 
the frequency of the pulse. In chronic rheumatism, as a liniment 
(1 to 3 of Glycerin), it is said to give relief equal to that pro- 
duced by any anodyne. It has also been used with benefit in 
chorea, moderating the spasmodic movements when not sus- 
pending them entirely. 



ARSENIUM, Arsenic, As. — The metal Arsenic is not used 
in medicine, but is represented by one of its Oxides, a salt of 
another Oxide, and the Iodide, which are official ; together w T ith 
four preparations of these compounds, or of their salts, viz. — 

Arsenic Compounds and their Preparations. 

Acidum Arseniosum, Arsenious Acid, Arsenious Oxide, White Arsenic, 
As 2 3 , — is a heavy, white solid, occurring as an opaque powder, or in semi- 



ARSENIUM. 85 

transparent masses having usually a striated appearance, soluble in 30 to 80 
of water at 59 F., the solubility varying with its physical condition, also sol- 
uble in 15 of boiling water, in alkalies and their carbonates, hydrochloric 
acid and in glycerin. It is volatilized at 424.5 F., without melting, and 
when thrown on ignited charcoal it emits an alliaceous odor. Arsenious 
Acid is obtained by roasting native arsenides, and condensing the fumes in a 
long horizontal chimney. Dose, gr. -^ to T \. 

Liquor Acidi Arseniosi, — is a 1 per cent, solution of Arsenious Acid in 
Hydrochloric Acid and Distilled Water. Dose, Tri_ij— x. 

Liquor Potassii Arsenitis, Solution of Arsenite of Potassium, Fowlers 
Solution, — is prepared by boiling together Arsenious Acid 1, Bicarbonate of 
Potassium I, and Distilled Water 10; then adding Compound Tincture of 
Lavender 3, and Distilled Water up to 100 parts. Dose, TTLij-x. 

Sodii ARSENIAS, Arseniate of Sodium, Na 2 HAs0 4 .7H 2 0, — is a salt of the 
second oxide, Arsenic Acid, As 2 5 . It is in colorless, prismatic crystals, of 
feebly alkaline taste and a faintly alkaline reaction, soluble in 4 of water at 
59 F., very soluble in boiling water, hardly soluble in alcohol. Dose, gr. 

tW ; of the dried salt > g r - aV-A- 

Liquor Sodii Arseniatis, Solution of Arseniate of Sodium, Pearson's 

Solution, — has of the Arseniate dried 1 part in 100 of Distilled Water. Dose, 

irtij-xv. 

Arsenii Iodidum, Iodide of Arsenic, Asl 3 , — in glossy, orange-red, crystal- 
line masses or scales, gradually losing iodine by exposure to the air, soluble 
in 3J of water and in 10 of alcohol at 50 F., is gradually decomposed by 
boiling water and by boiling alcohol, and is completely volatilized by heat. 
Dose, gr. ^Vi- 

Liquor Arsenii et Hydrargyri Iodidi, Solution of Iodide of Arsenic 
and Mercury, Donovan's Solution, — has of Iodide of Arsenic I, Red Iodide 
of Mercury I, in 100 parts of Distilled Water. Dose, TTUj-x. 

Physiological Action. 

Arsenious Acid, when applied to the skin denuded of its epi- 
dermis, acts as a painful escharotic, producing violent inflamma- 
tion and resulting in a slough which forms a barrier to its ab- 
sorption. If applied in dilute solution over a large surface, it 
will be absorbed, and may produce the systemic effects to be de- 
scribed. 

/;/ small doses it is a stomachic and general tonic, promoting 
the appetite and digestion, increasing the cardiac action, the re- 
spiratory power, and the intestinal secretions, — stimulating per- 
istalsis, exalting mental activity and the sexual appetite, and pro- 
ducing a fair skin and a rotund form. When tolerance of the 
drug is established, large doses are used with impunity, as by the 
arsenic-eaters of Styria, who can swallow at once as much as 5 
grains with safety. They are careful, however, not to take any 
water into the stomach at the same time, so that the dose is slowly 
absorbed, and probably eliminated rapidly. Not all those who 
begin its use can acquire tolerance of it, but those who do so 



86 ARSENIUM. 

seem to continue it without injury, and live to an old age, under- 
going great exertion without exhaustion, and being enabled to 
ascend steep mountains without difficulty of respiration. 

In full medicinal doses, continued for some time, it causes itch- 
ing and cedema of the eyelids, ptyalism, nausea and vomiting, 
diarrhoea or dysentery, epigastric pain and soreness, feeble and 
irritable heart, dyspnoea, disordered sensibility, herpes zoster, 
urticaria, eczema and other skin eruptions, jaundice and albumi- 
nuria. 

In large doses, it is a powerful irritant to the gastro-intestinal 
and bronchial mucous membranes. Toxic doses may produce 
either symptoms of gastro-enteritis, or those of profoundly nar- 
cotic character. In the first and most usual form of acute arsen- 
ical poisoning, there is burning pain in the throat and stomach 
extending over the abdomen, vomiting, thirst, bloody stools, 
strangury, suppressed, albuminous, or bloody urine, rapid and 
feeble heart, great anxiety, cold breath, finally exhaustion and 
collapse, — a group of symptoms much resembling cholera. Au- 
topsy shows erosions, ecchymoses, and softening of the gastro- 
intestinal mucous membrane, congestion of the lungs and bronchi, 
and fatty degeneration of the liver, kidneys and cardiac muscle. 
The poison is found in the urine, saliva, tears, sweat, etc., and 
may be detected even in the parenchymatous tissues. In the 
nervous form of poisoning by Arsenic, profound coma and insen- 
sibility come on suddenly without any gastro-intestinal symptoms. 

Arsenical preparations are generally classed as alteratives, but 
they are valuable tonics and antiseptics, and possess antiperiodic 
powers second only to those of Quinine. 

Chronic Arsenical Poisoning may occur from the inhalation 
of arsenical vapors or dust arising from wall-papers or other 
substances containing the poison. The quantity necessary. to 
produce symptoms of poisoning when inhaled seems to be 
very small. The most prominent symptoms are, at first in- 
creased appetite, next colicky pains, mucous or dysenteric 
stools, irritation of the eyes, coryza, a short, dry cough, and a 
white and silvery tongue, all accompanied by great bodily 
prostration. 

To avoid arsenical poisoning during a course of the drug, full 
doses (ttj?x of Fowler's Solution) should be used at the commence- 
ment, and always taken on a full stomach. The dose should 
then be steadily reduced. Susceptible persons often tolerate it 
better if a few drops of Tinctura Opii are administered with each 
dose. 



ARSENIUM. 87 

Antidotes and Incompatibles. 

Poisoning by Arsenic is treated by prompt evacuation of the stomach, and 
washing it by means of the stomach-pump, then Magnesia, Chalk and Lime- 
water freely, or better still, the chemical antidote to Arsenic in solution, viz., 
the Hydrated Oxide of Iron, freshly precipitated and in a soft magma, in 
the proportion of gr. viij for each grain of the poison ingested. (See Ferri 
Oxidum Hydratum for the preparation of this antidote.) Oil or mucilagi- 
nous drinks should be given to protect the mucous membranes, and diluents, 
alkaline mineral waters or Iodide of Potassium to promote elimination. Di- 
alyzed Iron has been shown to be quite efficient as an antidote, and is more 
easily obtained than the hydrated oxide. It has rendered good service in 
many cases of poisoning from inhalation of arsenical fumes. 

Incompatibles are the salts of iron, magnesia and lime, and astringents. 

Therapeutics. 

Externally, Arsenic has been employed in the form of paste as 
a depilatory, and as an escharotic in cancers, but is excessively- 
painful. Most of the secret " cancer-cures n have arsenious acid 
for their basis. Internally, it is used as a tonic and astringent 
to the intestinal canal, as a tonic and antispasmodic in nervous 
diseases, and for its action on tissue change. It is of especial 
value in irritative dyspepsia, gastralgia, pyrosis, gastric ulcer or 
cancer, regurgitation of food without nausea, diarrhoea coming 
on immediately after taking food, vomiting of drunkards and 
chronic alcoholism. It has proven of signal service in the com- 
mencement of phthisis, and in catarrhal pneumonia, probably by 
causing fatty degeneration of the exudation in the alveolar cavi- 
ties, thus breaking it up and quickening its absorption. It is often 
very serviceable in chronic bronchitis with copious expectoration, 
in acute catarrh, hay-fever, whooping-cough, asthma, chorea, 
epilepsy, angina pectoris and other spasmodic nervous disorders. 
In many forms of neuralgia, it often gives prompt and permanent 
relief, especially in cases due to malarial poisoning. As an anti- 
periodic, it has high rank, being, however, of particular value in 
chronic malarial poisoning, and as an adjunct to Quinine in the 
intervals between the paroxysms of intermittents. Anaemia and 
chlorosis are remarkably benefited by it, and in rheumatic ar- 
thritis and chronic rheumatism it is sometimes of great service. 
In chronic scaly and papular skin-diseases, its value is very great, 
but it is not serviceable in acute forms, and the more chronic the 
cutaneous affection the more likely is it to be amenable to Ar- 
senic. Epithelioma may be retarded by small doses long con- 
tinued, and it has certainly been useful in delaying the progress 
of other cancers, particularly scirrh us of the stomach and uterine 
carcinoma. Hypodermically its solutions have been extremely 



88 ASAFGETIDA. 

efficient in histrionic spasm, local chorea of the head and neck, 
obstinate cases of general chorea, and in lymphadenoma. 

ASAFCETIDA, Asafetida, — a gum-resin obtained by inci- 
sion from the living root of Ferula JVarthex and Ferula Scorodosma, 
perennial herbs of the nat. ord. Umbelliferae, and natives of Persia 
and Afghanistan. It occurs in whitish tears embedded in grayish 
sticky mass, of alliaceous odor and taste, soluble in alcohol to at 
least 60 per cent., and triturated with water it yields a milk-white 
emulsion. Its principal constituent is a Sulphuretted Volatile Oil, 
consisting chiefly of Sulphide of Allyl, C 6 H 10 S ; it also contains 
a gum and a resin, with ferulaic, malic, acetic, formic and vale- 
rianic acids. Dose, gr. v-xx. 

Preparations. 

Tinctura Asafgetid^e, — strength 20 per cent. Dose, ^ss-ij. 

Mistura Asafcetid^e, — a watery emulsion of strength 4 per cent. Dose, 
gss-gij. 

Emplastrum Asafcetida, — Asafetida 35, Lead Plaster 35, Galbanum 15, 
Yellow Wax 15, and Alcohol 120 parts. 

Pilule Asafcetida, — each has gr. iij with gr. j of Soap. Dose, j-iv. 

Pilule Aloes et Asafcetid^, — each has gr. 1 y£ of each ingredient. 

Pilule Galbani Composite, — each has gr. y^ of Asafetida, and gr. jss 
each of Galbanum and Myrrh, with syrup. Dose, j-iv pills. 

Mistura Magnesia et Asafcetid^:, De wees' Carminative, — Magnesium 
Carbonate 5, Tinct. Asaf. 7, Tinct. Opii 1, Sugar 10, Aqua Dest. q. s. ad 100 
parts. Dose, gss-^ss. 

Spiritus Ammonite Fcetidus (Unofficial), — Asafetida 1^, Liquor Ammo- 
nice Fortior 2, Spirit 20 parts. Dose, gss-j. 

Physiological Action, 

Asafetida is a powerful antispasmodic, a stimulant to the brain 
and nervous system, a stimulating expectorant, also tonic, laxa- 
tive, diuretic, diaphoretic, emmenagogue, aphrodisiac and anthel- 
mintic in action. Its odor and taste are extremely nauseous and 
persistent. 

In small doses continued it is said to cause impaired digestion, 
alliaceous eructations, acrid sensation in the fauces, gastralgia, 
flatulent distension, fetid flatulence, burning urination, diarrhoea 
and tenesmus. Full doses produce various nervous or hysterical 
phenomena, with nausea, vomiting and purging. 

The Volatile Oil diffuses into the blood and tissues, and is 
excreted in the urine, sweat, breath, etc. By its action the cir- 
culation is stimulated, the arterial tension raised, the power of 
the cardiac motor ganglia is increased and the inhibition relaxed. 



ASCLEPI AS ASPI DIUM. 89 

Asafetida also stimulates the brain even to a very pleasant intoxi- 
cation, and produces a subjective sensation of warmth without 
any rise of body temperature. It stimulates the nervous system, 
the secretions and excretions, the menstrual flow and the sexual 
appetite. In Asia it is used as a condiment with food, and 
though at first it is extremely nauseous to most people, a taste for 
it may be readily acquired. 

Therapeutics. 

The disgust which is generally felt for this remedy makes its 
use very restricted, though a valuable medicine. The Mixture is 
extremely serviceable in the flatulent colic of infants, and as an 
enema in infantile convulsions. There is no better remedy in 
hysteria and hypochondriasis with indigestion and flatulence, — in 
constipation with amenorrhcea of anaemic subjects, due to ovarian 
and intestinal torpor, — in bronchial affections, cough of habit, 
chronic catarrhs, and flatulent indigestion. 

ASCLEPIAS, Pleurisy Root, — is the root of Asclepias 
tuberosa, a plant of the nat. ord. Asclepiadaceae and a native of the 
Eastern and Southern States. Two other species of Asclepias are 
used in medicine and were formerly official. There are no offi- 
cial preparations, but a fluid extract is in the market, the dose of 
which is about 3j every 4 hours. An infusion or decoction may 
be made in the proportion of gj of the powdered root to a quart 
of water, and given in teacupful doses every 2 or 3 hours. 

Physiological Action and Therapeutics. 

Asclepias contains two resins, a peculiar principle, tannic and 
gallic acids, albumen, pectin, gum, various salts and a volatile, 
odorous, fatty matter. It is emetic and cathartic in full doses, 
also diaphoretic and expectorant, as well as depressant to the 
action of the heart, and probably slightly sedative and astringent. 
It is a popular remedy in the Southern States for pleurisy (hence 
its common name), and has been used in medicine for catarrh, 
pneumonia, phthisis, diarrhoea, dysentery, rheumatism, gastralgia, 
and to promote the eruption in exanthematous fevers. It is 
undoubtedly a powerful diaphoretic. 

ASPIDIUM, — is the rhizome of Aspidium Filix-mas (Male 
Fern) and of Aspidium marginale (Marginal Shield Fern), plants 
of the nat. ord. Filices, the former found in most parts of the 
world, the latter indigenous to N. America. It is 3 to 6 inches 

8 



90 AURANTIUM. 

long, thick, scaly, having fibro-vascular bundles within, arranged 
in an interrupted circle ; odor slight but disagreeable, taste 
sweetish and bitter, astringent and nauseous. The active prin- 
ciple is Filicic Acid, C u H ]8 5 , which is extracted in the oleo-resin. 
It also contains a green, fatty oil, a volatile oil, resin, tannin, etc. 
Dose, 5 SS- 5J SS i n a single dose fasting, or in divided doses at 
short intervals, followed by a purgative. 

Preparation. 

Oleoresina Aspidii, — is an ethereal extract and deposits Filicic Acid on 
standing. It should be well shaken before being used. Dose, gss-^j, in 
capsules, repeated every 3 hours for 2 or 3 doses. 

Physiological Action and Therapeutics. 

Aspidium is an efficient vermicide against tape-worm, particu- 
larly the unarmed variety (Bothriocephalus latus). The oleo- 
resin is the best form in which to use it, the patient having fasted 
for the previous day, or only used a milk diet, 5j mav then be 
given in 4 doses ^ hour apart. This may be repeated the next 
morning and followed by three drops of croton oil in emulsion. 
This is one of many methods. Brayera (Kousso) may be com- 
bined with it advantageously. A formula for a mixed treatment 
by Aspidium, Pomegranate and Pumpkin-seed is given under the 
title Granatum. 



AURANTIUM, Orange, — occurs in two official varieties 
of fruit and flowers, viz. — those of Citrus vulgaris, the Bitter 
Orange, and Citrus Aurantium, the Sweet or Portugal Orange, 
both trees of the nat. ord. Aurantiaceae, cultivated in almost all 
warm climates. Other varieties are described under Limon. The 
official titles are — 

Aurantii Amari Cortex, Bitter Orange Peel, — the rind of 
the fruit of Citrus vulgaris, characteristics well known. Con- 
tains a Volatile Oil isomeric with Oil of Turpentine, C 10 H 16 , and 
a bitter, crystalline principle, Hesperidin or Aurantiin. 

Aurantii Dulcis Cortex, Sweet Orange Peel, — is the rind of 
the fruit of Citrus Aurantium. It contains a Volatile Oil dif- 
fering from that of the bitter orange, and less of the bitter prin- 
ciple. 

Aurantii Flores, Orange Flowers, — the partly expanded fresh 
flowers of Citrus vulgaris a.ndCitrus Aurantium. They contain an 
aromatic Volatile Oil (the official Oleum Aurantii Florum) and 
a trace of bitter principle. 



AURUM. 91 

Preparations. 

Extr actum Aurantii Amari Fluidum, — Bitter Orange Peel 100, Alco- 
hol and Water. Used as flavoring. Dose, ,^ss-j. 

Tinctura Aurantii Amari, — Bitter Orange Peel 20, Diluted Alcohol 
q. s. ad 100. A flavoring preparation. Dose, ^j-ij. 

Tinctura Aurantii Dulcis, — Sweet Orange Peel 20, Diluted Alcohol 
q. s. ad 100. For flavoring. Dose, gj- ij. 

Syrupus Aurantii, — Sweet Orange Peel 5, Alcohol 5, Calcii Phosphas 
Prsecip. 1, Sugar 60, Water q. s. ad 100. Flavoring. 

Oleum Aurantii Corticis, — a volatile oil, extracted by mechanical means 
from fresh orange peel. Is soluble in 2 of alcohol, and is an ingredient of 
Bay Rum (Sp. Myrciae). Dose, gtt. j-v. 

Elixir Aurantii, Simple Elixir, — Oil of Orange Peel 1, Sugar 100, Alco- 
hol and Water q. s. ad 300. An excipient for extracts and tinctures, designed 
to replace the unofficial elixirs. 

Spiritls Aurantii, — Oil of Orange Peel 6, Alcohol 94 parts. Dose, to be 
regulated by the quantity of alcohol desired. 

Aqua Aurantii Florum, Recent Orange Flowers 40, Water 200 parts dis- 
tilled to 100 parts. Dose, indefinite. 

Oleum Aurantii Florum, Oil of Xeroli, — a volatile oil, distilled from fresh 
orange flowers. Is the most important constituent of Cologne Water (SpL. 
Odoratus). Dose, gtt. j-v. 

Syrupus Aurantii Florum, — Orange-flower Water 35, Sugar 65. A 
delicate flavoring agent, but having to some persons an extremely sickish taste. 

Physiological Action and Therapeutics. 

Orange is aromatic and tonic, also more or less bitter, but has 
little action except a mild influence on the nervous system due 
to its volatile oil. Persons much exposed to its fumes are liable 
to cutaneous eruptions and various nervous disorders. The oil 
may produce violent colic and convulsions in children, one case 
being reported in which death resulted from eating the rind. Its 
use in medicine is confined to flavoring purposes, though the 
preparations of the Bitter Orange may be used as mild tonics and 
stimulants to the digestion, but they are usually combined with 
more energetic agents for these purposes. 



AURUM, Gold, Au, — is represented by but one official 
preparation. The Chloride is found in the shops, being much 
used by photographers ; and triturations of the metal itself may- 
be prepared according to the general formula therefor. 

Preparations. 

Auri et Sodii Chloridum, — is a mixture composed of equal parts of dry 
Chloride of Gold and Chloride of Sodium, AuCl 3 -|- NaCl. An orange-col- 
ored powder, soluble in water. Dose, gr. ^j-^. 

Auri Chloridum (Unofficial), — occurs in needle-shaped prisms, of an 



92 AZEDARACH. 

orange-yellow color, deliquescent, freely soluble in water. Dose, gr. -£ s - -fa. 
Is best given in solution. 

Physiological Action. 

Locally used the Chloride of Gold is escharotic ; administered 
internally its action closely resembles that of the Bichloride of 
Mercury. In small doses, it promotes appetite and digestion, 
and stimulates the functions of the brain, producing marked 
mental exhilaration and a general sense of well-being. Continued, 
it induces aphrodisiac effects in both sexes, and in women in- 
creases the menstrual discharge. Full doses cause nausea and 
vomiting, glandular irritation, salivation without loosening of the 
teeth or sore gums, increased urinary discharge, sweat and fever 
(the auric fever) ; nutrition is impaired and rapid waste set up. 
A toxic dose produces effects similar to those from corrosive sub- 
limate, namely, violent gastro-enteritis, mental disturbance, priap- 
ism, tremor, convulsions and paralysis. 

Antagonists. 

Poisoning is treated by albumen (eggs) or flour, and evacuation of the 
stomach — just as in the case of Corrosive Sublimate. 

Therapeutics. 

Chloride of Gold is a useful remedy in irritative dyspepsia, 
gastro-duodenal catarrh, hypochondriasis, amenorrhcea, func- 
tional impotence, chronic metritis, habitual abortion, ovarian 
dropsy, vertigo and vertiginous sensations from disordered 
stomach. It is especially recommended in chronic albuminuria, 
hepatic sclerosis, granular and fibroid kidney, as it prevents hyper- 
plasia of connective tissue. In syphilis its utility is proven 
beyond doubt, particularly in the tertiary manifestations and 
syphiloma of the bones, in which it is fully as efficacious as the 
Bichloride of Mercury, with incomparably less inconvenience to 
the patient. 



AZEDARACH, — is the bark of the root of Melia Azeda?-ach, 
or Pride of China, a handsome tree of the nat. ord. Meliaceae, 
indigenous to China and India, but naturalized in the Gulf States. 
It occurs in curved pieces or quills, which are almost inodorous 
and have a sweetish taste, afterwards becoming bitter and nau- 
seous. There are no official preparations, but a decoction of the 
fresh bark (§ij to Oj boiled to 0)4) maybe used in tablespoonful 
doses. 



BALSAMUM PERUVIANUM. 93 

Physiological Action and Therapeutics. 

This drug is known to produce symptoms of narcotic poison- 
ing, as giddiness, dimness of sight, mental confusion, stertorous 
breathing, dilated pupils and stupor. Large doses are necessary 
to cause these effects, and some authorities question their occur- 
rence. It is, however, a gastro-intestinal irritant, producing vom- 
iting and purging, and an anthelmintic against the round-worm. 
Its active principle has not been isolated. It is only employed 
as an anthelmintic against lumbricoid worms, and as the fresh 
bark is difficult to obtain in any region where it does not grow, 
other agents will be more generally used. It is given to horses 
affected with " bots." 

BALSAMUM PERUVIANUM, Balsam of Peru —is 
a balsam obtained from Myroxylon Pcreirce^ a Central American 
tree, of the nat. ord. Leguminosae. Occurs as a thick brown black 
liquid, its odor reminding of benzoin and vanilla, soluble in 5 of 
alcohol, almost insoluble in water which only extracts from it 
some Cinnamic Acid and Cinnamein. It is not a true balsam, as 
it contains no volatile oil. Composition is, — Cinnamein (Benzyl 
Cinnamate, C^H^O.,) 60 per cent., Cinnamic Acid 6 percent., 
Resins 30 per cent. ; also, Benzoic Acid, and other bodies. Dose, 
ngx-xxv, in emulsion. There are no official preparations. 

Physiological Action. 

The actions of Balsam of Peru are those of its several con- 
stituents, namely, antiseptic, disinfectant, stimulant to the circu- 
lation, and sedative to the nervous system ; acting chiefly on the 
mucous membrane, it is tonic and expectorant, diuretic and dia- 
phoretic. In large doses, it causes gastralgia, nausea and vomit- 
ing, colic and diarrhoea. It closely resembles in physiological 
action its congeners Styrax and Benzoin. 

Therapeutics. 

Balsam of Peru is used locally in chronic skin-diseases of inflam- 
matory type and sore-nipples, to relieve itching, cleanse bed- 
sores, promote the healing of wounds and sores, and to kill the 
acarus scabiei, being considered by some authorities the best of 
all applications in itch. Internally, it is used as a stimulant and 
disinfectant expectorant in chronic bronchitis, asthma, etc., as 
well as in gonorrhoea, gleet, leucorrhcea, and other discharges 
from mucous membranes. Incorporated with Iodoform it par- 
tially rovers the odor of that drug. 



94 BALSAMUM TOLUTANUM — BAPTISIA. 

BALSAMUM TOLUTANUM, Balsam of Tolu,— is a 

balsam obtained from Myroxylon toluifera, a tree of the nat. ord. 
Leguminosae, native in Venezuela and New Granada. Its composi- 
tion and properties are similar to those of Balsamum Peruvianum, 
except that it is of lighter color, more agreeable odor, and con- 
tains a volatile oil, Tolene, in the proportion of about i per cent. 

Preparations, 

Tinctura Tolutana, Tincture of Tolu, — contains 10 per cent, of the 
balsam dissolved in 90 of alcohol. Dose, n#x-xxx. 

Syrupus Tolutanus, Syrup of Tolu, — has of the balsam 4 parts in 100 of 
sugar and water. Dose, £j-ij. Much used in cough-mixtures. Covers the 
taste of Chloral well. 

Physiological Action and Therapeutics. 

Balsam of Tolu has similar actions to those of Balsam of Peru, 
but being more agreeable in flavor it is used internally more than 
the latter. It is chiefly employed as a pleasant excipient in cough- 
mixtures, and is a constituent of the Compound Tincture of 
Benzoin. 



BAPTISIA, Wild Indigo (Unofficial),— is the root-bark of 
Baptisia tinctoria, a plant of the nat. ord. Leguminosae, native in 
North America, and contains an alkaloid and a resin, neither of 
which has been examined critically. The so-called Baptisin is 
an impure resinoid, obtained by precipitation from the alcoholic 
extract with water. 

Preparations. 

Extractum Baptisia, Extract of Baptisia (Unofficial). Dose, gr. j-x. 
Extractum Baptisia Fluidum (Unofficial). Dose, TUij-xx. 
Tinctura Baptisia (Unofficial). Dose, trtv-xxx. 
Baptisin (Unofficial), — the resinoid. Dose, gr. j-v. 

Physiological Action. 

Baptisia has a bitter and acrid taste ; in small doses it is laxa- 
tive, in large violently emeto-cathartic, and may excite severe 
gastro-intestinal inflammation. It is a decided stimulant of the 
liver, and increases the secretions of all the glandular appendages 
of the gastro-intestinal mucous membrane. It has considerable 
power as an antiseptic. 

Therapeutics. 

Baptisia has been used locally in decoction or cataplasm to 
obstinate and painful ulcers, in threatened or existing gangrene, 



BELLADONNA. 95 

and gangrenous sores. Internally, it is a useful remedy in amen- 
orrhea, typhoid and typhus fevers, variola, scarlatina, and epi- 
demic dysentery. In the common continued-fever, or in the first 
stage of typhoid, it will be found of great service in drop- doses 
of a fresh tincture, repeated every hour. 



BELLADONNA, Deadly Nightshade,— is an herba- 
ceous, perennial plant, of the nat. ord. Solanacese, having dark- 
purple, bell-shaped flowers, and glossy, purplish-black berries about 
the size of cherries. It is indigenous in the mountainous districts 
of Central and Southern Europe and Asia, and is cultivated in 
Europe and in the ynited States. It contains two alkaloids, — 
the official Atropi?ie (see below), and Beliadonnine, the latter 
being considered by many authorities as identical with Hyoscy- 
amine, Daturineand Duboisine. These exist in the plant in com- 
bination with Malic Acid. The plant also contains the usual 
vegetable constituents, as albumen, gum, etc., and a coloring 
principle named Atrosin. The official titles are as follows : 

Belladonna Folia, Belladonna Leaves, — ovate and tapering, 
brownish -green above, grayish -green below, of slight odor and 
bitter, disagreeable taste. Stramonium leaves are more wrinkled, 
Hyoscyamus leaves are more hairy. Dose, gr. j gradually in- 
creased. 

Belladonna Radix, Belladonna Root, — cylindrical, tapering, 
wrinkled pieces, ^ to 1 inch thick, nearly odorless, taste bitter 
and acrid. Dose, gr. j cautiously increased. 

Preparations of the Leaves. 

Extractum Belladonna Alcoholicum, — Dose, gr. £$-}&. 
Tinctura Belladonna, — 15 per cent. Dose, ^Uj-xxx. 
Unguentum Belladonna, — has of the Alcoholic Extract 10, Diluted Alco- 
hol 6, Benzoinated Lard 84. 

Preparations of the Root. 

Abstractum Belladonna, — Dose, gr. y^-j. 
Extractum Belladonna Fluidum, — Dose, TUj-v. 
Emplastrum Belladonna, — made with Resin Plaster. 
Linimentum Belladonna, — Fluid Extract 95, Camphor 5. 

Atropine and its Derivatives. 

Atropina, Atropine, C 17 H 23 N0 3 , — in white, acicular crystals, odorless, of 
bitter taste and alkaline reaction ; very soluble in alcohol and in chloroform, 
also in 600 of water at 59 F. Is decomposed by prolonged contact with 
caustic alkalies, and is resolvable into Tropin and Tropic Acid. 

Atropina Sulphas, Sulphate of Atropine (C n H 23 N0 3 ) 2 H 2 S0 4 , — a white 



g6 BELLADONNA. 

powder of bitter taste and neutral reaction, soluble in 0.4 of water and in 6.5 
of alcohol at 59 F. Dose, gr. x^—gV 

Homatropina, Homatropine, C 16 H 21 N0 3 (Unofficial), — is a derivative alka- 
loid obtained by the action of dilute HC1 on Amygdalate of Tropin. The 
Hydrobromate of Homatropine is used by ophthalmologists as a mydriatic, its 
effects passing off much sooner than those of Atropine. Homatropine slows 
the heart, Atropine quickening it. 

Tropeius (Unofficial), — is a result of the action of a mineral acid on Tropin. 

Physiological Action. 

Belladonna is an irritant narcotic, a mydriatic, an antispas- 
modic and an anodyne ; in small doses a cardiac, respiratory and 
spinal stimulant — in large doses a paralyzer of the cardiac and 
respiratory centres, the spinal cord, the motor nerves and invol- 
untary muscles. It produces congestion an8 dryness of the mu- 
cous membrane of the throat, mouth, nose and larynx, and at first 
lessens the gastric and intestinal secretions but soon reproduces 
these in large quantity. The heart-rate is at first slowed, but 
soon becomes very rapid and vigorous, the pulse being doubled 
in rapidity; the arterial tension being at the same time raised, 
the circulation is greatly increased. This is accomplished by 
stimulation of the cardiac sympathetic, and paralysis of the pneu- 
mogastric, thus stimulating the accelerator apparatus while les- 
sening the inhibitory. [Digitalis increases both.] . The vaso- 
motor ganglia are stimulated all over the body, but are afterwards 
paralyzed by over-stimulation, the heart weakens, the vessels 
relax, and the blood-pressure becomes greatly reduced. Com- 
plete motor paralysis follows, delirium, stupor, and finally death 
which usually occurs by asphyxia. 

The pupils are dilated by the local or systemic use of the drug, 
it stimulating the end-organs of the sympathetic and paralyzing 
those of the motor oculi, thus increasing the power of the radiat- 
ing iris fibres and lessening the action of its circular onec*k Atro- 
pine locally also paralyzes accommodation anaTSMMfetrreintra- 
ocular pressure. The least quantity of Atropine which will 
affect the pupil is stated at gr. Toihro (Wood), gr. 2ooo<r (Roosa), 
gr- whn ( Elv )> gr.T*i*rnr (Trousseau), gr. ¥ ^W (Loring), gr. 
Wooo (Donders). 

The brain is congested by Belladonna, headache, vertigo, busy 
delirium, hallucinations, etc., being produced, the latter from a 
selective action on the cells of the gray matter. The spinal cord 
is stimulated from the 3d cervical to the 10th dorsal vertebra, 
resulting in complete motor paralysis, central and peripheral, 
power being lost first in the lower extremities. Sensation is also 
impaired somewhat, but the muscular irritability is not. Respi- 



BELLADONNA. 97 

ration is increased and the body temperature elevated. Meta- 
morphosis is greatly promoted by the increased activity of the 
circulation. 

A diffused eruption of scarlet color, greatly resembling the 
eruption of scarlet fever, is often produced on the skin and fauces 
by Belladonna, with dysphagia and sore throat, and is sometimes 
followed by desquamation of the epidermis. It is due to capil- 
lary congestion caused by the greatly increased circulation. 

Belladonna is rapidly diffused and quickly eliminated particu- 
larly by the kidneys. The urine of an animal under the action 
of the drug will dilate the pupil of another animal. Herbivo- 
rous animals and birds are scarcely susceptible to it, and pigeons 
are not affected by it at all. 

Atropine has the same actions as above described, being the 
active principle of the plant. Belladonnine was long supposed 
to be inert, but has recently been shown to be identical with 
Hyoscyamine. It is a mydriatic when given internally, but not 
when used locally. 

Antagonists and Inco7npatibles. 

Opium is the physiological antagonist to the effects of Belladonna on the 
cerebrum, pupil, heart, respiration, arterial tension and kidneys. Physostig- 
mine, Aconite, Pilocarpine and Quinine are each antagonistic to some of its 
effects, Muscarine to most of them. In poisoning by this drug, Tannic Acid 
and emetics should be used, then Morphine, Physostigmine or Pilocarpine for 
the nervous disturbances. Caustic alkalies decompose Atropine and are 
therefore incompatible with the preparations of Belladonna. 

Therapeutics. 

Belladonna is one of the most valuable drugs in the Materia 
Medica, ranking with Aconite, Arsenic and Opium in efficacy 
and wide range of use. It is especially useful in the pain of in- 
flammation, particularly that of rheumatism, gout, neuralgia due 
to peripheral disturbance, sciatica, cancer and pelvic affections. 
In cerebral and spinal hypersemia, congestive headaches, ence- 
phalitis, meningitis and myelitis it proves one of the very best 
remedies. In erysipelas of superficial and non-vesicular character 
and when cerebral, it is really curative locally and internally 
administered. Inflammations of the lungs, iris, bladder, kidneys 
and breasts, are all amenable to it. In constipation from atony 
of the bowels it is remarkably efficient, and in the enuresis of 
children it is equally so if used freely, 10 to 20 drops of the tinc- 
ture thrice daily. In recent cystitis from chill, spasm of the 
urethra, bladder and sphincter ani, typhus and typhoid fevers, 
acute nasal catarrh, sore throat with fever, inflammation, and 



98 BENZINUM. 

swollen tonsils, many skin diseases, asthma and whooping-cough, 
epileptic and puerperal convulsions, spermatorrhoea and seminal 
losses, Belladonna is often a highly useful agent. Its local appli- 
cation is efficiently used in ulcers of the rectum, anal fissure, ab- 
scesses, boils, carbuncles, and other superficial inflammations. In 
scarlet fever it relieves many of the symptoms, and is especially 
indicated in this disease when the rash is imperfect, the pulse 
feeble and the condition one of adynamia. Its prophylactic power 
against scarlet fever is believed in by many of our best practi- 
tioners, though questioned by many others. 

Atropine is used in poisoning by Opium, Physostigma, and 
Prussic Acid ; in ptyalism from mercury, pregnancy, etc. ; in the 
sweats of phthisis, sudden cardiac failure, and by eye-surgeons to 
paralyze accommodation, dilate the pupil, contract the vessels, 
lessen pain, and diminish intraocular tension. In opium-poi- 
soning it should be given in very small doses and repeated for 
effect, as most of the unsuccessful cases of its use in this connec- 
tion were due to overdosing with the antagonist, superinducing 
belladonna-narcosis upon the opium-narcosis. In cases of heart- 
failure from Chloroform or Ether inhalation the hypodermic in- 
jection of Atropine has in the writer's hands saved several lives 
when all other methods of resuscitation had failed. 



BENZINUM, Benzin, Petroleum Ether, — isapurified 
distillate from American petroleum, consisting of hydro-carbons, 
chiefly of the marsh-gas series, having a specific gravity from 0.670 
to 0.675, an d boiling at 122 to i4o°F. It is a transparent, color- 
less liquid, highly inflammable, very diffusive, insoluble in water, 
but soluble in alcohol, ether, etc. It should be distinguished 
from Benzol, which is called Be?izene by English chemists. In 
pharmacy it has many uses, on account of its powers as a solvent 
for oils, fats, resins, caoutchouc and some alkaloids. Dose, gtt. 
v-x, on sugar or in mucilage. 

Physiological Action and Therapeutics, 

Benzin is reported to have caused death in one case from gas- 
tro-enteritis, but ordinarily it does not produce vomiting or diar- 
rhoea. It has been used with some success externally as a remedy 
for rheumatic pain, neuralgia, itch and prurigo ; and internally 
as a vermicide against tapeworm. Its chief value is that of a 
solvent in cleaning old clothing and in pharmaceutical operations. 



BENZOINUM. 99 

BENZOINUM, Benzoin, — is a balsamic resin obtained 
from Styrax Benzoin, a tree of the nat. ord. Styraceae, native in 
Sumatra andSiam, by incision of its bark. It occurs in agglutinated 
tears or a brown, mottled mass, is soluble in alcohol and solution 
of potassa, and is composed of Resins 80 per cent., Benzoic Acid 
10 to 20 per cent., and a trace of Volatile Oil. Some varieties 
of benzoin yield also Cinnamic Acid. 

Preparations of Benzoin. 

Adeps Benzoinatus, Benzoinated Lard, — has of Benzoin 2 parts in 100 
parts of Lard. 

Tinctura Benzoini, Tincture of Benzoin, — has of Benzoin 20 parts, Alco- 
hol q. s. ad 100. Dose, ^ss-j. 

Tinctura Benzoini Composita, Friar's Balsam, — has of Benzoin 12, 
Aloes 2, Styrax 8, Balsam of Tolu 4, Alcohol q. s. ad 100 parts. Dose, gss- 
ij- 

Preparations of Benzoic Acid. 

Acidum Benzoicum, Benzoic Acid, HC 7 H 5 21 , — occurs in light, feathery 
plates and needles, and is obtained from Benzoin by sublimation. It is sol- 
uble in 500 of water, and in 3 of alcohol at 59 F., but its solubility in water 
is aided by Borax, one part of each being soluble in 100 parts. It is a con- 
stituent of Tinctura Opii Camphorata. Dose, gr. x-xxv, in wafers. 

Ammonii Benzoas, Benzoate of Ammonium, — is soluble in 5 parts of 
water and in 28 of alcohol. Dose, gr. v-xxx. 

Lithii Benzoas, Benzoate of Lithium, — soluble in 4 parts of water and in 
12 of alcohol. Dose, gr. v-xxx. 

Sodii Benzoas, Benzoate of Sodium, — is efflorescent on exposure to air, 
soluble in 2 parts of water and in 45 of alcohol. Dose, gr. v-^j. 

Physiological Action. 

Benzoin is decidedly antiseptic and disinfectant, and when 
used externally is somewhat stimulant to the vessels. Its actions 
are due to its Benzoic Acid, which taken internally produces 
slight epigastric heat, increases the pulse-rate, and stimulates the 
action of the skin, the salivary glands, and of the bronchial mu- 
cous membrane. It is chiefly excreted by the kidneys, in part as 
hippuric acid by combination with glycocoll, and in part un- 
changed. It renders the urine acid and increases its quantity. 
Benzoin is irritant to the fauces, and the powder inhaled excites 
sneezing and coughing. 

Therapeutics. 

Benzoin is principally used as a stimulant expectorant, espe- 
cially in the chronic bronchitis of the aged, and by atomization in 
laryngeal affections. It has also been used beneficially in chlo- 
rosis and some uterine disorders. The compound tincture is a 



IOO BERBERIS. 

good local application (i to 4 of Glycerin) for sore nipples and 
chaps of the hands and lips. For use as a cosmetic, either tinct- 
ure is mixed with 20 parts of water, and employed to remove 
freckles and other skin eruptions. They are excellent applica- 
tions to foul-smelling wounds, and form the basis of all the pro- 
prietary preparations sold for that purpose. 

Benzoic Acid and its salts are the only certain means we 
possess, by which to neutralize morbid alkalinity of the urine. 
In cystitis, with phosphatic deposits and alkaline urine, they are 
extremely valuable, acidulating the secretion, and stimulating 
and disinfecting the mucous surfaces involved. Phosphatic cal- 
culi are said to be dissolved by the long-continued use of Ammo- 
nium Benzoate. 

Benzoate of Sodium has been largely used as a substitute for 
the salicylates in the septic diseases, being equally antiseptic and 
antipyretic. Though slower in action, its effects are more per- 
manent, and it is capable of being used in larger closes (3y _n j 
daily). In diphtheria and scarlet fever it has been highly effi- 
cient, and in acute rheumatism, typhoid and the malarial fevers, it 
has rendered good service. In phthisis its use by inhalation to 
the extent of T ^ of the body- weight daily has seemed to be of 
value in some cases. It has also proven very efficient in whoop- 
ing-cough. 

Benzoate of Lithium is intended for use in gout and the uric 
acid diathesis, with the object of forming the very soluble urate 
of lithium in the system, as also on the theory that, as benzoic 
acid is converted into hippuric acid at the expense of nitrogenous 
material which would otherwise become uric acid, the latter pro- 
duct will be lessened. 



BERBERIS, Barberry (Unofficial),— is the root of several 
species of the nat. ord. Berberidaceae, the one generally used 
being the BerbeiHs aquifolium, or Oregon grape, which grows on 
the Pacific slope of the United States. Its value is probably due 
to its alkaloid, Berberine, C 20 H 17 NO 4 , a yellow, crystalline body, 
soluble in hot water and alcohol, but not in ether, which is found 
also in several other plants, as Hydrastis, Coptis, Podophyllum 
Menispermum, Calumba, Xanthoxylum, etc. 

Preparations. 

Extractum Berberidis Fluidum (Unofficial), — Dose, ttlv-xxx. 

Tinctura Berberidis (Unofficial), — 1 to 5. Dose, -rrtx-^j. 

Berberina, Berberine (Unoffic'al), — Dose, gr. j-x. Usually occurs in 



BERGAMII OLEUM BISMUTHUM. 10 1 

commerce as u Hydrastin," which is a Muriate of Berberine, prepared from 
Hydrastis. 

Physiological Action and Therapeutics. 

Berberis is an astringent bitter, a tonic and stomachic in 
small doses, but in large doses it is cathartic, producing watery 
diarrhoea with abdominal pain. It is also believed to possess 
considerable alterative powers. 

Berberine has some antiseptic and antiperiodic value, and in 
large doses is a gastro-intestinal irritant. 

Berberis has been successfully used as a local application in 
conjunctivitis, and internally as a remedy for intermittent, remit- 
tent and typhoid fevers, diarrhoea and dyspepsia. As an alter- 
ative and tonic it has been found useful in syphilitic and stru- 
mous affections, and in pain, soreness and burning sensations 
along the biliary or urinary tracts with a tendency to gravel or 
gall-stones it will be found a useful remedy. 

The Muriate of Berberine is a useful injection in gonorrhoea, 
in which it acts by virtue of its antiseptic and astringent powers. 



BERGAMII OLEUM, Oil of Bergamot,— is a volatile 
oil, extracted from the rind of the fresh fruit of Citrus Berganiia, 
an orange-tree of the nat. ord. Aurantiaceae, native in Southern 
Europe. It is of greenish color, faintly acid, sp. gr. 0.87, and 
is soluble in alcohol, glacial acetic acid and liquor potassae. It 
contains several hydrocarbons of the formula C 10 H 16 , together 
with Bergaptene or Bergamot Camphor. It is an ingredient of 
Spiritus Odoratus, and is exclusively used as a perfume in the 
manufacture of toilet articles. 



BISMUTHUM, Bismuth, Bi,— is represented by three of 
its salts, and one combination of the Citrate with Aqua Ammoniae. 

Preparations. 

Bismuthi Citras, Citrate of Bismuth, BiC 6 H 5 7 , — is a white, amorphous 
powder, odorless and tasteless, insoluble in water or alcohol, but soluble in 
water of ammonia. Used only for pharmaceutical purposes. 

Bismuthi et Ammonii Citras, Citrate of Bismuth and Ammonium, — is 
not proven to have any definite composition. Small, pearly scales, very sol- 
uble in water. Dose, gr. j-v. 

Bismuthi Subcarbonas, Subcarbonate of Bismuth (BiO\ 2 C0 3 .H 2 0, — is a 
white or yellowish-white powder, tasteless, insoluble in water or alcohol. 
Dose, gr. x— gj, in powder or emulsion. 

Bismuthi Subnitras, Subnitrate of Bismuth, BiOX0 3 .H 2 0, — a heavy, 



102 BOLDUS. 

white powder, odorless and almost tasteless, slightly acid, insoluble in water 
or alcohol. Dose, gr. x-^j. 

Physiological Action. 

The action of the last two Bismuth salts is chiefly a local one, 
being sedative to the end-organs of the nerves, though a minute 
quantity passes into the blood and acts as a tonic, promoting con- 
structive metamorphosis by increasing the appetite and digestion. 
They are also feebly astringent, and produce constipation after 
a time, coloring the stools and tongue a dark clay color, from 
their conversion in part into the sulphide. Toxic effects when 
occurring are due to Arsenic, with which the commercial prepa- 
rations are usuallv contaminated. 

The Citrate of Bismuth and Ammonium, being soluble, is more 
rapid in action, more astringent and probably more irritant, 
though it is probably precipitated in the stomach by the hydro- 
chloric acid of the gastric juice. 

Therapeutics. 

The insoluble Bismuth salts are used internally in many forms 
of disordered digestion, gastralgia, vomiting and diarrhoea, espe- 
cially in children, but large doses are necessary for efficiency. 
The best vehicle for them is milk. Locally they are used with ad- 
vantage in acne rosacea, stomatitis, nursing sore mouth, eczema, 
intertrigo, ulcers, conjunctivitis, coryza, gonorrhoea, gleet and 
leucorrhcea. The Citrate is not used except for pharmaceutical 
purposes, and the Citrate of Bismuth and Ammonium is only 
serviceable in diarrhoea without irritation of the intestinal mucous 
membrane, but rather with relaxation thereof. 



BOLDUS, Boldo (Unofficial), — the leaves and stems of 
Peiunus Boldus, an evergreen shrub of the nat. ord. Monimiaceae 
found in Chili. It contains a volatile oil and a bitter alkaloid, 
Boldine. A tincture is made (i to 5), of which the dose is 
"niv-viij, gradually increased, but large doses have a somewhat 
narcotic effect, besides causing vomiting and purging. 

Thei'apeutics. 

Boldo is used in anaemia, rheumatism, dyspepsia and general 
debility, also in catarrhal affections of the urinary passages, and 
as a substitute for Quinine. In France it is employed as a tonic, 
especially for cases with chronic torpor of the liver; and in South 
America it is much used in gonorrhoea and in chronic cystitis. 



BRAYERA — BROMUM. IO3 

BRAYERA, Kousso, — is the female inflorescence of Bray- 
era anthelmintic a, an Abyssinian tree of the nat. ord. Rosacea^. 
It occurs in bundles or rolls, of fragrant, tea-like odor, and bitter, 
nauseous taste, and contains tannic acid, a volatile oil, and a crys- 
talline principle named Koussin, which by itself is apparently inert. 
Dose of Bray era, 5iJ~5j- 

Preparations. 

EXTRACTUM BRAYERA FLUIDUM, — Dose, .^ij-gj. 

Infusum Brayer^e, — 6 per cent. Dose giv-viij or more. 

Physiological Action and Therapeutics. 

Kousso has little or no effect except the nausea, vomiting, colic 
and slight diarrhoea produced by large doses. Its chief action is 
anthelmintic against both varieties of tape-worm, but it rarely 
expels the head of the parasite, and is very nauseous to the taste 
and difficult of retention by the stomach in the large doses ne- 
cessary to efficiency. 3u t0 oj of tne flowers infused in %\v of 
boiling water is the usual dose, and should be taken on an empty 
stomach and followed by a castor-oil or saline purge after 3 or 4 
hours. An emulsion of the official infusion with castor-oil, yolk 
of egg, a few drops of ether and oil of anise with 10 to 20 drops 
of Oleoresin of Male- fern, is more agreeable and efficient than 
the infusion alone. 



BROMUM, Bromine, Br, — is a dark, brownish-red, vola- 
tile liquid, evolving an irritant vapor of peculiar and suffocating 
odor. It is soluble in 33 of water at 59 F., very soluble in 
alcohol, ether, chloroform and carbon disulphide; is a non- 
metallic element found in sea-water, and in the mother-liquor 
of certain salt-works, usually in combination. It is only used by 
inhalation and as an escharotic. 

Bromides and their Preparations, 

Potassii Bromidum, Bromide of Potassium, KBr, — colorless, cubical crys- 
tals, soluble in 1.6 of water, and 200 of alcohol. Dose, gr. v-^j. 

Sodii Bromidum, Bromide of Sodium, NaBr, — colorless, monoclinic crys- 
tals, soluble in 1.2 of water, and 13 of alcohol. Dose, gr. v-gj. 

Lithii Bromidum, Bromide of Lithium, LiBr, — a white, granular, deli- 
quescent salt, very soluble in water and alcohol. Dose, gr. v-xx. 

Ammonii Bromidum, Bromide of Ammonium, NH 4 Br, — colorless, pris- 
matic crystals, soluble in 1.5 of water, and 150 of alcohol. Dose, gr. v-xx. 

Calcii Bromidum, Bromide of Calcium, CaBr 2 , — a white, granular, deli- 
quescent salt, very soluble in water and alcohol. Dose, gr. v-^j. 

Zinci Bromidum, Bromide of Zinc, ZnBr 2 , — a white, granular, deliques- 
cent powder, very soluble in water and alcohol. Dose, gr. j^-ij. 



104 BROMUM. 

Syrupus Ferri Bromidi, Syrup of Bromide of Iron, — is a syrupy liquid 
containing 10 per cent, of Ferrous Bromide, FeBr 2 , prepared by acting on Iron 
Wire 35 parts with Bromine 75, adding Sugar 600 and Water up to 1000 parts. 
A translucent, pale-green, odorless liquid of sweet, ferruginous taste and neu- 
tral reaction. Dose, ^ss-j. 

[Hydrobromic Acid is described on page 26, Ethyl Bromide on page 
43, and Camphora Monobromata under Camphora.] 

Physiological Action. 

Bromine is an active and very painful escharotic, a deodorant 
and an antiseptic, setting free ozone. Its vapor is highly irritant 
to the respiratory mucous membrane and the eyes, producing 
cough, hoarseness and dyspnoea. Internally, it is an active, cor- 
rosive poison, causing violent gastritis, depression and collapse. 

The Bromides are cerebral and spinal depressants, alteratives, 
antispasmodics and hypnotics. They have a disagreeable, saline 
taste, and are very diffusible, but slowly eliminated. They are 
decomposed in the blood, and reformed at the points of elimina- 
tion (fauces, bronchi, intestines, skin and kidneys), where they 
irritate the mucous membranes. Continued for some time, they 
produce severe gastric catarrh. They reduce the number of the 
respirations and the heart's action and force, and, though dimin- 
ishing the calibre of the arterioles, they lower arterial tension. 
They produce somnolence by lessening the activity of the brain- 
cells, — diminish the sensibility of the peripheral nerves, causing 
anaesthesia of the skin and mucous membranes, — impair motility 
and the sexual function. They also cause pallor, emaciation, 
lowered body-temperature, acne on the face and upper extremi- 
ties, fetid breath, dysphagia, sluggish reflexes, defective coordi- 
nation, and, if long-continued, may even impair the mental fac- 
ulties, producing melancholia with suicidal tendency and periph- 
eral paralysis extending to the centres. The general result of 
their action is termed " Bromism," and this condition is heralded 
by the acne and lowered faucial sensibility. It is probably due 
to the sedative influence of these agents on the sympathetic ner- 
vous system, causing a general anaemia of the brain, spinal cord, 
sexual organs and skin. 

Potassium Bromide is the most paralyzant to the heart and 
muscles, and is the least hypnotic. It contains less bromine than 
the others, 66 per cent. 

Sodium Bromide is the least toxic, but the most hypnotic, and 
is most energetic in its action on the circulation. It contains 78 
per cent, of bromine. 

Ammonium Bromide resembles the potassium salt in action, 



BROMUM. IOS 

except that it exerts less influence on the heart and muscular sys- 
tem, and is more stimulating. 

Lithium Bromide contains the most bromine, 92 per cent., 
and resembles the sodium salt in action. It has proved better 
than the others in some cases of epilepsy, and is by several au- 
thorities considered to be the best hypnotic of the series. 

Calcium Bromide is an efficient hypnotic, but otherwise much 
less active than the other salts. 

Zinc Bromide, in large doses, is violently irritant. It is sup- 
posed to combine the tonic effects of zinc with the sedative actions 
of the bromides. 

Ferrous Bromide is official only in the Syrup. It is supposed 
to combine the actions of iron and the bromides, and to produce 
the effects of a sedative chalybeate tonic. It is not an eligible 
chalybeate. 

Antagonists and Incompatibles. 

The physiological actions of the Bromides are antagonized by agents which 
stimulate the vaso-motor nerves, as Digitalis, Ergot, Belladonna, etc. Nitrous 
Ether is incompatible with the ammonium salt, and acids and metallic salts 
with all the Bromides. 

Therapeutics. 

The Bromides are used as sedatives to the nervous system, to 
lower reflex activity and excitement of the genital apparatus, and 
to produce sleep. They are contraindicated in anaemic condi- 
tions. The much-employed combination of the potassium salt 
with chloral is particularly unsafe where fatty or weak heart ex- 
ists, both drugs being active cardiac depressants. In convulsive 
and spasmodic affections the bromides are very efficient, and in 
epilepsy, especially when the seizures are diurnal, the sodium salt 
is used with great advantage over a long period, in sufficient 
quantity to maintain anaesthesia of the fauces. It requires occa- 
sional purgation to prevent its accumulation, and arsenic to com- 
bat the acne. In diabetes of nervous origin, the ammonium salt, 
long used, has proved curative by its sedative influence on the 
medulla ; and in acute rheumatism it is an excellent alkali. In 
muscular rheumatism, rheumatic arthritis and myalgia, the lithium 
salt gives good results, and in tetanus and strychnine-poisoning 
the potassium salt, in large doses, is antagonistic. These agents are 
generally efficient in nervous erethism, insomnia with congestion, 
infantile colic, cholera infantum, vomiting of cerebral origin, 
cardiac irritability when not due to anaemia, delirium tremens, 
melancholia, whooping cough and other reflex coughs, seminal 
losses when plethora exists, and nymphomania. The potassium 
salt is, by some writers, considered almost specific in subinvolu- 

9 



106 BRYONIA. 

tion of the womb, and uterine hemorrhage not due to a mechan- 
ical cause. 

Bromine is not much used. Its vapor may be inhaled from 
hot water in acute coryza, hay-asthma, etc., and in chancre and 
hospital gangrene it is the best escharotic. In diphtheria and 
membranous croup, a solution of -rriyiij to the g, used internally, 
and inhalation of the vapor have been used successfully in the 
most severe cases. 

The Syrup of the Bromide of Iron has been reported by some 
observers as very efficient in chorea, and its usefulness as stren- 
uously denied by others. 



BRYONIA, Bryony, — is the root of Bryonia alba and of 
Bryonia dioica, European perennial plants of the nat. ord. Cucurbi- 
tacese. It occurs in transverse sections about 2 inches in diameter, 
having numerous small wood-bundles arranged in circles and 
projecting lines in the central portion, which is white or grayish. 
Its taste is acrid and bitter, but it is inodorous. The active prin- 
ciple is the glucoside Bryonin, C^H^O^, which is intensely bitter, 
and soluble in water and in alcohol, but insoluble in ether. Dose, 
of the powdered root, gr. x-xxx. 

Preparations. 

Tinctura Bryonia, Tincture of Bryonia, — a 10 per cent, solution of the 
root in alcohol. Dose, n^v-^ss. 

Bryonin f Unofficial), — is a violent poison in doses of from 3 to 4 grains. 
Dose, as a drastic purgative, gr. y^ - y^. 

Physiological Action. 

Bryonia is a pure irritant, setting up local inflammation wher- 
ever applied, with febrile phenomena. It has a vesicant action on 
the skin, and is violently irritant to the serous and mucous mem- 
branes. Taken internally, it has caused fatal gastritis; introduced 
into the pleura, fatal pleuritis has resulted with fibrinous effusion. 
It has a specific determination to serous and synovial membranes, 
especially the pleurae, and is also irritant to muscular fibre, and 
to the bronchial mucous membrane, causing dry, continuous, 
shaking cough, with soreness behind the sternum. It produces 
cerebral congestion, with frontal headache, vertigo, and epistaxis; 
also, hepatic and renal congestion, burning pain and tenderness 
in the hepatic region with bilious disturbance amounting some- 
times to severe jaundice, vesical tenesmus, and depression of the ac- 
tion of the heart. It is a drastic purgative and a powerful diuretic. 



BUCHU. I07 

Therapeutics. 

Bryonia is a very old medicine, its most ancient reputation 
having been in epilepsy, hysteria and mania, conditions in which 
it is now superseded by other agents. It is a most valuable drug 
in the second stage of serous inflammations, especially in pleurisy, 
pleuro-pneumonia, and pericarditis, after Aconite has reduced 
pyrexia, to limit the extent of the effusion and to promote its 
absorption. For this, small doses frequently repeated are required. 
Also, in rheumatic fever, after the swelling of the joints has been 
reduced by other means, Bryonia is extremely efficient for the 
pain and stiffness. It is one of the best remedies for a " cold- 
on-the-chest, M with dry, shaking cough, soreness, or shooting 
pains. It has been used with success in common, continued, or 
" gastric" fever, relapsing fever, congestive headaches increased 
by stooping, bilious headache with vomiting, gastralgia with 
pyrosis and soreness of the epigastrium, constipation, cholera 
infantum during dry, hot weather, congestion of the liver, croup, 
and threatened mammitis. Pains of shooting or tearing character, 
which are increased by movement, are often quickly relieved by 
this drug. In dropsies of various forms it is used as a drastic 
purgative and diuretic to remove the accumulated fluid. 



BUCHU, — is the leaf of Barosma betulina, B. crenulata, and 
B. serratifolia, S. African shrubs, of the nat. ord. Rutaceae, each 
species having differently-shaped leaves, but all the leaves having 
crenated or serrated margins, and conspicuous oil-glands at the 
edges and on their under surface. They contain a Volatile Oil, 
which is probably the active principle, and gives them a peculiar 
and penetrating odor, resembling that of peppermint ; also, 
Barosmin, a bitter extractive, and resin, gum, lignin, etc. Dose, 
of the leaves, gr. xv-xxx. 

Preparations. 

Extr actum Buchu Fluidum, — Dose, -nix- gj. 

Infusum Buchu ^Unofficial), — gj to the pint. Dose, gss-ij. • 

Physiological Action. 

Buchu in small doses causes a sense of heat in the stomach, 
which is gradually diffused over the body. It increases the pulse- 
rate, stimulates the appetite, and produces slight moisture of the 
skin. It increases the flow of urine, which becomes of darker 
color and strongly aromatic odor, and deposits a brownish 
sediment. 



108 CADMIUM — CAFFEA. 

In large doses, it produces vomiting, purging, and strangury, 
with a burning sensation at the stomach. 

Therapeutics. 

Buchu is of especial value in chronic affections of the genito- 
urinary mucous membrane, on which the volatile oil acts topically, 
being eliminated by the kidneys. It is a very useful remedy in 
pyelitis, cystitis, and urethritis ; also, in lithiasis, chronic bron- 
chitis, and affections of the prostate gland. It is recommended 
in atonic dyspepsia, chronic rheumatism, affections of the skin, 
and for dropsy, but it is not so actively diuretic as to be very 
efficient in the latter condition. 

The infusion makes an excellent vehicle for saline diuretics. 



CADMIUM, Cd (Unofficial).— This metal was official in 
the Pharmacopoeia of 1870, but is no longer so. In its physio- 
logical action it resembles both Antimony and Zinc, being 
escharotic, astringent, and a very depressant emetic. In .over- 
doses, its salts act as irritant poisons, with cerebro-spinal symp- 
toms, such as coma and convulsions. It is never used internally. 
Its salts in general use are — 

Cadmii Sulphas (Unofficial), — transparent oblique prisms, efflorescent, and 
very soluble in water. Used externally in a solution of gr. ss - iv ad gj aq. 
destil., or as an ointment (1 to 40 of fresh lard). 

Cadmii Iodidum (Unofficial), — large, white, pearly crystals, soluble in water 
and alcohol. Used as an ointment, I to 8 of lard. 

Therapeutics. 

The Sulphate has been used almost exclusively as a stimulating 
astringent in gonorrhoea and diseases of the eye. Corneal 
opacities are absorbed under the use of a solution of gr. ij to the 
§, and in gonorrhoea a mild injection (gr. ^ ad gj) is very 
beneficial. The ointment of the Iodide has been usefully em- 
ployed for enlarged glands, chronic joint affections, cutaneous 
diseases,* nodes and chilblains. 

CAFFEA, Coffee, — the seed of Coffea Arabica, is officially 
represented only by its active principle, Caffeine. The coffee- 
plant is a small tree, of the nat. ord. Rubiaceae, 15 to 30 feet high, 
native of South Arabia and Abyssinia, but cultivated in various 
parts of the world. Its seeds contain Caffeine (partly free, partly 
as a tannate), tannic and caffeic acids, sugar, legumin, etc. By 
roasting them, part of the caffeic acid is converted into methyla- 



CAFFEA. IO9 

mine, the sugar is changed into caramel, and an empyreumatic 
oil is developed. 

Preparations. 

Caffeina, Caffeine, C 8 H 10 N 4 O 2 .H 2 O, — is a proximate principle of feebly 
alkaloidal power, existing in the seeds and leaves of Coffea Arabica, Camel- 
lia Thea, Paullinia sorbilis, and other plants (also made artificially), being 
identical with Theine and Guaranine, and containing more nitrogen than 
almost any other proximate vegetable principle. It occurs in colorless, flex- 
ible crystals, which are soluble in 75 of water and 35 of alcohol at 59 F. 
Dose, gr. j-v. 

Caffeine Citras (Unofficial), — Dose, gr. j-v. 

Extr actum Caffe^e Viridis Fluidum (Squibb), Fluid Extract of Green 
Coffee (Unofficial), — is intended as a substitute for the Fluid Extract of Gua- 
rana. Dose, 3ss-ij. [Compare the title Guarana.] 

Physiological Action. 

Coffee is a cerebro-spinal stimulant, a stomachic tonic, and a 
laxative. It is decidedly diuretic, and somewhat antiperiodic 
and antiseptic. The green bean produces very different effects 
from those of the roasted one. It increases secretion, blunts sen- 
sation, exalts reflex excitability, increases mental activity, and 
produces insomnia and nervous restlessness. It first briefly stim- 
ulates the heart, and raises arterial tension, but soon depresses 
both. The wakefulness is preceded by a brief period of drowsi- 
ness. 

As a beverage, it assists digestion, promotes intestinal peristal- 
sis, allays the sense of fatigue and of hunger, lessens tissue-waste, 
and consequently the excretion of urea. Used to excess it dis- 
orders digestion, and causes functional disturbance of the nervous 
system, shown by headache, vertigo, mental confusion and pal- 
pitation of the heart. 

Caffeine is poisonous to the smaller animals, exalting reflex 
excitability by direct action on the spinal cord, and producing 
tetanus. In large doses it paralyzes both the cardiac muscle and 
its ganglia in dogs, and if given in sufficient quantity, would 
doubtless prove toxic to man. It is an efficient diuretic, and is 
excreted unchanged in the bile and urine. 

Comparison of the Stimulant Beverage:* 

Coffee is more stimulating than Coca, and less sustaining. It is apt to 
cause severe palpitation of the heart, and may greatly disorder digestion. 

Tea [Camellia Tkea) is the most refreshing and stimulating member of 
the group. Used to excess it affects the stability of the motor system, causing 
tremulousness of the limbs. It is apt to produce flatulent dyspepsia in those 
addicted to its use. Theine is identical with Caffeine. 

Coca (Erytkroxylon Coca) is more sustaining, and less of a stimulant. It 



110 CAJUPUTI OLEUM. 

also markedly lessens the sense of fatigue. Cocaine resembles Caffeine, but 
is not identical therewith. 

• Cocoa ( Theobroma Cacao) is more directly nutritious than any member of 
the group, containing a large quantity of fat (Oleum Theobromae), which, 
however, makes it difficult of digestion to many persons. Theobromine re- 
sembles Caffeine, but contains more nitrogen. 

Mate [Ilex Paraguay ensis) contains Caffeine, and is supposed to have 
effects intermediate between those of tea and coffee. 

Guarana (Patillinia sorbilis) is especially noted as a remedy for migraine. 
Its alkaloid, Guaranine, is identical with Caffeine. (Compare the title 
Guarana.) 

Therapeutics. 

Coffee and Caffeine are valuable as stimulants in many forms 
of nervous depression, and have proved especially efficient in head- 
aches of nervous or neuralgic type, gastric catarrh with periodical 
attacks of migraine, choleraic diarrhoea, cervico-brachial neural- 
gia, dropsies both cardiac and renal, hay fever, insomnia of 
chronic alcoholism, adynamic fevers as a stimulant in lieu of al- 
cohol, intermittent^ and spasmodic asthma. In lithaemia and 
gout, a tincture of the green bean has marked power as an elimi- 
nating agent. In opium-narcosis, strong black coffee is most 
efficacious in antagonizing the increasing torpor of the nerve- 
centres, and acts better than Caffeine. 



CAJUPUTI OLEUM, Oil of Cajuput,— is a volatile oil 
distilled from the leaves of Melaleuca Cajuputi, a tree of the nat. 
ord. Myrtaceae, native of the Molucca Islands. It is a bluish- 
green or colorless liquid, of camphoraceous odor, and neutral 
reaction. Specific gravity about 0.920, freely soluble in alcohol. 
It contains Cajuputol or Bihydrate of Cajuputene, which forms 2 /z 
of it, the other y$ being another oil. Dose, ttvj-v. 

Physiological Action and Therapeutics. 

Cajuput Oil resembles Oil of Turpentine, and has similar ac- 
tions to those of the other volatile oils, being a stimulant carmi- 
native, somewhat diuretic and diaphoretic, antiseptic, parasiticide 
and anthelmintic. Externally used, it is irritant to the skin. 
Swallowed, it produces a sense of warmth in the stomach and 
accelerates the pulse. 

It is not much used internally, though it has been given with 
benefit in flatulent colic, dropsy, hysteria, chronic rheumatism, 
scrofula, syphilis, elephantiasis and other cutaneous disorders. 
Externally, as a strong, stimulating rubefacient, it is efficient in 
chilblains, muscular rheumatism and nervous headaches. 



CALAMUS — CALCIUM. 1 1 I 

CALAMUS, Sweet Flag, — is the rhizome of Acorus Cala- 
mus, a plant of the nat. ord. Aracese, native in Europe and North 
America, having an aromatic odor and pungent taste. The un- 
peeled root should only be used, peeled or bleached calamus 
being almost inert. It contains a volatile oil and Acorin, which 
is a nitrogenous, bitter principle, also benzoic acid, starch, etc. 
Dose, indefinite. 

Preparation. 

Extractum Calami Fluidum, — is made with Alcohol as a menstruum. 
Dose, TTI.XV-3J. 

Physiological Action and Therapeutics. 

Calamus is an aromatic bitter, and stomachic tonic, increasing 
the appetite and stimulating digestion. It is one of the constit- 
uents of the preparations termed " bitters/' and is chewed as an 
appetizer. 



CALCIUM, Ca, — is the metal characteristic of Lime, Chalk 
and all calcareous substances, and though itself unofficial is 
represented by several official salts and preparations. 

Official Salts of Calcium. 

Calcii Carbonas Pr^ecipitatus, Precipitated Carbonate of Calcium, 
CaC0 3 , — a fine, impalpable, white ^powder, odorless and tasteless, insoluble 
in water or alcohol, but soluble in mineral acids or acetic acid with efferves- 
cence. Creta (chalk) is the native carbonate of calcium (see below). Dose, 
gr. v-xx. 

Calx, Lime, Oxide of Calcium, CaO, — hard, white masses, gradually re- 
solving to a white powder in the air, odorless, of sharp, caustic taste and alka- 
line reaction, soluble in 750 of water and 1300 of boiling water, insoluble in 
alcohol. Not used internally except in solution. Is a constituent of Potassa 
cum Calce. (See under Potassium.) 

Calcii Chloridum, Chloride of Calcium, CaCl 2 , — hard, colorless masses, 
deliquescent, of sharp, saline taste, soluble in iy^ of water and 8 of alcohol 
at 59 F. Dose, gr. x-xx in solution. 

Calcii Bromidum, — described under Bromides, ante page 103. 

Calcii Hypophosphis. — described under Phosphorus. 

Calcii Phosphas Pr^ecipitatus, — described under Phosphorus. 

Calcii Sulphidum, — described under Sulphur. 

Preparations of the Carbonate. 

Creta Preparata, Prepared Chalk, — is native Carbonate of Calcium freed 
from most of its impurities by elutriation ; a white, amorphous powder, odor- 
less and tasteless, insoluble in water or alcohol. Dose, gr. v-xx. Is a con- 
stituent of Hydrargyrum cum Creta, and also of the following: 

Pulvis Cret^: Compositus, Compound Chalk Powder, — has of Prepared 
Chalk 30, Acacia 20, Sugar 50 parts. Dose, gr. V-3J. 



1 1 2 CALCIUM. 

MiSTURA Cret^e, Chalk Mixture, — has of the preceding 20 parts, Cinna- 
mon Water 40, Water 40, rubbed together and made fresh as required. 
Dose, gss. 

Trochisci Cretve, Troches of Chalk, — each contains of Prepared Chalk 4 
grains, Acacia 1, Sugar 6, with a little Nutmeg. Dose, indefinite. 

Testa Preparata, Prepared Oyster-shell (Unofficial), — contains animal 
matter intimately mixed with the carbonate of calcium. Dose, gr. x-xx or 
more. 

Preparations of the Oxide. 

Liquor Calcis, Solution of Lime, Lime-water, — contains about 0.15 per 
cent, of Calcium Hydrate, Ca(HO) 2 . A clear, colorless liquid, of saline taste 
and alkaline reaction. Dose, .^ss-ij. 

Syrupus Calcis, Syrup of Lime, Saccharated Solution of Lime, — contains 
5 per cent, of Lime, 30 of Sugar, the latter aiding the solvent power. Dose, 
gss-ij. Is the antidote to poisoning by carbolic or oxalic acid. 

Linimentum Calcis, Lime Liniment, — contains equal parts of Liquor 
Calcis and Cotton-seed Oil. Is nearly the same as the application known as 
"Carron Oil." 

Calx Chlorata, — described under Chlorine. 

Calx Sulphurata,— described under Sulphur. 

Potassa cum Calce, — described under Potassa. 

Preparations of the Phosphate and Hypophosphite. 

Syrupus Calcii Lactophosphatis, 1 described under 

Syrupus Hypophosphitum, \ Phosphorus 

Syrupus Hypophosphitum cum Ferro, J 

Physiological Action. 

Lime before it assumes the condition of Hydrate is irritant and 
caustic, and if inhaled or swallowed may produce dangerous in- 
flammation. The preparations of Lime and Chalk are feebly 
alkaline and astringent ; they neutralize the acid of the gastric 
juice and are sedative to the mucous membrane of the stomach. 
A small quantity of the oxide passes into the blood and promotes 
constructive metamorphosis, — but if used in large quantity or for 
a long time it will act in the opposite manner, producing waste. 

Calcium Chloride is a gastro-intestinal irritant, very diffus- 
ible and remarkably alterative, being apparently a powerful an- 
tagonist to the strumous diathesis. 

[The actions of the other salts of Calcium are described under 
the titles of their respective bases.] 

Antagonists and Incompatibles. 

The preparations of Lime and Chalk are incompatible with acids and 
metallic salts. In poisoning by Lime the antidote is a dilute vegetable acid, 
followed by demulcents or the fixed oils to protect the mucous membrane. 



CALENDULA. 1 1 3 

Therapeutics. 

Lime may be used as a caustic and depilatory, but is better 
known as an agent for hastening decomposition which it does by 
its affinity for water, the resulting Hydrate absorbing many of 
the products. Chlorinated Lime is an excellent antiseptic and 
disinfectant, but as it owes its energy entirely to its chlorine it 
will be noted under that title. Lime-water is a favorite remedy 
for vomiting, especially in children, and is added to milk to in- 
crease its digestibility. It is also efficient for acid dyspepsia 
and mucous enteritis, as an antacid and astringent. Locally it 
is usefully employed as an enema against thread-worms, as a 
lotion in many mucous and purulent discharges, and in aphthae. 
The vapor of slaking lime or lime-water as spray are often very 
serviceable inhalations in diphtheria. Syrup of Lime contains 
more lime in solution than lime-water, and may be used instead 
of the latter where a diluent is not advisable. It is the antidote 
for poisoning by Carbolic or Oxalic Acid, while lime in any form 
(as wall-plaster) is a valuable antidote for poisoning by any 
mineral acid. 

Chalk-mixture is used in the diarrhoeas of children with sour- 
smelling, watery stools ; and may be conveniently prescribed in 
combination with other astringents. Lime Liniment is used on 
cotton or lint as a dressing for burns. 

Calcium Chloride has been advantageously employed in the 
various manifestations of the strumous diathesis. It sometimes 
resolves glandular enlargements, calcifies tubercular deposits, aids 
the cicatrization of ulcerating cavities, and has been curative in 
eczema and lupus. It is strongly recommended in chorea, phthi- 
sis and in the colliquative diarrhoea of strumous children. In 
solution externally as a fomentation it will hasten the maturation 
of boils. 

[The therapeutics of the other salts of Calcium are included 
under those of their respective bases.] 

CALENDULA, Marigold, — is the fresh, flowering herb 
of Calendula officinalis, the common Garden Marigold, a plant of 
the nat. ord. Compositae, frequently cultivated for ornament. 
The tincture (20 per cent.) is also official, and is exclusively used 
as a local application to promote the healing process in wounds, 
ulcers, burns and other breaches of tissue. Extravagant views of 
its powers as a vulnerary are promulgated by the so-called " ho- 
moeopathic surgeons," and serve as one of their excuses for pro- 
fessing an exclusive position in the art of surgery. 

10 



114 CALUMBA — CAMBOGIA. 

CALUMBA, Columbo,— is the root oijateorrhiza Calumba, 
a plant of the nat. ord. Menispermaceae, native in southeastern 
Africa, but cultivated in the East Indian Islands. It occurs in 
nearly circular disks, having two or three interrupted circles of 
projecting wood-bundles, odor slight, taste mucilaginous, aro- 
matic and bitter. It contains the alkaloid Berberine (see under 
Berberis, ante, page ioo), a bitter principle named Calumbin, 
also Calumbic Acid and Starch, but no Tannin. Dose, gr. v-xxx. 

Preparations. 

Extractum Calumba Fluidum, — Dose, rn_v-xxx. 
Tinctura Calumba, — i in 10. Dose, gss-ij. 

Physiological Action. 

Calumba is the first in alphabetical order of the simple bitters, 
having no astringency or aroma, and its action, as herein de- 
scribed, will apply to the other members of that class (Quassia, 
Gentian, Cornus). It stimulates the nerves of taste, increases 
the flow of saliva, excites the flow of the gastric juice and the 
gastric circulation, thus increasing the appetite and promoting 
digestion, and so promoting the constructive metamorphosis. 
As it also increases the gastric mucus, its continued use will set 
up catarrh of the stomach, and interfere with digestion, though 
it is one of the least irritant of stomachic tonics. 

Therapeutics. 

As Calumba contains no Tannin, it may be administered with 
the salts of Iron, and is often prescribed with the sub-carbonate. 
It is useful in atonic dyspepsia with pain after eating, in the 
convalescent stage of disease to promote appetite and digestion, 
in diarrhoea and dysentery, vomiting, sea-sickness, cholera mor- 
bus and cholera infantum. An Infusion of Calumba with Ginger 
and Senna is effective in flatulence, and the same preparation is 
a good vehicle for the administration of acids and alkalies, tonics, 
aromatics and mild cathartics. Having little or no irritant quality, 
it is an excellent tonic in the hectic of phthisis. 



CAMBOGIA, Gamboge, — is a gum-resin, obtained from 
Garcinia Hanburii, a Siamese tree of the nat. ord. Gutti ferae. 
It occurs in cylindrical pieces, of orange-red color, but yellow 
when powdered. Its taste is very acrid. It contains 73 per 
cent, of Gambogic Acid, a resinous substance, also 25 per cent. 



CAMPHORA. 1 1 5 

of gum and 2 of water. It is partly soluble in alcohol and ether. 
The only official preparation is the Pil. Catharticae Co. (de- 
scribed under Colocynthis), each pill containing gr. ^ of Gam- 
boge. Its dose, as a cathartic, is gr. ij-v, — as a diuretic, gr. j at 
short intervals. 

Physiological Action. 

Gamboge is an irritant purgative, decidedly diuretic, and its 
powder is sternutatory. Its catharsis is accompanied by vomiting 
and colic, and the stools produced are watery, but not so much 
so as generally believed. It has no cholagogue action. Full doses 
are liable to produce violent gastro-enteritis, and incautiously 
used (as in Morrison's pills) it has frequently caused death. On 
the other hand, large doses have been given continuously in 
some C£ses, without producing any dangerous symptoms. 

Therapeutics. 

Gamboge was formerly much used as a hydragogue cathartic 
and diuretic in dropsies, but its irritant qualities have caused it 
to be superseded by other agents (elaterium, digitalis, etc.). 
However, for dysentery, especially when in young subjects, very 
small doses (gr. ^) at short intervals, up to gr. ^ in 24 hours, 
have proven to be remarkably efficacious. 



CAMPHORA, Camphor, C 10 H 16 O, — is a stearopten (solid 
volatile oil), derived from Cinnamomum Camphora, a tree of the 
nat. ord. Lauraceae, and purified by sublimation. Occurs in 
white, translucent, waxy masses, of penetrating odor and pun- 
gent taste, lighter than water, in which it is sparingly soluble 
(1 to 1300), but dissolves readily in alcohol, ether, chloroform, 
benzin, oils, etc. The camphor-tree is indigenous in China. 
Japan, Formosa and other parts of eastern Asia. Borneo Cam- 
phor has the formula C 10 H 18 O, bears the same relation to Japanese 
Camphor as alcohol bears to aldehyde, and is heavier than water. 
Dose, gr. j-xx. 

Derivatives of Camphor are — Camphor- cymol, which is ob- 
tained by its distillation with zinc chloride, — Camphoric and 
Camphretic Acids, which result respectively from its lesser or 
greater oxidation. 

Preparations. 

Aqua Camphors, Camphor-water, — Camphor 8, Alcohol 16, Distilled 
Water q. s. ad 1000 parts. Used externally or as a vehicle. Dose, gj-iv. 

Spiritus Camphor/e, Spirit of Camphor, — Camphor 10, Alcohol 70, Water 
20 parts. Dose, ntv-xx. 



Il6 CAMPHORA. 

Linimentum Camphors, Camphor Liniment, — Camphor 20, Cotton-seed 
Oil 80 parts. For external use. 

Ceratum Camphors, Camphor Cerate, — has of the Liniment 3, Olive Oil 
12, Cerate 85 parts. Used for itching skin-affections. 

Camphora Monobromata, Monobromated Camphor, C 10 H 15 BrO, — color- 
less, prismatic needles or scales, of mild camphoraceous odor and taste, and 
neutral reaction, almost insoluble in water, slightly in glycerin, freely in alco- 
hol, ether, oils, etc. Dose, gr. j-x, in emulsion. 

Rubini's Tincture of Camphor (Unofficial), — is a saturated solution in 
alcohol, of which the dose is from 4 to 20 drops. 

Raspail's "Eau Sedatif" (Unofficial),— contains Aq. Ammoniae gij, 
Sodii Chloridum ^ij, Camphorated Spirits of Wine ^iij, Water Oij. Used 
externally. 

Camphor is also an ingredient of Linimentum Saponis, Linimentum Sina- 
pis Compositum, and Tinctura Opii Camphorata. 

Physiological Action. 

Camphor is antispasmodic, anodyne, antiseptic, diaphoretic, 
a stimulant expectorant, a cerebral excitant, a gastro-intestinal 
irritant, and a rubefacient. It has an acrid, hot taste, and irri- 
tates the skin and mucous membranes, in quantity exciting severe 
gastric inflammation with all the effects of an irritant poison. In 
medicinal doses, it stimulates the vaso-motor system and the car- 
diac motor ganglia, and lessens the influence of the pneumogas- 
tric, — thus increasing the circulation and raising arterial tension. 
It also stimulates respiration and mental activity, even producing 
intoxication; promotes diaphoresis, allays pain, and increases 
the menstrual flow and the sexual appetite, but its continued use 
depresses the generative function. " Camphora per nares castrat 
odore mares. " 

Large doses cause gastro-intestinal inflammation, depress the 
heart and lower arterial tension, diminish the reflex function of 
the spinal cord, produce coldness of the surface, insensibility, 
coma, convulsions and perhaps death. 

It is eliminated by the bronchial mucous membrane, skin and 
kidneys, and has often caused dysuria. 

Monobromated Camphor resembles the bromides in action, 
but is not identical therewith. In mammals it produces muscular 
weakness passing into paralysis, lowered temperature and respira- 
tion, stupor and death. In some cases its use by man has been 
followed by epileptiform convulsions. It is a nervous sedative and 
hypnotic, and a gastric irritant. 

Antagonists and Incompatibles-, 

Arterial sedatives, coffee, cold, etc., antagonize its action. Water precipi- 
tates it from the alcoholic solution, alkalies and earthy salts precipitate even 
the small quantity which is soluble in water. 



CANNABIS. 117 

Therapeutics. 

Camphor was much used by the older physicians as an anti- 
spasmodic, and is yet greatly valued in China and Japan. It has 
a reputation for uncertainty of therapeutic action, but is usefully 
administered in cholera and choleraic diarrhoea, summer diarrhoea 
and that of infants, vomiting, gastralgia, cardiac depression, 
nervousness and nervous headache, nymphomania, capillary bron- 
chitis, typhoid and eruptive fevers, dysmenorrhcea, afterpains, 
chordee, strangury, and catarrhal colds. Locally it is effective 
in myalgia, lumbago, toothache, gangrene, and other conditions 
where counter-irritation or a local anodyne are required. A 
solution in ether has been found to be a beneficial application in 
erysipelas. 

Monobromated Camphor is used as a nerve sedative and 
hypnotic, but is not particularly efficient in this regard. It has 
been used with advantage in whooping-cough, neuralgia, chorea, 
hysteria, delirium tremens and epilepsy. 

Camphora Carbolata is a name given to a mixture of 2j^ 
parts of camphor with one each of carbolic acid and alcohol. 
This preparation, mixed with olive-oil, is a good non-irritating 
and antiseptic dressing for wounds and breaches of surface. 

Camphor-Chloral is a fluid obtained by triturating together 
equal parts of camphor and chloral hydrate. It has decided sol- 
vent powers, dissolving sulphate of morphine readily (gr. xx in 
3ij), and many other salts of alkaloids. It is often a serviceable 
application in superficial neuralgia, and is said to allay spasmodic 
cough if painted over the larynx. 

Camphora Salicylata is obtained by heating together 1 1 parts 
of salicylic acid and 14 of camphor. An ointment prepared 
from this substance has been used with very satisfactory results 
in the treatment of phagedena, spreading syphilitic sores, epi- 
thelioma, lupus, etc. 

CANNABIS, Hemp, — is Cannabis sativa, the hemp-plant, a 
coarse, pubescent, somewhat viscid annual of the nat. ord. Urti- 
caceae, having an erect, branching stem 3 to 6 feet high, with 
alternate or opposite digitate leaves on long, weak petioles \ and 
dioecious flowers, the staminate clusters being lax, drooping, 
leafless at the base ; the pistillate clusters erect and leafy at the 
base. It is indigenous to Asia, but is cultivated in most civilized 
countries for its textile bast-fibres and its oily fruit. The two 
official varieties are specifically identical with each other, differ- 
ing only in the degree of their action, that grown in India being 



I 1 8 CANNABIS. 

the most powerful. They contain a resin named Cannabin, and a 
Volatile Oil, from the latter of which are obtained Cannabene, a 
light hydrocarbon, and Hydride of Cannabene, a crystalline body. 
Cannabis should not be confounded with the so-called " Indian 
or Canadian Hemp," Apocynum cannabinum (see ante, page 74). 
The official varieties of Cannabis are as follows : 

Cannabis Americana, American Cannabis, — is Cannabis sativa, 
grown in the Southern United States and collected while flower- 
ing, having a stem about six feet long and rough, leaves petiolate 
and digitate, opposite below, alternate above, flowers dioecious, 
odor heavy, taste bitter and slightly acrid. No official prepara- 
tions. 

Cannabis Indica, Indian Cannabis, Indian Hemp, — the flow- 
ering tops of the female plant of Cannabis sativa, grown in the 
East Indies. Is about two inches long, branching, compressed 
and brittle, having a few digitate leaves with linear-lanceolate 
leaflets, and numerous bracts, each containing two small pistillate 
flowers, sometimes with the nearly ripe fruit, the whole agglutin- 
ated with a resinous exudation. Color brownish, odor peculiar 
and narcotic, taste slightly acrid. 

Preparations. 

Extractum Cannabis Indict, — Dose, gr. 3^-j, if active. 

Extractum Cannabis Indict Fluidum, — an alcoholic preparation which 
in mixtures must be emulsified with Gum Acacia, otherwise the resin will 
separate and float to the top or adhere to the sides of the bottle. Dose, "Hlj-v. 

Tinctura Cannabis Indict, — strength 20 per cent. Dose, rri_xx-^j. The 
above remark on mixtures containing the fluid extract applies also to the tinc- 
ture. 

Similar preparations of Cannabis Americana are prepared by the manu- 
facturers and may be used in larger quantities. The dosage of all prepara- 
tions of hemp is uncertain, as specimens of the plant vary very much in 
activity. The best rule is to begin with a small dose, gradually testing the 
activity of the drug and the susceptibility of the patient by carefully increased 
doses. 

Cannabin Tannate (Unofficial), — is a yellowish-brown permanent powder, 
insoluble in water and ether, slightly soluble in alcohol, having a not unpleasant 
odor and a bitterish, astringent taste. No formula has been published for it, 
but it is claimed to be the tannate of a glucoside by Merck of Darmstadt 
who placed it on the market. Dose, as a hypnotic gr. v-x. 

Preparations used in the East. 

Churrus is an impure resin, prepared by rubbing the leaves of the plant 
together and scraping off the adhering resin. 

Gunjah is the dried leaf and tops as sold in the bazaars for smoking pur- 
poses. 

Hashish, Bhang or Siddhi is a confection consisting of the leaves and 



CANNABIS. 



II 9 



small stalks coarsely broken and mixed with fruits and aromatics. It is em- 
ployed in the preparation of various electuaries and beverages, and is also 
smoked with or without tobacco. 

Physiological Actio?i. 

Cannabis is an antispasmodic, analgesic, anaesthetic and nar- 
cotic, a cerebro-spinal stimulant and a powerful aphrodisiac. It 
increases intellectual and motor activity, stimulates the vaso- 
motor nerves raising arterial tension, depresses sensation, and 
strengthens the energy of the uterine muscular fibre, but has no 
power to initiate uterine contractions. In large doses it causes 
a pleasurable intoxication during which the peculiar traits of the 
individual are exalted, and the ideas follow each other so rapidly 
as to produce a sense of great prolongation of time, minutes 
seeming as if hours or even days. With this occurs increased 
sexual desire, great uterine activity, and sensations of double 
consciousness and enormous dimensions. The sight and hear- 
ing are exalted, pupils dilated, anaesthesia sets in, the reflexes 
are lowered by stimulation of inhibition (Setchenow's centre ?), 
and if the dose be a heavy one a cataleptic state is induced. 
Sleep or coma follows according to the size of the dose, but death 
has never been produced by this drug. 

After-effects are dullness, heaviness, vertigo, headache, and 
confused thought, anaesthesia of the skin, and marked diuresis, — 
but no nausea, no vital depression, no constipation. Repeated 
use of the drug causes mental weakness and impotence, the result 
of over-stimulation. A ravenous appetite is usually one of its 
effects. 

Antagonists and Incompatibles. 

Strychnine and faradism are antagonistic. Caustic alkalies are incompat- 
ible. In poisoning by it the stomach should be evacuated, stimulants given 
cautiously, and respiration maintained. The effects of a large dose last over 
24 hours. Lemon-juice is said to antagonize its effects. 

Therapeutics. 

Cannabis was formerly much employed as an anodyne and 
hypnotic, also as an anaesthetic during surgical operations. It is 
now somewhat out of fashion. In migraine it is useful to prevent 
recurrence of the attack, and in neuralgia it is often very efficient. 
Uterine affections, as — chronic metritis, subinvolution, men- 
orrhagia, dysmenorrhcea, etc., are greatly benefited by its ano- 
dyne quality and its power over the uterine muscular fibre. It is 
the best hypnotic in delirium tremens, and in traumatic tetanus 
and pararysis agitans large doses will lower the reflex activity. 
Dysuria and retention of urine are often relieved by it, while in 



1 20 CANTH ARIS. 

spasm of the bladder and other painful affections of that organ it 
will be found a most efficient remedy. It is useful in functional 
impotence, especially if combined with Ergot and Nux-vomica. 
In gonorrhoea it lessens the discharge, relieves the inflammation, 
burning pain and restlessness, and allays chordee. The tincture 
of C. Americana is the most useful in this affection, being fully as 
efficient as Copaiba or Sandal Oil, and much more agreeable. It 
should, however, be prepared from the fresh plant, and be given 
in 3 to 5 drops doses 3 or 4 times daily after the subsidence of the 
acute symptoms. Full doses of the tincture of the Indian plant 
are extremely efficient in many cases of headache at the meno- 
pause, but should be used cautiously until the activity of the 
sample and the susceptibility of the patient are tested. 

Tannate of Cannabin is recommended as a powerful hyp- 
notic, not in any degree dangerous and neither disturbing the 
secretions nor leaving unpleasant after-effects. It has been used 
with benefit in acute mania. 



CANTHARIS, Cantharides, Spanish Flies,— is the 

dried beetle Cantharis vesicatoria, an insect of the nat. ord. 
Coleoptera, about an inch long, of a shining green color, the 
powder being grayish-brown, with green particles, odor very dis- 
agreeable. Contains Cantharidin, C 10 H 12 O 4 , the active princi- 
ple, — also a greenish volatile oil and peculiar fatty bodies. 

Preparations. 

Tinctura Cantharidis, — strength 5 per cent. Dose, "nt j-xx. 

Ceratum Cantharidis, Cantharides Cerate, Blistering Cerate, — Cantha- 
rides 35, Yellow Wax 20, Resin 20, Lard 25 parts. 

Ceratum Extracti Cantharidis, — Cantharides 30, Resin 15, Yellow 
Wax 35 parts, Lard 35 parts, Alcohol q. s. 

Charta Cantharidis, — Cantharides 1, Canada Turpentine 1, Olive Oil 4, 
Spermaceti 3, White Wax 8, Water 10 parts — spread on paper. 

Linimentum Cantharidis, — Cantharides 15, Oil of Turpentine q. s. ad 
100. 

Emplastrum Picis cum Cantharide, Pitch Plaster with Cantharides, 
Warming Plaster, — Burgundy Pitch 92 parts, Ceratum Cantharidis 8 parts. 

Collodium CUM Cantharide, Cantharidal Collodion, — Cantharides 60, 
Flexible Collodion 85, Commercial Chloroform q. s. 

Physiological Action. 

Cantharis applied to the skin is a rubefacient and vesicant, 
acting more slowly than mustard but much more severely. Inter- 
nally it is also irritant, causing heat of stomach, ^astralgia, 
nausea, and vomiting, the circulation is stimulated, temperature 



CANTHARIS. 121 

elevated, urine becomes scanty and irritating, is voided with diffi- 
culty and pain, and often contains blood and albumen. After- 
wards the pulse falls, temperature and arterial tension are lowered, 
and depression ensues. A toxic dose produces severe gastro- 
enteritis, abdominal tenderness, tenesmus, mucous or bloody 
stools, pain in the stomach and loins, dysphagia, ptyalism, stran- 
gury, priapism, hematuria, swollen genitals, abortion, muscular 
tremor, convulsions, coma and insensibility. Post-mortem shows 
evidences of violent metritis, gastro-enteritis and general peri- 
tonitis. Cantharis is aphrodisiac by causing vascular turgescence 
of the genital apparatus, but only in doses which produce dan- 
gerous symptoms. It is only abortive in toxic dose. In small 
doses it is diuretic and emmenagogue. 

Counter-irritation by rubefacients or blisters acts on disease prob- 
ably through the nervous system. Its influence is explained by the 
theory that the peripheral extremities of the nerves supplying the 
skin of the part to which the agent is applied undergo some mole- 
cular change, which extends to the, nerve centre and is thence 
radiated to centrifugal or trophic nerves, effecting various changes 
in nutrition and secretion over the areas to which they are dis- 
tributed. In addition to this method of action, neighboring 
parts are affected by direct extension of the inflammation pro- 
duced, and distant parts are also affected by absorption through 
the vesicated surface of agents having special affinities for certain 
organs. 

Blisters act primarily as a stimulant to the body generally as 
well as to the organs in its vicinity, but if permitted to remain 
long enough to produce large blebs, the result is a depression pro- 
portionate to the amount of serum abstracted, the serum contain- 
ing nearly as much albumen as the blood itself. 

Antagonists. 

There is no chemical or physiological antagonist to Cantharis. Evacuation 
of the stomach, mucilaginous drinks freely, Opium for the gastro-enteritis, are 
the best measures in poisoning by this agent. 

Therapeittics. 

As a counter-irritant and vesicant Cantharis is of great value in 
neuralgia if applied close to the emergence of the nerve from the 
spinal column, also in sciatica and neuritis, and in acute rheuma- 
tism around the affected joints. A blister at the nape of the 
neck controls many headaches, and one behind the ear will mod- 
ify inflammatory affections of the eye. In pleuritic effusions a 
succession of small blisters (flying-blisters) will promote absorp- 



122 CAPSICUM. 

tion of the pleural contents, and a blister applied to the perineum 
will often cure a rebellious gleet. Though valuable as a thera- 
peutic measure in very many conditions, blistering is going out 
of fashion except in hospitals arid among people who believe in 
heroic treatment. 

As an internal remedy Cantharis must be employed in very 
small doses (""ij-iij of the tincture) in order to be efficient. 
When so used it is an admirable agent in acute desquamative ne- 
phritis after the active inflammation and fever have subsided, to 
reduce the albumen and blood in the urine. Drop-doses are par- 
ticularly useful in irritable bladder with frequent desire to mictu- 
rate, so often observed in women, also in the incontinence of the 
aged and of children, and in cystitis, gonorrhoea and gleet. The 
same dose thrice daily will generally abate chordee. In sperma- 
torrhoea, prostatorrhcea, scanty menstruation and menorrhagia 
in subjects of lax fibre and general want of tone it is often very 
serviceable. Cutaneous squamae and vesiculae are greatly im- 
proved by small doses frequently administered and gradually 
increased, and it is one of the best remedies for psoriasis. For 
alopecia areata it is of the utmost value as an external application, 
and the tincture, greatly diluted, is an ingredient of all the hair- 
renewers in common use. In pleurisy, after effusion has taken 
place, it will be found admirable in i to 2 drop doses every 2 or 
3 hours, and in the after prostration of diphtheria it proves a 
serviceable stimulant. One of the best applications to burns or 
scalds is a cloth dipped in a lotion of the tincture one part to 
thirty or forty of water. The same lotion is an efficient applica- 
tion to vesicular erysipelas and herpes zoster 



CAPSICUM, Cayenne Pepper, — is the fruit of Capsicum 
fastigiatum, a plant of the nat. ord. Solanaceae native in tropical 
Africa and America. Occurs in small red pods, enclosing two 
cells containing flat, yellowish seed, and has a peculiar odor and 
an intensely hot taste. It contains Capstan, which is a thick, 
red liquid, and is the active principle, — also a volatile alkaloid 
having the odor of Conine. Dose of the powdered drug, gr. v-x. 

Preparations, 

Extr actum Capsici Fluidum,— alcoholic. Dose, ""1 v-gj. 
Tinctura Capsici, — 5 per cent, strength. Dose, ""Ix-gj. 
Oleoresina Capsici, prepared by ether. Dose, ""l j-v. 
Emplastrum Capsici, Capsicum Piaster, — prepared from the oleoresin of 
capsicum and resin plaster. 



CARBO. 123 

Physiological Action, 

Capsicum is irritant to the skin and mucous membranes. Exter- 
nally used for sufficient length of time it will produce vesication, 
internally in quantity it will excite gastritis. In medicinal doses 
it increases the saliva, excites a sensation of warmth in the 
stomach, promotes appetite and digestion, and produces more 
easy and copious alvine evacuations. It stimulates the action of 
the heart, is diaphoretic and diuretic, also decidedly aphrodisiac. 
It is a general stimulant to the nervous system, but in repeated 
doses produces a slight narcotic effect upon the brain. On the 
vascular system it acts like ergot, powerfully constringing the 
vessels by influencing the unstriped muscular fibre in their walls, 
either directly or through the vaso-motor nerves. 

Therapeutics. 

Capsicum is an excellent stomachic tonic in atonic dyspepsia 
and in that of chronic alcoholism with tremor and insomnia. In 
acute dipsomania and delirium tremens large doses are efficient 
in producing sleep and promoting appetite. It is the best sub- 
stitute for alcohol and opium in attempts to cure those habits. 
It is well used in intermittents, chiefly as an adjuvant to more 
active drugs, — in flatulent colic especially when occurring in hys- 
terical women and hypochondriacs, — also in low fevers and 
cholera as a stimulant. It gives good results in functional impo- 
tence, in spermatorrhoea from loss of tone, in chronic parenchy- 
matous nephritis to check the waste of albumen, and is beneficial 
in chronic cystitis and in prostatorrhcea. The tincture internally 
and a plaster externally over the loins are efficient in cases of 
renal congestion with habitual pain in the back and a trace of 
albumen in the urine. 

Locally the tincture diluted (5j to gviij) or the powder with 
honey, form excellent gargles for relaxed throat and its accom- 
panying cough, relaxed uvula, inflammatory sore throat, and the 
cynanche of scarlet fever, but they must be used with caution as 
such applications are sometimes very irritating. 

The Capsicum-plaster is a mild counter-irritant, of great value 
in lumbago and other muscular rheumatisms as a palliative appli- 
cation. 



CARBO, Carbon, — exists in nature in many forms, of which 
two are official, namely the charcoals specified below. 

Carbo Animalis, Animal Charcoal, — prepared from bone, 



124 CARBO. 

occurring in dull black fragments or powder, odorless and nearly- 
tasteless, insoluble in water or alcohol. 

Carbo Ligni, Charcoal, — prepared from soft wood, is black, 
shining, brittle, inodorous, tasteless and insoluble. 

Preparations, 

Carbo Animalis Puriftcatus, Purified Animal Charcoal, — the bone- 
phosphate and calcium carbonate being removed by digesting with Hydro- 
chloric acid and washing. Dose, gr. xx-^j. 

Carbonei Bi-sulphidum, Bisulphide of Carbon, CS 2 , — is a clear, colorless, 
diffusive liquid, of strong, offensive odor, aromatic taste and neutral reaction ; 
soluble in alcohol, ether, chloroform and oils, insoluble in water; vaporizes at 
ordinary temperatures, and is highly inflammable. Dose, ""Iss-j. 

Physiological Action. 

Charcoal is an efficient deodorant and disinfectant, as it ab- 
sorbs and condenses many gaseous bodies and vapors. It is 
evacuated unchanged by the bowel and exerts no specific action 
on the body. 

Carbon Bisulphide is largely used in the arts, hence its effects 
are frequently observed. Persons exposed to its fumes are af- 
fected by headache, vertigo, overexcitement of the nervous sys- 
tem, emaciation, incoordination of movement, depression of all 
the special senses with impairment of sensation and motility and 
perhaps insanity. Inhaled directly, it excites violent coughing 
and produces anaesthesia characterized by great muscular rigidity. 
Being a powerful cardiac paralyzant, it is extremely dangerous as 
an anaesthetic. In 3-drop doses, it produces severe nausea and 
vomiting, with a sense of heat in the stomach and a weak and 
rapid action of the heart. It is a good solvent for Caoutchouc and 
many other substances. 

Therapeutics. 

Charcoal is used in pharmacy for decolorizing vegetable prin- 
ciples, removing alkaloids from infusions of plants, and making 
several preparations, as acidum sulphurosum, potassii iodidum, etc. 

Externally, it makes an efficient disinfectant, absorbent and 
deodorant application to cancerous discharges, foul ulcers and 
gangrenous wounds. Having no odor it is not open to the charge 
of substitution of one smell for another. A small quantity added 
to water will keep it sweet for a long time. It is an excellent 
dentifrice if finely powdered. 

Internally, it is used for the same purposes, namely, to absorb 
gases and offending products of indigestion. In flatulent dys- 
pepsia, gastralgia, pyrosis, diarrhoeas, nausea of pregnancy, epi- 



CARDAMOMUM — CARDUUS. 125 

demic cholera, and constipation, it has warm advocates. When 
used internally for any time, an occasional purgative should be 
given to prevent its accumulation in the intestines. It has been 
proposed as an antidote for several alkaloidal poisons on theo- 
retical grounds, but its efficacy in this respect is doubtful. 

Carbon Bisulphide has such a horribly offensive odor that it 
will never be used for any purpose for which another agent can 
be found. It relieves the pain of gastric cancer, and in ^J-drop 
doses will alleviate nausea and vomiting, also gastralgia. Locally 
it has been used as a counter-irritant and a local anaesthetic, for 
deafness due to want of nervous energy, in facial neuralgia and 
various local pains. 



CARDAMOMUM, Cardamom,— is the fruit of Elettaria 
Cardamomum, a plant of the nat. ord. Zingiberaceae, cultivated 
in Malabar. Occurs as dried capsule's, containing small, reddish- 
brown seeds, of warm, aromatic taste and agreeable odor. Con- 
tains about A^/2 per cent, of a Volatile Oil, C 10 H 16 , isomeric with 
Oil of Turpentine, which oil is the active principle, also a fixed 
oil, coloring matter, etc. It is an ingredient of Pulvis Aromati- 
cus and of Extractum Aromaticum Fluidum (see under Cinna- 
momum), as well as of several compound preparations. 

Preparations. 

Tinctura Cardamomi, — 1 5 per cent, strength. Dose, gj-ij. 
Tinctura Cardamomi Composita, — Cardamom 20, Cinnamon 20, Cara- 
way 10, Cochineal 5, Glycerin 60, Diluted Alcohol q. s. ad 1000. Dose, 

Infusum Cardamomi (Unofficial), — may be made in the strength of ^j to 
0)4, and used in wineglassful doses. 

Physiological Action and Therapeutics. 

Cardamom is aromatic, carminative and stomachic, and is used 
as an agreeable flavoring for bitter mixtures in dyspepsia and 
other stomach affections. It is especially useful when combined 
with purgatives to check flatulence and griping, and it makes the 
best flavoring for saline solutions or mineral waters. 



CARDUUS (Unofficial), — the seeds of Carduus marianus, or 
St. Mary's thistle, an annual European plant of the nat. ord. Com- 
positae. A decoction (Jij ad Oj) is the preparation usually em- 
ployed. It js an old remedy recently revived as a hemostatic, 
and reported as very efficient in hemoptysis, uterine hemor- 



1 26 CARUM — CARYOrHYLLUS. 

rhage, melaena and amenorrhoea connected with derangement of 
the portal circulation. It has proved curative in congestion of 
the liver and simple jaundice, and in Germany it has long been 
popularly deemed efficacious in gall-stones, and liver affections 
generally. Dose, of the decoction, 3J"Sss, — of a tincture, ttix-xx. 
Carduus Benedictus, the "blessed thistle, " also called Cnicus 
benedictus and Centaurea benedicta, is another plant of the same 
order, formerly held in high esteem as a popular " cure-all. ,, It 
contains Cnicin, an amorphous, bitter principle, which has been 
used as an antiperiodic in doses of gr. v-x, but generally pro- 
duces burning sensations and pharyngeal constriction, with nau- 
sea, vomiting, colic and diarrhoea. It acts chiefly as a bitter 
tonic, resembling Calumba and Taraxacum most closely. 



CARUM, Caraway, — is the fruit of Carum Carvi, a Euro- 
pean plant, of the nat. ord. Umbelliferae, and is of oblong shape, 
£th of an inch in length, separating into two parts, each having 
5 ribs and 6 oil-tubes. Its odor and taste are aromatic and 
agreeable. The active principle is the Volatile Oil, which is also 
official. Caraway is an ingredient of Tinct. Cardamomi Com- 
posita. 

Preparations. 

Oleum Cari, — is the volatile oil distilled from Caraway, and is resolvable 
into Caruen, C 10 H 16 , isomeric with Turpentine, and Caruol, C 10 H n O, iso- 
meric with Thymol. It is an ingredient of Spiritus Juniperi Compositus. 
Dose, Tnj-v. 

Infusum Cari (Unofficial), — sjj-ij ad Oss. Dose, ^ss-ij. 

Physiological Action and Therapeutics. 

The Oil of Caraway is fatal to small animals, and in one case 
3j produced cerebral congestion, delirium and rigors in man. 
The chief use of Caraway is as a flavoring agent, but it is efficient 
in the flatulent colic of children, and to prevent griping from the 
use of purgatives. 



CARYOPHYLLUS, Cloves,— are the unexpanded flowers 
of Eugenia caryophyllata, a handsome evergreen tree of the nat. 
ord. Myrtaceae, cultivated in the East and West Indian Islands. 
They are about J^-inch long, of a dark-brown color, consist of 
a calyx-tube terminated by four teeth and surmounted by a glob- 
ular head formed by four petals which cover numerous, curved 
stamens and one style. They emit oil when scratched, have an 



CASCA BARK. \2J 

aromatic odor, and a pungent, spicy taste, and are contained in 
Tinctura Lavandulae Composita, Tinctura Rhei Aromatica and 
Vinum Opii. They contain a heavy Volatile Oil, which is official, 
— also Eugenin, C 10 H 12 O 2 , a crystalline body ; Caryophyllin, 
C 10 H 16 O, a camphor \ Caryophyllic Acid, and tannin, gum, etc. 

Preparations. 

Oleum Caryophylli, Oil of Cloves, — a volatile oil distilled from Cloves, 
soluble in alcohol, and of sp. gr. 1.050. It consists of a light and a heavy 
oil, the latter containing Engenol, C 10 H 12 O, a phenol-like compound, and 
Caryophyllin, C 10 H 16 O, which yields as a product of its oxidation Caryophyl- 
linic Acid, C 20 H 32 O 6 . Dose of the oil, "nij-iv. 

Infusum Caryophylli (Unofficial), — maybe made of strength 1 to 40, and 
used in doses of one to two fluid ounces. 

Physiological Action and Therapeutics. 

Cloves may be considered as a type of several agents yielding 
aromatic oils, which as a rule consist of terpenes with camphors, 
resins, fatty and other acids, etc., closely allied to phenol and 
benzoic acid, the balsams and gum-resins. Such are Orange, 
Lemon, Allspice, Cajuput, Caraway, Peppermint, etc. Their 
oils are antiseptic, locally anaesthetic, stimulant and irritant, anti- 
spasmodic, stomachic and carminative. Internally they increase 
circulation and temperature, promote digestion and nutrition (in 
quantity may cause inflammation), relieve pain and spasm, and 
are excreted by the kidneys, skin, liver and the bronchial mucous 
membrane, stimulating and disinfecting their routes through the 
organism. 

These agents are used to flavor pharmaceutical preparations, 
to correct the griping tendency of many purgatives, to correct 
flatulence, to relieve pains in the stomach and bowels, and to 
promote the flow of saliva and gastric juice. As external appli- 
cations they are efficiently employed for anaesthetic and counter- 
irritant purposes, to relieve pain in chronic rheumatism, myalgia, 
lumbago, superficial neuralgia, toothache, etc. The Oil of Cloves 
is an effective deodorizer for sponge-tents, a good application to 
a painful tooth, and is occasionally applied over the course of an 
aching nerve with relief to the pain. 



CASCA BARK, Sassy Bark, Ordeal Bark (Unofficial), 
— is the bark of Erythrophlaum Guinense, an African tree used 
by the negroes as an ordeal in trials for witchcraft. It contains a 
poisonous alkaloid, Erythrophleine, and when used in quantity 
produces nausea and vomiting, stricture across the brow, severe 



128 CASCARA AMARGA — CASCARA SAGRADA — CASCARILLA. 

cephalalgia, narcosis and death. It is used as a remedy in Africa 
for intermittent fever, dysentery, diarrhoea and colic, and in 
England is considered to resemble Digitalis in action and uses. 
A tincture is made (gij ad Oj) of which the dose is mx, or a 
watery Extract may be used in doses of gr. j. 

CASCARA AMARGA, Honduras Bark (Unofficial),— 
is the bark of a Mexican tree of the nat. ord. Simarubaceae, which 
has been used with apparent success as an alterative tonic and 
diuretic in syphilis and various chronic skin affections. The use 
of tobacco and alcohol seems to counteract its usefulness It is 
certainly a very powerful tonic and has been employed by com- 
petent observers with uniformly good results in syphilis and syphi- 
lodermata, chronic liver complaints, chronic eczema, chronic 
nasal catarrh and psoriasis. A Fluid Extract is on the market 
of which the dose is 3ss-j thrice daily. 

CASCARA SAGRADA, Chittem Bark, Sacred Bark 

(Unofficial), — is the bark of Rhamnus Rurshiana, or California 
Buckthorn, a small tree of the nat. ord. Rhamnaceae growing on 
the Pacific coast of the United States. It contains a Volatile Oil, 
a neutral crystalline substance, several Resins, with tannic, malic 
and oxalic acids. A Fluid Extract is on the market, of which 
the dose is 3ss-j, two or three times a day. It has been found 
very serviceable in the treatment of chronic constipation, given 
in gradually diminished doses. It produces large, soft and pain- 
less evacuations, and the bowels are said to act naturally and 
regularly after its disuse. 

Cascara Cordial is a trade preparation, intended as a remedy 
for constipation, dyspepsia and hemorrhoids, and as a pleasant 
excipient for nauseous and bitter drugs. A similar preparation 
may be made by combining the fluid extract with the official 
Elixir Aurantii in the proportion of 3j to §ij, of which teaspoon- 
ful doses or more may be administered. 

Another species of the same genus, Rhamnus Frangula, is 
official under the title Frangula, which see. 

CASCARILLA, — is the bark of Croton Eluteria, a shrub or 
small tree of the nat. ord. Euphorbiacese, growing in the Bahamas. 
It occurs in grayish-brown quills, having a warm, bitter taste, and 
a fragrant odor when burned. Contains Cascarillin a crystalline 
principle, two resinoid extracts, aromatic volatile oils, with 



CASSIA FISTULA — CASTANEA. I 29 

tannic acid, etc. There are no official preparations, but an 
Infusion (1 to 10) or a Tincture (1 to 10) may be prepared 
and given in doses of 3j~3j- 

Physiological Action and Therapeutics. 

Cascarilla is an aromatic bitter. It increases appetite and 
digestion, the mucous secretion, the flow of saliva and gastric 
juice, stimulates the intestinal secretions, and acts as a mild 
astringent by the influence of its tannin. Large doses produce 
nausea, vomiting and diarrhoea, and in medicinal doses continued 
it will set up gastric catarrh and consequently indigestion. It 
has slight antiperiodic powers. 

It has been used with success in epidemic dysentery, flatulent 
dyspepsia, debility, chronic bronchitis, intermittents, and low 
nervous fevers. It is difficult to dispense, as the infusion 
decomposes quickly, and acids precipitate the resin from the 
tincture. 

CASSIA FISTULA, Purging Cassia,— is the fruit of 
Cassia Fistula, a tree of the nat. ord. Leguminosae, growing in 
tropical regions of Asia, Africa and America. It occurs in long, 
brown pods which are divided into numerous transverse cells, 
each containing a dark pulp in which is a glossy seed. No 
active principle has been isolated as yet. The pulp is the only 
valuable part of the drug. There are no official preparations, 
but it is one of the ingredients of Confectio Sennas. 

Cassia-pulp is laxative in doses of ^]-\), and purgative in larger 
quantities, producing nausea, flatulence and griping. It is rarely 
prescribed alone, owing to its tendency to cause colic and flatu- 
lence. 

CASTANEA, Chestnut, — the leaves of Castanea vesca, a 
stately tree of the nat. ord. Cupuliferae, and should be collected 
while green. Chestnut leaves are 5 to 10 inches long and about 
2 broad, have a slight odor and somewhat of an astringent taste. 
They contain tannic and gallic acids, salts, gum, etc. 

Preparation. 
Extractum Castanet Fluidum, — Dose, ^ss-^ij. 

Physiological Action and Therapeutics. 

This drug has not been studied as to its physiological actions, 
if it has any. It is classed among the vegetable astringents by 

11 



I 30 CATECHU — CAULOPHYLLUM. 

reason of its containing tannin. Its only reputation therapeuti- 
cally is as a remedy for whooping-cough, in which it is said to be 
very efficacious. An infusion or decoction of the leaves has been 
used in indefinite doses. 



CATECHU, — is an extract prepared from the wood of 
Acacia Catechu, a tree of the nat. ord. Leguminosae, native of 
the East Indies. Occurs in irregular masses, dark-brown and 
brittle, nearly inodorous, but of astringent and sweetish taste, 
soluble in alcohol, and partly so in water. It contains Caiechu- 
tannic Acid 50 per cent., and Catechuic Acid which is converted 
into the former by heat. Dose, gr. j-3 ss « 

Preparations. 

Tinctura Catechu Composita, — contains Catechu 12, Cinnamon 8, 
Diluted Alcohol q. s. ad 100 parts. Dose, TTT. x-£j. 

Trochtsci Catechu, — each troche contains of Catechu 1 grain, mixed 
with Sugar, Tragacanth and Orange-flower water. 

Physiological Action and Therapeutics. 

Catechu is a powerful astringent, acting by virtue of its tannic 
acid. (See ante, page 38, for actions and incompatibles.) Its 
uses depend entirely on its astringency. In the diarrhoea of 
children the Tincture with Chalk-mixture is very serviceable, 
and with Opium it is efficient in dysentery. It is also used as a 
gargle and mouth-wash in relaxed conditions of the pharyngeal 
mucous membrane, as an injection in leucorrhcea, and to control 
passive hemorrhages, spongy gums, etc. 



CAULOPHYLLUM, Blue Cohosh,— is the rhizome and 
rootlets of Caulophyllum thalictroides, a plant of the nat. ord. 
Berberidaceae growing in Canada and the northern United States. 
Rhizome about 4 inches long, thick and bent, rootlets numerous 
and matted, taste sweetish, bitter and acrid. Contains Saponin 
a glucoside, and two resins. Dose, gr. v-xx. There are no 
official preparations. The eclectic preparation Caulophyllin is a 
resinous precipitate obtained by pouring an alcoholic extract 
into water. 

Physiological Action and Therapeutics. 

Caulophyllum is a new addition to the pharmacopoeia, and 
has not yet been made the subject of experimental work by 
reliable observers. It was much used by the aborigines of this 



CERA — CERII 0XALA5. I 3 I 

:.:ry::: all affections t: which their- women were :ccal 
: :. 1 was k::cw:; among then: by the name '"s :::-: : ■:: " 

It is said to produce inter:::itte::t contractions of the gravid 
uteru^. t~ ~ave diuretic. en:mena cr ~'3'ue a v ~ f ami^a^rnodic Dowers ! 

pains, spasmodic pains in the uterus at any time, spasmodic dys- 

menorrhcea. and pains in other organs seemingly in sympathy 
: a teniae affect: ins. It has somewhat of a reputation in acute 
rheumatism of the hands and fingers, and as a preparative medi- 
cine for labor. 



CERA, Wax,— is a mixture cf Myricin, Cerotic Acid and 
Cerolein, is formed by the honey-bee. and exists in the pollen and 
leaves of many plants, particularly in Myrica cerifera^ the wax 

myrtle. That produced by the bee is alone official. 

Cera Alka. White Wax. — is yellow wax bleached. 

Cera Flava. Yellow Wax. — is a peculiar concrete substance 
prepared by Apis mellitca. the honey-bee. It is a yellowish solid. 
of agreeable odor and faint, balsamic taste, melting at 145.4 to 
i:; : F.. oi sp. gru 0.955-2.067. insoluble i:: water and almost 
so in cold alcohol, but soluble in 35 of ether, 1 1 oi chloroform, 
boiling alcohol, fixed and volatile ::ls. 

Preparations. 

LI7.ATV:-:. Cer.-r.— ::r. = -s:= -:* T .V*.-.-.:e V\";.x ;?. L.vr:l 7?, 
Unguentdm, Ointment, — consists of Yellow Wax 20, Lard 80. 
Wax is also a constituent of the 7 compound Cerates, 5 of the 25 compound 
Ointments, and S :: he 17 Plaster-. 

Physiologic a! Act: on and Therapeutics. 

Wax owes its value to its power of resistance to decomposition 

and to many chemical agents. Its fusibility at a moderate degree 

with its unirritating quality, make it a valuable ingredient oi the 
cerates and ointments to give them consistence. 

Ceratum and Unguextum may be used as simple protective 
applications. They form the bases cf mist ■:: the compound 
preparations so named. 



CERII OXALAS, Oxalate of Cerium, Cep CO/ : -cHpj ; 

_a :n water C'r aiC'.atcl. :ut souatue in i:vcrucmoric acid, 
e, gr. j— x, in pill. 



I 3 2 CETACEUM CETR ARI A. 

Physiological Action and Therapeutics. 

Oxalate of Cerium is a gastric sedative (like Bismuth), and is 
thought to have selective action as a sedative to the motor distri- 
bution of the pneumogastric nerve. It is considered to be par- 
ticularly useful in vomiting of reflex origin, especially in the 
vomiting of pregnancy, but it often fails, probably because not 
given in sufficient doses. To be effective at least 4 or 5 grains 
should be given 3 times a day to adults, and no results promised 
until after it has been used several days. It is also recommended 
in the vomiting of phthisis and bronchitis, cough with vomiting, 
gastralgia, chorea and diarrhoea. 



CETACEUM, Spermaceti, — is a peculiar, concrete, fatty 
substance obtained from Physeter macrocephalus, the sperm 
whale. Occurs in white, pearly masses, odorless, of bland taste, 
and neutral reaction, becoming rancid in the air, soluble in ether, 
chloroform, carbon bisulphide and boiling alcohol. Is a constit- 
uent of Unguentum Aquae Rosae, and Charta Cantharidis. 

Pi'eparation. 

Ceratum Cetacei, Spermaceti Cerate, — consists of Spermaceti 10, White 
Wax 35, Olive Oil 55 parts. 

Physiological Action and Therapeutics. 

Spermaceti consists of Cetin or Palmitate of Cetyl with several 
other fats in small quantities. Its action is solely that of an 
emollient, and it is rarely used internally. The Cerate is used 
as a bland ointment in blisters, abrasions, and ulcers. 



CETRARIA, Iceland Moss, — is the lichen Cetraria 
islandica, found in northern latitudes. Occurs about 2 to 4 
inches long, brown above, whitish beneath, taste mucilaginous 
and bitter. Contains Lichenin or lichen starch, which forms as 
a jelly when the plant is boiled in water ; — also Cetraric Acid. 

Pi'eparation. 
Decoctum Cetrari^e, — 5 per cent, strength. Dose, ^ij-iv. 

Physiological Action and Therapeutics. 

Cetraria is nutrient, demulcent and feebly tonic. It has a 
popular reputation in pulmonary affections, and is of value in 
chronic catarrhs, chronic bronchitis, purulent discharges from 



CHAULMOOGRA OIL CHELIDONIUM CHENOPODIUM. 1 33 

mucous surfaces generally, also in chronic diarrhoea and 
dysentery. 



CHAULMOOGRA OIL (Unofficial),— is a fixed oil ex- 
pressed from the seeds of Gynocardia odorata, an East Indian 
tree of the nat. ord. Bixacese. It is nauseous and bulky, solid at 
62. 6° F., and soluble in alcohol, ether, chloroform, etc. Its 
active principle, Gynocardic Acid, is the best preparation for 
use, and may be given internally in doses of gr. ss-iij, or applied 
as an ointment, gr. xx ad §j of Petrolatum. Dose of the oil, 
gtt. v-x, in capsules. 

Chaulmoogra Oil is credited with a few cures of leprosy, and 
several cases improved by its use both interally and externally. 
It is recommended as an external application in scaly eczema, 
psoriasis, syphilitic skin-diseases, chronic rheumatism, rheumatic 
arthritis and tabes mesenterica. 



CHELIDONIUM, Celandine,— is the plant Chelidonium 
majus, nat. ord. Papaveracese, which grows in Europe and N. 
America about rocky places. It has a peculiar, unpleasant odor, 
and a pungent, acrid taste. Contains 2 alkaloids, Chelidonine, 
C 19 H 17 N 3 3 , and Chelerythrihe, the latter being identical with 
Sanguinarine : also Chelidoxanthin, a yellow, crystalline substance, 
and Chelidonic Acid, supposed to be identical with Succinic Acid. 
Dose of the plant, gr. x-xxx, — of the fresh juice ""tv-xx. There 
are no official preparations. 

Physiological Action and Therapeutics, 

Chelidonium used externally is irritant, internally it is a 
drastic purgative but an unreliable one. It is also perhaps diu- 
retic, diaphoretic and expectorant. In overdoses it is considered 
poisonous. It is an old remedy for jaundice and liver affections, 
but has been obsolete for some time. The fresh juice is a popular 
application for warts and corns, and a tincture in whiskey is used 
in Indiana as a remedy for phthisis, the menstruum being proba- 
bly the most useful agent. It seems to be of real service in simple 
jaundice, whooping-cough, right-sided pneumonia with hepatic 
involvement, and the catarrhal pneumonia of children. 



CHENOPODIUM, American Wormseed,— is the fruit 
of Chenopodium ambrosioides, var. anthelminticum, a plant of the 



134 ► CHIMAPHILA. 

nat, ord. Chenopodiaceae, indigenous in the United States. It 
is about yL inch in diameter, and contains a glossy, black seed, 
has a peculiar, terebinthinate odor, and a pungent, bitter taste. 
Its active principle is a Volatile Oil which is official. 

Preparation. 

Oleum Chenopodii, — a thin, colorless or yellowish liquid, of aromatic 
odor and pungent, bitter taste. Dose, "Nlv-xv. 

Physiological Action and Therapeutics. 

The Oil is the only preparation used and that rarely, its odor 
and taste being very disagreeable. It increases the cardiac rate, 
and promotes the secretions of the skin, bronchi and kidneys. 
It is an efficient anthelmintic against the round worm in doses of 
gtt. x three times a day for two days and followed by a cathartic. 
It seems to possess some tonic properties, and certainly is a dif- 
fusible stimulant. As such it has been used with benefit in cho- 
rea, hysteria, flatulent dyspepsia, and chronic malaria. 



CHIMAPHILA, Pipsissewa, — the leaves of Chimaphila 
umbellata, or Prince's Pine, an evergreen plant of the nat ord. 
Ericaceae, indigenous in all parts of the United States. The 
leaves are about 2 inches long, serrate above, wedge-shaped 
towards the base, having an astringent and bitter taste. Con- 
tains Chimaphilin a yellow crystalline principle, Arbutin also 
crystalline but colorless, with tannic acid, etc. 

Preparations. 

Extractum Chimaphiue Fluidum, — Dose, ^ss-ij. 
Decoctum Chimaphila (Unofficial), — 1 to 17. Dose, §j-iij. 

Physiological Actio?i and Therapeutics. 

Chimaphila is a tonic, astringent diuretic, belonging to the 
same group as Buchu, Uva Ursi, Pareira and Scoparius. It is 
probably the most active diuretic among them, stimulating all 
the excretory organs but especially the kidneys. It is an agree- 
able tonic, excites the appetite and promotes digestion. The 
fresh leaves, bruised and applied to the skin, are rubefacient and 
vesicant, showing the presence of some irritant principle. 

Chimaphila is a good diuretic in dropsy, and is efficient in 
several forms of chronic kidney disease with albuminuria, and in 
chronic catarrhal affections of the urinary passages, as hematuria, 
ischuria, dysuria and gonorrhoea. It is believed to check the 



CHINOLINA — CHIRATA. 1 35 

secretion of uric acid, and should prove useful in gout and rheu- 
matism. Externally, it has been applied to ulcers and tumors 
with benefit. 



CHINOLINA,Chinoline,Leucoline,C 9 H 7 N (Unofficial), 

— is an alkaloidal derivative of Quinine or Cinchonine, obtained 
by their destructive distillation with Potassium Hydrate; also 
found as a constituent of coal-tar, and artificially prepared by 
heating Anilin or Nitrobenzol with Glycerin in the presence of a 
dehydrating agent. It is a colorless, oily liquid, strongly re- 
fractive, sp. gr. i. 08 1 at 50 F., boils at 460 F., without decom- 
position, turning dark on exposure to air, soluble in alcohol, 
ether, and carbon bisulphide, sparingly soluble in water. It com- 
bines with acids to form salts, which, except the tartrate, are very 
deliquescent. 

Preparation. 

Chinoline Tartras,— a white, micaceous, crystalline powder, of pungent 
odor and sharp taste, stable in the air and soluble in water. Dose, gr. v-xx. 

Physiological Action and Therapeutics. 

Chinoline is a valuable antiseptic and antipyretic, being nearly 
as effective in this respect as Quinine, which it closely resembles 
in chemical character and physiological action. It is one of the 
most powerful antipyretics of all the substances which have been 
discovered in the search for an artificial quinine (Hydroqui- 
noine, Antipyrin, Pyrocatechin, Resorcin, Thallin, Kairine, etc.). 
Chinoline has a very disagreeable taste and smell, and is irritant 
in action, hence the tartrate is preferred for medicinal use. It has 
been extensively used as an antipyretic in pneumonia, typhus, 
diphtheria, typhoid and other fevers, with varying success. In 
diphtheria, a 5 per cent, solution in weak alcohol is painted on 
the affected surface with great benefit. The tartrate has been 
used beneficially in neuralgia and whooping-cough, and as an 
antiperiodic in intermittents. 



CHIRATA, Chiretta, — is the Indian plant Ophelia Chirata, 
nat. ord. Gentianaceae, occurring in bundles composed of all but 
the coarser woody stems. It is inodorous but intensely bitter, 
and contains Chiratin and Ophelic Acid, two amorphous, bitter 
principles, but no tannin. Dose of the powdered plant, gr. xv- 

XXX. 



I36 CHLORAL. 

Preparations, 

Extractum Chirat^: Fluidum,— made with glycerin and diluted alco- 
hol. Dose, TTixv-xxx. 

Tinctura Chirat^, — io per cent. Dose, ^ss-ij. 

Physiological Action and Therapeutics. 

The action of this plant is that of a simple bitter, like its con- 
gener Gentian. It is an excellent tonic, in this respect rivalling 
Cinchona, and is used in India as a substitute for the latter. It 
is laxative and stomachic, diminishes flatulency and acidity, and 
is particularly serviceable in the dyspepsia of gouty subjects. As 
it contains no tannin, it may be administered with preparations 
of Iron. 



CHLORAL, Hydrate of Chloral, C 2 HC1 3 0,H 2 0,— is in- 
accurately named, the hydrate being the official preparation. 
Chloral, properly so-called, is Trichloracetyl-hydride, C 2 HC1 3 0, an 
unstable, oily, colorless fluid, formed by the action of Chlorine 
upon Alcohol, whence its name Chlor-al. Its hydrate, the official 
Chloral, is a colorless, crystalline solid, which slowly evaporates 
on exposure to the air, of aromatic and acrid odor, bitter and 
caustic taste, and neutral reaction. It is freely soluble in water, 
alcohol, ether, glycerin, oils, etc., liquefies when mixed with 
camphor or carbolic acid, melts at 136 F. and is decomposed 
by alkalies into chloroform and a formate of the alkaline base. 
Its aqueous solution becomes acid, but the alcoholic solution re- 
mains neutral. 

Dose varies much with individual susceptibility and with the presence or 
absence of cardiac and pulmonary disease. Death has been caused in several 
instances by gr. xxx, in one case by gr. x, and in another gr. vijss produced 
alarming symptoms, all being adults. On the other hand several hundred 
grains have been ingested at one time without lethal effects, and where toler- 
ance has been established by habitual use, ^ij —3 iij are frequently taken with- 
out poisonous symptoms. An average dose for a healthy adult is gr. xv, for 
a child gr. j for each year of age up to gr. vj. It is best given in Syrup of 
Tolu. 

When prescribed in combination with alcoholic preparations, Chloral Hy- 
drate is very apt to separate as an alcoholate, especially if the Bromides of 
Potassium or Sodium are used in the same mixture and if the solutions are at 
all concentrated. In this way great danger is incurred of giving a heavy 
overdose, as the alcoholate floats on the surface of the mixture. 

Physiological Action. 

Chloral is a powerful hypn#tic, also an antispasmodic, an anti- 
ferment, a preventive of the coagulation of fibrin, indirectly an 



CHLORAL. 137 

anaesthetic, and especially a depressant of the cerebral, medullary 
and spinal centres and of the cardiac muscle. It is more hypnotic 
than chloroform but less of an anaesthetic. Applied to the skin or 
mucous membranes a 1 per cent, solution (gr. v ad §j) is anti- 
septic, but strong solutions are irritant and vesicant, may produce 
sloughing ulcers, and if taken internally may excite gastritis with 
nausea and vomiting. 

After a brief period of stimulation a medicinal dose depresses 
the heart and lowers arterial tension, diminishes oxidation and 
decreases the body temperature. On the brain cells it has a selec- 
tive action, producing a deep sopor very like normal sleep, from 
which the patient may be awakened, but immediately falls asleep 
again, and which is not followed by headache or depression. This 
effect is considered by some authorities to be the result of cerebral 
anaemia produced by the drug. In some persons, instead of 
sleep it causes headache, insomnia and delirious excitement. It 
is not an anodyne as it does not affect the conductivity of the 
sensory nerves, and does not interrupt the transmission of pain ; 
but by overwhelming the centres it drowns the consciousness of 
pain, and is therefore only indirectly anaesthetic. A toxic dose 
produces profound narcotism, abolishment of reflexes and sensi- 
bility, complete muscular relaxation and a great fall of body tem- 
perature. Death may result in the chloral sleep from paralysis of 
the respiratory centre or the cardiac motor ganglia, or by sudden 
failure of the heart-muscle in cases of fatty degeneration or in old 
drunkards. 

The Chloral-habit produces a state of marked anaemia, its 
subject presenting a weak, irritable, often irregular heart, deranged 
hepatic functions, jaundice, bileless stools, perhaps purpura and 
sloughing of a finger from decreased blood-supply. Its votaries 
are on the border of insanity, excitable, uncontrollable in speech 
and action, talking in a silly manner and very volubly. Many 
cases of insanity have their origin in chloralism. 

On the blood its action is to increase the fluidity, crenate the 
red corpuscles, and to destroy the leucocytes if used in large 
quantity. It is rapidly diffused, and is excreted by the kidneys 
partly unchanged, but chiefly as urochloralic acid, producing some 
diuresis, — also by the skin, causing various eruptions if used for 
any lengthened period. It has been held that the blood, being 
an alkaline fluid, decomposes it, setting free chloroform, but there 
are many facts against this theory. 

Chloral and Atropine, though antagonistic in their action 
on the spinal cord, both produce motor paralysis, the former by 

12 



133 CHLORAL. 

paralyzing the cord, the latter by direct paralysis of the motor 

--'•:-:;-/'-::';-; .:■';.:" .';.•; '-::.::: V:. 

Atropine antagonizes its cardiac, respiratory and spinal depression, and 
should be injected in small doses frequently repeated, until its eflec: 

:.":.7r7_:. M: J.ri-iiNi .-. :.z:: --.•?: r:r." : . -".:/. C:.'.:t-i. .ir.u-Tr.izr? :.~e :t~ :t~ :v 
:: ::-7:.:;.: :";,: /.ire. >' e ?y~r: -:«::: :: :~r hvrr.:::?—. T .\":S_± !':.'.:• 71. i- :;e 

S : . hriine, opposing the spinal action of that drug, the re 
is only true to a very limited extent. Heat is a necessary application, to main- 
tain the body-temperature, and artificial respiration should be practiced if 
required. All alkalies are incompatible. 

Thcrapcut 

Chloral Hydrate is of great value as a hypnotic and antispas- 
modic, bat must be cautiously used if at all in old alcoholi 
persons with weak or fatty hearts, atheromatous vessels a need 

pulmonary disease. In combination with Potassic Bromide it is 
much used in asylum and general prac A equally ab 

: : :."- irv^s je::-^ ;. :::*•" e .:.--:::::• : 7 riszns. I: is highly servirei'iTe 
in fevers, when high temperature ex ement, res: 

and a sthenic condition, as it lowers temperature and pre- 
vents the coagulation of fibrin. In the algid stage of cholera 
and in violent cases of cholera morbus it may be injected hypo- 
dermically in 15 -grain doses with extraordinary efficacy. In 
seasickness small doses (gr. v) two or three times ire gen- 

eral! t efficient. In obstetr ; is used to relieve suffering, 
relax the os uteri, palliate convulsions and to relieve after-pains. 
For nocturnal epilepsy a full dose at bedtime is a useful palliative. 
In neuralgia it may be triturated with camphor and applied over 
the course of the affected nervr Tetanus is best treated by 
chloral and potassic bromide. It is an excellent remedy for in- 
fantile convulsions and colic, chorea, spasmodic asthma, whoop- 
ing-cough, laryngismus stridulus, and the first stage of diphth 
but not when the heart is weak. In acute mania and delirium 
tremens it is the best hypnotic, but has been too incautiously 
employed. In cancers and ulcers a 25 per cent, solution 
good antiseptic and anodyne application. In strychnine- poison- 
ing Chloral is the antagonist. It is generally given by the mouth 
in dilute solution with some simple elixir or cinnamon-water, but 
ell absorbed by the rectum. Its hypodermic administration 
is liable to result in great local irritation and even sloughing 
u.:e:s. 

The mixture of Chloral and Camphor is a good local applica- 
tion in superficial neuralgia, and may be painted over the kr 
for spasmodic cough. It makes a good remedy for internal use 



CHLORAL BUTYLICUM CHLOROFORMUM. I 39 

in colic, cholera and cholera morbus, especially if combined with 
Morphine. 



CHLORAL BUTYLICUM. Butyl-chloral Hydrate, 
Croton-chloral, CJ3 5 C1 3 0,H.,0 (Unofficial),— is termed by the 
action of Chlorine upon Aldehyde, then adding to the Butyl- 
Chloral thus produced the necessary water. It occurs in c 
talline scales, insoluble in chloroform, sparingly soluble in water, 
but freely soluble in alcohol, hot water and glycerin. Dose gr. 
v-xx, in syrup or pill. But the best method is to give 5 grains 
every half-hour until 20 grains have been taken or relief afforded. 

Physiological Ach I TJurapeii: 

Croton-chloral so far as is ascertained has an action parallel 
to that of Chloral Hydrate, but feebler and less certain. It is 
said to have a specific paralyzant power over the 5th nerve, and 
to have no paralyzant effect on the heart. It has been used with 
benefit in various neuralgias, especially tie-douloureux, also in 
sciatica and dysmenorrhea. All statements of the action and 
therapeutics of this drug are to be received with hesitation, as 
wide differences are reported by the best authorities. 



CHLOROFORMUM, Chloroform, CHCL.— the 7>r- 
chloride of Methyl, or the Chi f Bicklot M '; is 

formed by the substitution of 5 atoms of Chlorine for 3 of Hy- 
drogen in Methyl Hydride ^marsh-ga^;, CH 4 \ In practice it is 
obtained from Ethylic Alcohol or Methylated Spirit by the action 
of Chlorinated Lime, or from Chloral by an alkaline hydrate, 
and is known chemically as J form. If prepared from 

Methylic Alcohol ^wood-spirit) it is called Meth; 'aroform 

and is purified with great difficulty. The object of purification 
is to remove the chlorinated pyrogenous oil. Absolute Chloroform 
.1 sp. gr. of [.500, and decompose- easily in sunlight or dif- 
fused daylight, but when reduced to a sp. gr. of 1.4S5 to 1.490 
by alcohol it will keep well. It is official in two forms, viz. — 

Chloroformum Vexale. Commercial Chloroform, — is a liquid 
containing at least 9S per cent, of Chloroform, and having a 
gr. not lower than 1.470. It contains sundry Hydrocarbons, free 
Chlorine, Aldehyde and Hydrochloric Acid, and is used only for 

rrnal applications, or to make the purified article. It 
constituent of Linimentum Chloroformi. 

Chloroformum Purificatum, Purified Chloroform, — is a 



I40 CHLOROFORMUM. 

heavy, clear, colorless, diffusive liquid, of characteristic odor, 
sweet, burning taste and neutral reaction, soluble in 200 of water, 
freely so in alcohol or ether, also in oils, benzol or benzin. Sp. 
gr. 1.485 to 1.490 at 59 F., and contains ^ to 1 per cent, of 
alcohol. Dose, internally, TT£ij-xx, for inhalation about 3j, re- 
peated until the desired effect is produced. 

Preparations. 

Mistura Chloroformt, — contains of Purified Chloroform 8, Camphor 2 
fresh Yolk of Egg 10, Water 80 parts. Dose, 3J- t ^j. 

Spiritus Chloroformi, — contains of Purified Chloroform 10, Alcohol 90 
parts. Dose, TUx-^j, well diluted. 

Linimentum Chloroformi, — Commercial Chloroform 40, Soap Liniment 
60 parts. 

Linimentum Chloroformi Compositum (Unofficial), — Chloroform gj, 
Oil of Turpentine 3jj, Tincture of Opium ^iv, Tincture of Aconite gij. 

Chlorodyne (Unofficial), — a celebrated secret mixture, put forth by Dr. 
J. Collis Browne, of London, and since imitated by many others. It is sup- 
posed to contain Chloroform, Ether, Morphine, Cannabis Indica, Hydrocyanic 
Acid, Capsicum, etc., and is powerfully anodyne, antispasmodic and narcotic, 
and therefore highly dangerous in non-professional hands. Dose, Til x-xxx, 
according to the quantities of Morphine and Chloroform present, these being 
the active agents in the preparation. A comparison of the principal formulae 
which have been used in imitation of Browne's Chlorodyne is given in the 
appendix, and will show the wide differences between them. A list of 25 
formulae for Chlorodyne was published in the Therapeutic Gazette for Octo- 
ber, 1883. 

Anesthetic Mixtures containing Chloroform, — see under ^Ether, ante, 
page 44. 

Some Chlorinated Anesthetic Compounds. 

Ethylene Bichloride, Dutch Liquid, Chloric Ether, C 2 H 4 C1 2 , — is a 
rapid and powerful anaesthetic, probably safer than Chloroform and less so 
than Ether. It always paralyzes the respiratory centre before the heart, so 
that its effects may be easily watched and controlled. This is the substance 
which Guthrie supposed he had obtained when he discovered chloroform. 

Ethylidene Chloride, Chlorinated Muriatic Ether, CH 3 ,CHC1 2 , — is a 
mixture of varying sp. gr., and is not inflammable. It closely resembles Chlo- 
roform both physically and physiologically, but is less depressant to the heart, 
consequently safer, and recovery from its effects is very prompt. 

Methylene Bichloride, Dichloro-methane, CH 2 C1 2 , — is an effective an- 
aesthetic which it was supposed would displace Chloroform as being much 
safer. Dr. Richardson introduced it and Mr. Spencer Wells advocates its use, 
but though little used as compared with other anaesthetics several deaths have 
occurred from its employment. It kills by paralyzing the heart. 

Carbon Tetrachloride, CC1 4 , — is less irritant than Chloroform, but far 
more dangerous to the heart. 

Physiological Action. 

The action of Chloroform is similar to that of Ether (see ante, 
page 44) with several important differences, as follows : It is more 



CHLOROFORMUM. I4I 

irritant to the mucous membranes, and if swallowed undiluted it 
produces violent gastro-enteritis, which becomes apparent after 
the subsidence of the profound narcotism which at first follows 
its ingestion in quantity. A dose of gj internally will cause 
death. It is less of a stimulant than Ether, and more depressant 
to the heart and circulation. It clots blood outside the body, 
making a mass like sealing-wax. 

Inhaled for anaesthetic purposes it is considered much more 
dangerous than Ether from its direct paralyzant effect on the 
heart. Its vapor requires admixture with 96^ per cent, of air to 
produce anaesthesia with safety according to the authorities on the 
subject. As compared with Ether its vapor is less irritant to the 
air-passages, uninflammable, more pleasant, more prompt in ac- 
tion, has a shorter stage of excitement and a more profound nar- 
cosis, and produces much less vomiting. Its mortality is greater, 
being 1 in 3000, against 1 in 16,000 for Ether, about 500 fatal cases 
being reported, none of which, however, were in obstetrical prac- 
tice. Death from Chloroform-inhalation is almost always sudden 
and by cardiac paralysis, — from Ether it is slow and usually by 
paralysis of respiration. 

[For modes of death from anaesthetic vapors, and the treatment 
of dangerous symptoms, see ante, page 45.] 

Antagonists. 

There is no chemical antidote. If swallowed, the stomach should be 
evacuated and the case treated as one of poisoning by an irritant. Amyl Ni- 
trite by inhalation, and Atropine hypodermically, to sustain the heart. 

Therapeutics. 

Chloroform is used for the same conditions as is Ether, and 
is much employed in liniments as a rubefacient and anodyne 
application, as in pruritus, rheumatic and neuralgic pains, etc. 
Internally it is advantageously administered in true cholera, in 
which it has been more efficacious than any other single remedy, 
in cholera morbus, vomiting, colic, dysmenorrhcea, hepatic colic, 
and other pains of internal and spasmodic character. In sciatica, 
tic-douloureux and other neuralgiae of important nerves the deep 
injection of Trgv-xv of pure Chloroform in the vicinity of the 
nerve is highly recommended, though it may cause dangerous 
local disturbance. The writer has, in several cases of severe 
supra-orbital neuralgia, injected two or three minims of Chloro- 
form into the vicinity of the supra-orbital nerve just above its 
foramen of exit, with the most gratifying results, though severe 
local pain and considerable swelling were experienced for several 



142 CHLOROFORMUM. 

days. The vapor in small quantities inhaled from warm water is 
useful in many respiratory neuroses, as hay-fever, spasmodic 
asthma, reflex cough. 

As an Ancesthetic the use of Chloroform is decreasing every 
year in favor of Ether, except for young children and in obstet- 
rical practice. Its vapor being four times denser than air, and 
the rule for its effective use requiring fully 96^ per cent, of air 
with it, its administration according to the orthodox fashion 
requires most careful management, and should never be attempted 
in any but the recumbent posture. An ounce of Brandy and a 
hypodermic injection of Morphine, gr. \, with Atropine, gr. 
Y^-Q, given 20 minutes before commencing the inhalation, are 
means of great utility in sustaining the heart and respiration, as 
well as in rendering the anaesthesia more profound. No opera- 
tion, especially on parts supplied by the fifth nerve, should be 
undertaken during partial chloroform anaesthesia, for the reasons 
given on page 45. 

Dr. Sayre of New York administers Chloroform in a manner 
which is calculated to strike terror to the heart of an emotional 
observer who is impressed by the orthodox rule of 96^ per cent, 
air with 3^ per cent, of the anaesthetic as the only safe propor- 
tion. Having been made familiar with the practice of Dr. Sayre 
through observance of the method employed by some of his 
pupils, the writer sought for more direct instructions from that 
distinguished surgeon, and received from him a letter from which 
the following paragraphs are extracted. 

" I have employed no other method for more than twenty years, have used 
it in this manner in some thousands of cases without the least appearance of 
danger, and can therefore speak with confidence as to its safety. 

" My plan is simply to anaesthetize the patient with the smallest amount of 
Chloroform possible ; and as Oxygen is the antidote to the anaesthetic I ex- 
clude all air that is not impregnated with the ancesthetic. 

" In this manner a very few inspirations will produce immediate anaesthesia 
without the muscular struggling which always follows when pure air is ad- 
mitted with the chloroform. I always measure my dose with the same care 
as if I were administering Arsenic, Strychnine, Corrosive Sublimate, or any 
other potent agent; and then I know what I am doing. If by accident there 
should be some peculiarity about the patient, making him unduly susceptible, 
a few artificial respirations would soon remove the influence of the few drops 
which had been inhaled, and thus all danger can be avoided. Five, ten or 
twenty drops of Chloroform administered in this manner is all that is requisite 
to produce immediate and profound anaesthesia. I have explained my method 
hundreds of times at my clinical lectures in Bellevue Hospital, many of which 
have been published at different times in different medical journals by various 
persons who have made stenographic reports of my lectures. In the ' Trans- 
actions of the International Medical Congress,' held in Philadelphia in 1876, 



CHLORUM. I43 

is a verbatim report of my remarks on this subject made while I was perform- 
ing an exsection of the hip-joint in the hospital before the Congress." 

I remain, yours truly, 

Lewis A. Sayre. 

The writer can add his testimony to that of the above letter 
respecting the thorough anaesthetic effect and freedom from un- 
pleasant symptoms observed in a large number of cases in which 
Chloroform was administered in the manner described under his 
observation during the past three years. As to the safety of this 
method over the ordinary way no conclusion can be reached 
without the results of many thousands of examples in the hands 
of many different observers. 



CHLORUM, Chlorine, CI, — is a greenish-yellow gas hav- 
ing a suffocating odor and belonging to the group of Halogen 
elements, so named (from SXq, the sea) because its most impor- 
tant members Chlorine, Bromine and Iodine are derived from the 
ocean, Chlorine being obtained from sea-salt, Bromine from sea- 
water, and Iodine from sea-weed. Chlorine itself is not official, 
but is represented in medicine by 2 Chlorates and 2 Chlorides 
(of Potassium, Sodium, etc.), which are described under the titles 
of their respective bases, also by the following preparations which 
furnish it. 

Preparations. 

AQUA Chlori, Chlorine Water, — is an aqueous solution of Chlorine, con- 
taining at least 0.4 per cent, of the gas ; and is prepared by heating together 
Black Oxide of Manganese 10 parts and Hydrochloric Acid 40 parts, then 
saturating 400 of distilled Water with the gas so obtained. It is a clear, green- 
ish-yellow liquid, of suffocating odor and disagreeable taste. Dose, 3J-5SS, 
well diluted, as a lotion or spray ; internally, Tflx— xx in water. 

Chlorine Water may be extemporaneously prepared by mixing in a mortar 
Chlorate of Potassium 40 grains and Hydrochloric Acid y 2 ounce, and add- 
ing a pint of distilled water by agitation during the evolution of the vapors. 
If done in a closed vessel danger may arise from the explosive gas, C1 2 4 , 
which is liberated at the same time. It should be quickly bottled. 

Calx Chlorata, Chlorinated Lime, Chloride of Lime, — is a compound 
resulting from the action of Chlorine upon Calcium Hydrate, and containing 
at least 25 per cent, of available Chlorine. It is obtained by exposing slaked 
Lime to the action of Chlorine gas as long as the latter is absorbed, and should 
not be confounded with Chloride of Calcium (see ante, page in). It occurs 
as a whitish, dry powder or friable lumps, gradually decomposing in the air, 
of saline, disagreeable taste and a feeble Chlorine odor, partially soluble in 
water and in alcohol, and when dissolved in dilute Hydrochloric acid gives off 
Chlorine gas. Dose, gr. iij-vj in water ; for external use a 1 to 3 per cent, 
solution. Liquor Calcis Chlorate, B. P., is a solution of 1 pound in 1 
gallon of water. 

Liquor Sod^e Chlorat/e, Solution of Chlorinated Soda, Labarraque's 



144 CHLORUM. * 

Solution, — a pale-greenish liquid, of faint Chlorine odor, and alkaline taste 
and reaction ; prepared by adding together watery solutions of Sodium Car- 
bonate ioo parts and Calx Chlorata 80, then adding Water up to 1000. Dose, 
TTLx-gj in 20 parts of water. 

Physiological Action, 

Chlorine is actively irritant to the skin and mucous membranes. 
Locally applied it produces heat, burning and even vesication. 
Inhaled in any quantity it causes cough, sneezing and spasm of 
the glottis, also inflammation of the air-passages and of the lungs. 
It is the most powerful of all disinfectants and deodorants, also 
an antiseptic and antifermentive agent of the highest activity. 
Its power in all these respects is due to its affinity for hydrogen, 
decomposing all bodies in which hydrogen enters as a molecular 
constituent, forming chlorhydric acid and setting oxygen free in 
its nascent form (ozone). Used internally it has the same local 
action on the parts with which it comes in contact, and on reach- 
ing the stomach in dilute solution it is converted into hydro- 
chloric acid and chlorides, losing all further action on the body 
in its own character. 

Antidotes. 

Ammoniacal vapors inhaled after Chlorine form Ammonium Chloride. 
Ammonium Sulphide has a similar reaction, but should be inhaled in great 
moderation. Albumen is the antidote if Chlorine preparations have been 
taken into the stomach, and a little Aqua Ammonise, sufficiently diluted, may 
also be administered with advantage. 

Therapeutics. 

The chlorinated preparations are used as disinfectants and 
deodorizers of rooms, drains and discharges from the body. 
They are rarely used about the person or clothing of patients by 
reason of the irritation produced by them when inhaled, and 
their power to destroy the color of fabrics. In dilute solution 
they are well employed as local applications in aphthae, gangrene, 
scarlet fever and diphtheria, in which their principal action is to 
destroy fetor. The same may be said of their use in sloughing 
ulcers and gangrenous wounds, foul discharges, etc., as they are 
rarely employed about the person in sufficient strength to have 
any destructive effect on disease-germs. A strong solution of 
Chlorinated Soda is a good application to bites of serpents and 
insects, to prevent infection by the syphilitic poison, and to wash 
the hands after contact with infectious material. 

These preparations have been administered internally in septic 
diseases, low fevers, etc., but without producing any marked 
beneficial results. 

To disinfect unoccupied rooms all means of exit should be 



• CHONDRUS CHRYSAROBINUM. I45 

stopped up, then a pound of Chlorinated Lime sewed loosely in 
a strong canvas bag is immersed in a mixture of a pint and a 
half of common muriatic acid with 4^ pints of water, and left 
24 hours. 



CHONDRUS, Irish Moss, — consists of two sea-algse, 
Chondrus crispus and Chondrus niammilosus, dried and bleached. 
Is horny, translucent, pale yellowish-white, swelling in water, of 
sea-weed odor and mucilaginous, saline taste. On boiling with 
30 parts of water for ten minutes it yields a solution which gela- 
tinizes on cooling. It contains 90 per cent, of mucilage with 
traces of Iodine and Bromine, also 1 per cent, of Nitrogen. 
There are no official preparations. A jelly or blanc mange may 
be prepared by boiling gij in gxxxiv of water for an hour, strain- 
ing and adding giij of sugar while hot. Dose, indefinite. 

Physiological Action and Therapeutics. 

Irish Moss is a demulcent and nutrient substance of some slight 
value in bronchial and catarrhal affections. Having no starch in 
its composition it is not so valuable as Iceland moss (Cetraria) as 
an article of food for the sick. 



CHRYSAROBINUM, Chrysarobin,— is a mixture of 
proximate principles extracted from Goa-powder, a substance 
found in cavities formed by decay in the wood of the trunk of 
Andira Araroba, a Brazilian tree of the nat. ord. Leguminosae. 
It is commonly misnamed " Chrysophanic Acid" (which is one 
of the constituents of Rheum) — though easily converted into 
that substance. Occurs as an orange-yellow powder, odorless 
and tasteless, nearly insoluble in water and alcohol, but readily 
soluble in ether, solutions of alkalies and sulphuric acid. Dose, 
gr. }£-gr. xx. 

Preparation. 

Unguentum Chrysarobini, — Chrysarobin 10, Benzoinated Lard 90 parts. 
Should be diluted for average use from 3 to 5 times. 

Physiological Action and Therapeutics. 

In 30-grain doses Chrysarobin is a gastro-intestinal irritant, 
producing large, watery, bilious stools, with repeated vomiting but 
not much nausea. Locally it produces diffuse dermatitis often 
followed by follicular and furuncular inflammation. It stains the 
skin a dark yellowish-brown color, which may be removed by a 



I46 CIMICIFUGA. 

weak solution of chlorinated lime. The use of this remedy is 
confined to superficial parasitic skin diseases of vegetable origin, 
and for psoriasis, in the latter affection it being the best remedy 
known. It maybe used in weak ointment locally, and internally 
in }£ -grain doses. 



CIMICIFUGA, Black Snake-root, Black Cohosh,— 

is the rhizome and rootlets of Cimicifuga racemosa, a plant of the 
nat. ord. Ranunculacese native in the United States. Rhizome 
horizontal, 2 inches long or more, about 1 inch thick, with nu- 
merous upright or curved branches. Rootlets numerous, con- 
taining a ligneous cord which branches into four or five rays. 
Contains a Volatile Oil when fresh, resin, tannic and gallic acids, 
also an acrid, crystallizable, neutral principle. Cimicifagin or 
Macrotin is an impure resin obtained by precipitation from a con- 
centrated tincture by the addition of water. The active principle 
has not been isolated. 

Preparations of the Fresh Root. 

Extractum Cimicifuga Fluidum, — alcoholic. Dose, ""Ix-^j. 
Tinctura Cimicifuga, — 20 per cent. Dose, ^ss-ij. 
Macrotin (Unofficial), — Dose, gr. J^-ij. 

Physiological Action. 

Cimicifuga is stomachic, antispasmodic, aphrodisiac, diapho- 
retic, diuretic and expectorant. Its taste is bitter and nauseous, 
resembling that of Opium. It acts on the heart and circulation 
similarly to Digitalis, and on unstriped muscular fibre like Ergot, 
but is much feebler in activity than either of these agents. 
Small doses stimulate digestion and secretion, the generative 
function and the menstrual flow, and especially the secretions of 
the bronchial mucous membrane and the kidneys. Full doses 
slow the heart while increasing its force, raise arterial tension 
and stimulate uterine contraction. Large doses dilate the pupils 
and produce dimness of vision, vertigo, intense headache, nausea, 
vomiting, and in some persons soporific and anodyne effects. 

Therapeutics. 

Cimicifuga closely resembles Digitalis in action, but it is safer, 
and should be more frequently used when the latter drug is indi- 
cated. In cardiac diseases it is very efficient, especially in weak 
or fatty heart where Digitalis would be dangerous. It is a good 
stomachic tonic particularly in the irritable dyspepsia of alco- 



CINCHONA. I47 

holism. As an expectorant it is used in acute and chronic bron- 
chitis. It is a good nerve-tonic in delirium tremens, and in 
functional impotence it is remarkably efficient. In rheumatism 
of the localized muscular variety, as lumbago, torticollis, pleuro- 
dynia, intercostal rheumatism, etc., it is one of the most effica- 
cious remedies, having a strong affinity for the muscular system. 
Neuralgias of various kinds are benefited by it, particularly ova- 
rian neuralgia. Chorea about the age of puberty is one of the 
affections in which it is most efficient, and the same may be said 
of the hysterical form of this disease. 

Many uterine disorders are remarkably benefited by Cimici- 
fuga, such as amenorrhcea, neuralgic and congestive dysmenor- 
rhea, subinvolution, spinal irritation due to some obscure sympa- 
thetic or neuralgic affection of the womb, sympathetic pains and 
neuralgias arising from the so-called irritable womb, passive men- 
orrhagia, etc. In obstetrics it gives excellent results when used to 
initiate uterine contractions, check hemorrhage, allay afterpains 
and nervousness after delivery. In puerperal mania and periton- 
itis its good effects are frequently remarkable, and in puerperal hy- 
pochondriasis it is strongly recommended by very high authority. 



CINCHONA, Peruvian Bark. — The Cinchona tree 
belongs to the nat. ord. Rubiaceae and is a native of the eastern 
slope of the Andes, but has been largely planted in India, 
Ceylon, Java and Burmah, with the result of improving the 
quinine-yielding value of many species by cultivation. In late 
years the test of appearance has given way to that of assay in 
judging of the various barks of commerce, and only those are 
official which yield 3 per cent, of total alkaloids of which at least 
2 per cent, must be Quinine. Yellow bark contains most Qui- 
nine (as high as 9 per cent, having been obtained from one spe- 
cimen), pale bark contains most Cinchonine and least Quinine, 
while red bark contains these alkaloids in about equal propor- 
tions. The Columbian varieties afford the largest percentage of 
Cinchonidine. 

The principal varieties of the sub-order Cinchoneae, the barks 
of which are found in commerce and used by manufacturers of 
the alkaloids, are — 

Cinchona Calisaya, Yellow Bark, — from Peru, Bolivia and India. 
Cinchona succiruba, Red Bark, — from Ecuador, Java and Ceylon. 
Cinchona Condaminea, Pale Bark, — from Ecuador and Peru. 
Cinchona Pitayensis, Pitaya Bark, — from New Granada. 
Cinchona micrantha, Gray Bark, — from Peru and Bolivia. 



I48 CINCHONA. 

Altogether there are some 31 species acknowleged by botanists, 
and the list is constantly increasing from the tendency of the 
different trees to hybridize. Several trees formerly acknowledged 
as Cinchonas are now placed in the genus Cascarilla, but their 
barks are to be found on the market. Cuprea bark is from trees of 
the genus Remijia, growing in Columbia; it contains Quinine 
and a peculiar alkaloid, Cinchonamine, but no Cinchonidine. 

Official Species. 

Cinchona, — is the bark of any species of Cinchona which 
contains at least 3 per cent, of its peculiar alkaloids, as deter- 
mined by assay according to a prescribed rule. 

Cinchona Flava, Yellow Cinchona, Calisaya Bark, — is the bark of Cin- 
chona Calisaya, containing at least 2 per cent of quinine. Occurs in tawny- 
yellow flat pieces or quills, ridged exteriorly, finely striated on inner surface, 
breaking with a transverse fracture showing numerous rigid fibres in bundles 
or radial rows. 

Cinchona Rubra, Red Cinchona, — the bark of C. succirnba, containing at 
least 2 per cent, of quinine. Occurs in brown-red quills and flat pieces of 
various sizes, with ridges and warts on outer surface, coarsely striated on inner 
surface. 

Bark may be administered in doses of gr. x-gj, hut it is never used now in 
substance, being too bulky and disagreeable. 

Composition of Cinchona. 

The bark contains 21 natural alkaloids (of which 4 are official), 
8 artificial alkaloids, 2 simple acids, 2 tannic acids, a resinoid 
and coloring-matter, as follows : — 

Quinine, C 20 H 24 N 2 O 2 , — a strong base, fluorescent, the most valuable of all 
the alkaloids ; heated with glycerin to 374 F., it is converted into the isomeric 
base Quinicine. 

Quinidine, C 20 H 24 N 2 O 2 , — isomeric with Quinine, fluorescent, probably the 
most powerful as an antiperiodic, but existing in very small quantity. 

Cinchonine, C 20 H 24 N 2 O, — the least active of the official four, having about 
half the therapeutic power of Quinine. Not fluorescent. 

Cinchonidine, C^rL^N^O, — isomeric with Cinchonine, not fluorescent, 
one of the most powerful of the alkaloids. 

Kinic and Kinovic Acids, — are combined in the bark with the alkaloids. 
The former is used to make a Kinate of Quinine, and the latter occurs in non- 
official pharmacy as Kinovate of Lime, an ingredient in Deloudre's Extract, 
which is used in Europe and India for dysentery. 

Kino-tannic and Kino vo -tannic Acids, — give to bark its peculiar and 
powerful astringent qualities. They have not been fully studied. 

Kinovin, — is a bitter, amorphous resinoid, which is resolvable into Kinovic 
Acid and sugar. It is soluble in alcohol, but not in water. 

Cinchona Red, — a reddish-brown, insipid, inodorous substance. 
[The other alkaloids are of no interest medicinally.] 



CINCHONA. I49 

Preparations of the Bark. 

Extractum CiNCHONiE, — made from Yellow Cinchona. Dose, gr. j-v. 
Extractum Cinchona Fluidum, — from Yellow Cinchona. Dose, ""Ix-^j. 
Tinctura CiNCHONiE, — Yellow Cinchona, strength 20 per cent. Dose, gss-ij. 
Tinctura CiNCHONiE Composita, — made from Red Cinchona, strength 10 
per cent. Contains Bitter Orange-peel 8, and Serpentaria 2 per cent. Dose, 

Infusum Cinchon.e, — made from any official bark. Cinchona 6, Aromatic 
Sulphuric Acid 1, Water 93 parts. Is the only official infusion containing 
this acid. Dose, ^j-§j or more. 

Huxham's Tincture of Bark, 1788 (Unofficial), — is still used. Red 
Cinchona ^iv, Orange-peel ^iij, Serpentaria gr. lxxx, Spanish Saffron gr. clx, 
Cochineal gr. lxxx, Brandy gxl, digested for 4 days, expressed and filtered. 
Dose, 3ss-ij. 

Quinine and its Salts. 

Quinina, Quinine, C 20 H 24 N 2 O 2 .3H 2 O, — a white, amorphous or minutely 
crystalline powder, of alkaline reaction and very bitter taste, soluble in 1600 
of water and 6 of alcohol at 59 F., in 25 of ether, 5 of chloroform, and readily 
in dilute acids. Dose, gr. j-xx, or xl in special cases. Is insoluble in saliva. 

QuiNiN/E Sulphas, Sulphate of Quinine (C 20 H 24 N 2 O 2 ) 2 .H 2 SO 4 .7H 2 O, — very 
light, snow-white, fragile crystals, of very bitter, persistent taste, soluble in 
700 of water and 65 of alcohol at 59 F., in 30 of boiling water, 3 of boiling 
alcohol, also in acidulated water. Dose, gr. j-xx, or even gr. xl in special 
cases. 

QUININE Bisulphas, Bisulphate of Quinine, C a0 H a4 N 2 O 2 .H 2 SO 4 .7H 2 O J — 
clear, colorless, efflorescent crystals or small needles, of very bitter taste and 
strongly acid reaction, soluble in 10 of water with blue efflorescence, and in 
32 of alcohol, at 59 F. Dose, gr. j-xxx, or even gr. lx in special cases. 

QuiNINiE Hydrobromas, Hydrobromate of Quinine, C 20 H 2i N 2 O 2 HBr. 
2H 2 0, — colorless needles, of very bitter taste, soluble in 16 of water and in 3 
of alcohol at 59 F., and in 1 of boiling water or alcohol. Is the best salt for 
hypodermic use, £j of water dissolving gr. iv, which may be injected every 4 
hours without causing irritation. Dose, gr. j-xx. 

QuiNlNiE Hydrochloras, Muriate of Quinine, C 20 H. 24 N 2 O 2 HC1.2H 2 O, — 
white needles in tufts, of very bitter taste, soluble in 34 of water and 3 of alcohol 
at 59 F., in 1 of boiling water or alcohol. Is used hypodermically. Dose, 
gr. j-xx. An excellent salt which should be more generally used ; 5 to 10 gr. 
doses are antipyretic. 

Quinin.e Yalerianas, Valerianate of Quinine, C 20 H 24 X 2 O 2 C 5 H 10 O 2 .H 2 O, — 
white, pearly crystals, of valerianic odor and bitter taste, soluble in 100 of 
water and in 5 of alcohol at 59 F. Dose, gr. j-iij. It is the only salt of 
Quinine supposed to be affected by the constituent acid. 

Quinin.e Hydrochlobas Carbamidata, Carbamide Hydrochlorate of 
Quinine (Unofficial), — is a new compound salt of Quinine and Urea, soluble 
in equal parts of water and therefore admirably adapted for hypodermic ad- 
ministration in a 50 per cent, solution. It is almost unirritating to the tissues, 
and is given subcutaneously in doses of gr. j-iij. 

Chininum Amorphum Boricum, Amorphous Borate of Quinine (Unof- 
ficial), — is a new preparation, soluble in an equal quantity of water, and 
claimed by its introducers to be equally as satisfactory as any other Quinine 
salt, and much better borne by the stomach than any other one. It is also 
said to cause little or no congestion of the membrana tympani. 



I50 CINCHONA. 

TiNCTURA Pyrexialis, Warburg's Tincture (Unofficial), — is a celebrated 
preparation, formerly secret, but published in 1875 by the originator, whose 
formula is as follows : R. Aloes soc. lb j ; Rad. rhei (chinens), Sem. angelicae, 
Confec. Damocratis,* aa §iv ; Rad. helenii (s. enulae), Croci sativi, Sem. fceni- 
culi, Cretae prep, aa gij ; Rad. gentianae, Rad. zedoarise, Pip. cubebae, Myr- 
rhae elect., Camphorse, Bolet. laricis, aa ^j. Digest the whole with 500 oz. 
of proof spirit in a water-bath for 12 hours, express, add gx JBisulphate of 
Quinine, dissolve by aid of a water-bath, cool and filter. Dose, §j, in two 
doses 3 hours apart. Hager's modification of the original formula is — R. 
Quininae sulph. part, j, Spt. camphorae part, ij, Elix. proprietatis (Tinct. aloes 
et myrrhaa) part, xxij, Alcoholis part. xvj. The evidence published in favor 
of this preparation goes to show that its power does not wholly lie in the qui- 
nine, camphor, aloes or rhubarb, but in some of the aromatic plants contained 
in it. 

Other Official Alkaloids and their Preparations. 

Cinchonina, Cinchonine, C 20 H 24 N 2 O, — white, lustrous prisms or needles, 
of bitter after-taste, almost insoluble in water, readily so in dilute acids and 
in no of alcohol at 59 F. Dose, gr. j-xxx or more. 

Cinchonina Sulphas, Sulphate of Cinchonine (C 20 H 24 N 2 O) 2 H 2 SO 4 . 
2H 2 0, — white, shining prisms, of very bitter taste, soluble in 70 of water and 
in 6 of alcohol at 59 F., and readily soluble in dilute acids. Dose, gr. v-xxx 
or more. 

Cinchonidin/E Sulphas, Sulphate of Cinchonidine (C 20 H 24 N 2 O) 2 H 2 SO 4 . 
3H 2 0, — white, silky crystals, of bitter taste, soluble in 100 of water pud in 
71 of alcohol at 59 F., freely soluble in acidulated water. Dose, gr. j-xx or 
more. 

Quinidina Sulphas, Sulphate of Quinidine (C 20 H 24 N 2 O 2 \H 2 SO 4 .2H 2 O, — 
white, silky needles, of bitter taste, soluble in 100 of water and in 8 of alcohol, 
readily in acidulated water, at 59 F. Dose, gr. j-xx or more. It is not so 
bitter as Quinine, is less expensive, and is a valuable antipyretic and anti- 
periodic. 

Chinoidinum, Chinoidin, Quinoidin, — a mixture of alkaloids, mostly amor- 
phous, obtained as a by-product in the manufacture of the cystallizable alka- 
loids from Cinchona. A black solid when cold, plastic when warmed, of 
bitter taste, almost insoluble in water, freely soluble in alcohol and in dilute 
acids. It contains the 4 alkaloids in amorphous condition, and has about ^ 
the therapeutic power of Quinine. Dose, gr. v-xxx or more. 

Non- Official Preparations. 

Quinquinina, or Quinetum, — is an Indian preparation containing the total 
alkaloids extracted from bark by acidulated water, then precipitated by soda 
and dried. In India it is called " febrifuge." 

Cinchonidine Salicylas, Salicylate of Cinchonidine, — has anti-malarial 
power only inferior to the salts of Quinine. 

Substitutes for Quinine. 

Chemists have for some time been searching for an artificial 
quinine made synthetically, and in the search have found a 
number of bodies, closely related to each other and to quinine, 

* For the formula for this ingredient see the article on Confections in the 
section on Extemporaneous Pharmacy, Part II. 



CINCHONA. 151 

both in physiological action and in chemical composition. The 
most important of these are Antipyrine, Resorcin and Chino- 
line, which are respectively described under their own titles. 
The latter substance is obtained from the cinchona alkaloids and 
from coal-tar, and like the other two may be produced syntheti- 
cally. Others of the same class are as follows. 

Some Unofficial Antipyretics. 

Kairina, Kairine (Hydrochlorate of Oxy- ethyl - chinoline -hydride), 
C 10 H 13 NO.HCl.H2O, — is an artificial alkaloid prepared from Chinoline, be- 
longing to the phenol group of carbon compounds, and a powerful antipyretic 
in 8-grain doses hourly. It stains the urine a deep green, and has not proven 
toxic though 220 doses have been administered in one case. In some cases 
of typhus it has caused cyanosis and collapse. It produces profuse sweating 
and vomiting, and the subsequent rise of temperature after its antipyretic in- 
fluence has worn off is generally ushered in by a severe rigor. It is by many 
authorities considered to be the most certain, most powerful and most rapid 
antipyretic drug we possess, though this claim is now disputed by the advo- 
cates of Antipyrine. It occurs in white crystals, which are freely soluble in 
water, but is best given in wafer-paper or capsules. Dose, gr. iij-xxx. 

Kairolina, Kairoline (Sulphate of Tetra-hydromethyl-chinoline), — is anti- 
pyretic, but much less efficient than Kairine. 

Thallin (Parachinanisols), — is a very powerful antipyretic, in 4-grain 
doses causing a rapid fall of temperature, but its effects are not lasting, it is 
not so well borne as Antipyrin, it sometimes causes a very alarming tendency 
to collapse, and as it excites profuse sweating it leaves the patient consider- 
ably weakened. 

Hydroquinone (Di-hydroxyl-benzole), C 6 H 6 2 , — crystallizes in rhombic, 
colorless prisms which are slightly soluble in water, readily so in alcohol and 
in ether, and is obtained from Arbutin, a glucoside constituent of Uva Ursi 
and other Ericaceae. It is an efficient antipyretic, without injurious effects so 
far as observed, but its influence is only temporary. The action of this drug 
on animals is summarized in the N. Y. Medical Record for August 15th, 1885, 
and its influence on pyrexia elucidated in the same journal for May 30th, 
1885. Dose, as an antipyretic, gr. xv-xx, best given in alcohol. Gr. xl have 
been given without disagreeable effects. 

Pyrocatechin, Catechol, C 6 H 6 2 , — one of the acid constituents of coal-tar, 
also obtained from wood-tar and from kinic acid. It is a good antipyretic but 
much inferior to Quinine or Resorcin. 

Pheno-resorcin, — is a mixture of Carbolic Acid 67 with Resorcin 33 and 
Water 10, forming a liquid which mixes readily with water. It is supposed 
to combine the virtues of both its ingredients. 

Physiological Action. 

The action of Cinchona in sufficient dose is generally that of 
its alkaloid Quinine, except that bark is decidedly astringent, 
more of a gastric irritant, and by reason of its bulk its active prin- 
ciples are more slowly absorbed. In large doses (3ij) the pow- 
dered bark has produced flatulence and eructation, and in many 
well-authenticated instances has produced a well-marked febrile 



152 CINCHONA. 

paroxysm, beginning with chill, then fever and headache, which 
gradually subsided in slight perspiration. So also, Quinine, while 
incapable of producing intermittent fever in a healthy person, 
will, if taken in large doses unnecessarily, throw the nervous 
system into high commotion, and if untimely used by a malarial 
subject may reproduce the paroxysm with greater or less severity. 

Cinchona is an astringent bitter and a stomachic tonic. At 
first it promotes appetite, digestion, the flow of saliva and of 
gastric juice ; long-continued it sets up a gastric catarrh, impeding 
digestion and causing constipation. 

Quinine is a bitter tonic, antiseptic, antiperiodic, antimias- 
matic and antipyretic, a diminisher of reflex action, a protoplas- 
mic poison, a cardiac depressant and perhaps an oxytocic. It is 
rapidly diffused and slowly excreted, being found in the urine in 
15 minutes after its administration and for two or three days 
afterwards. Its action on the stomach is similar to that of cinchona. 
It arrests the movements of the white blood-corpuscles though in- 
creasing their number, and prevents acetification and decay of the 
blood. It is actively destructive of lowly organized life, a solution 
of 1 to 500 being fatal to infusoria and fungi, while one of double 
this strength prevents alcoholic fermentation and checks putrefac- 
tive decomposition. The heart and arterial tension are somewhat 
stimulated by small doses, but depressed by large ones (gr.xl-lxxx), 
which slow and enfeeble the pulse by direct action on the cardiac 
ganglia. The brain is rendered hypersemic and exhilarated by small 
or moderate doses, but large ones produce a sense of fulness and 
constriction in the head, cerebral anaemia, pallor, tinnitus aurium, 
vertigo, staggering gait, amaurosis and deafness, great headache, 
dilated pupils, delirium, coma, and in animals convulsions. The eyes 
and ears are very rarely injured permanently. These symptoms col- 
lectively are termed Cinchonism. It reduces the size of the spleen 
when enlarged, and lowers the temperature of pyrexia, though it 
does not depress the body temperature in health. Large doses lower 
the reflex function of the spinal cord. In some subjects it pro- 
duces sexual excitement, in others cutaneous eruptions sometimes 
followed by desquamation. It lessens the excretion of uric acid, 
but not that of urea, and is a uterine stimulant in labor, but its 
power to initiate uterine contractions is a much debated question. 

Quinidine and Cinchonidine correspond in action with Qui- 
nine both qualitatively and quantitatively, the latter however 
producing less severe head symptoms. 

Cinchonine also corresponds in effect, but is much the least 
active of the four alkaloids. It is said to produce greater head- 



CINCHONA. I53 

ache, and much precordial pain and muscular weakness, but to 
have little effect on sight or hearing. 

Antagonists and Incompatible*. 

Morphine antagonizes its cerebral action, Atropine its nervous, cardiac 
and antipyretic powers. Free Tannic Acid is incompatible with the Infusion 
of Cinchona. Iodine preparations, Alkalies, Alkaline Carbonates and Earths, 
are incompatible with solutions of the alkaloids, the first-named forming in- 
soluble compounds, the latter precipitating them. 

Therapeutics. 

Cinchona is used as a tonic and has many applications. The 
Infusion or Compound Tincture with a mineral acid is extremely 
serviceable in atonic dyspepsia, gastric catarrh of alcoholics, ady- 
namia, convalescence, asthma, chronic bronchitis, and generally 
in weak subjects of flabby flesh and perspiring skin. 

Quinine finds its principal field of action in the malarial dis- 
eases, over which its power is that of a specific. In intermittents, 
a ten-grain dose of the sulphate should be given in the sweating 
stage and again 5 hours before the expected time of the next par- 
oxysm. In the intervals Arsenic is better used, as Quinine will 
cause a daily exacerbation of temperature if long continued. In 
remittents 20- to 30-grain doses should be administered once or 
twice a day until the temperature is reduced to the normal point. 
In pernicious remittents large doses (gr. xxx to lx) are necessary 
to the safety of the patient. In chronic malarial poisoning Qui- 
nine has considerable power, but Chinoidin is more effective. 
Small doses of Quinine (gr. ij-iij per diem) are efficient as a 
prophylactic against malaria. 

As an antipyretic Quinine is used with the best results, espe- 
cially in typhus, typhoid, variola, pneumonia and acute rheuma- 
tism. Inflammations may, at their inception, be aborted by 15- 
or 20-grain doses, combined with Morphine, which in this respect 
is synergistic to Quinine. Acute tonsillitis and acute catarrh may 
sometimes be aborted by a full dose. In surgical fevers, pyaemia 
and exhausting suppurative conditions, also in septicaemia, hectic 
fever, and before surgical operations, Quinine is much employed. 
Neuralgias of malarial origin are amenable to it, as also neuralgia 
of the ophthalmic division of the fifth nerve. In eruptive fevers, 
especially scarlet fever, erysipelas and measles, it is advantageously 
administered throughout their course. In some skin diseases, 
particularly erythema nodosum, it is quite efficient, also in whoop- 
ing-cough and hay- fever. In the latter affection a solution of gr. 
vj to the % of the neutral hydrochlorate is a very useful local 
application. 

*3 



154 CINNAMOMUM. # 

Antipyresis has of late received considerable attention, par- 
ticularly in the German hospitals. The most certain and safe of 
all antipyretics is undoubtedly the cold bath, but it is not always 
the most practicable, especially in private practice. Internal 
antipyretics are therefore of great value, and of these the safest 
and best is Quinine, next in order being Antipyrine. 

Warburg's Tincture has obtained a very high reputation in 
the hands of Indian army-surgeons in the treatment of remittent 
and other malarial fevers of the most malignant types, in mala- 
rial neuralgiae, acute nervous exhaustion and sudden collapse 
without organic disease. The most pronounced testimony to its 
value is that of Dr. Maclean (Med. Times and Gazette, Nov., 
1875), wn o se authority will not be questioned by the most cap- 
tious. He affirms that the influence of this combination to arrest 
an exacerbation of remittent fever is far more powerful than that 
of Quinine alone. The remedy has become much less of a favorite 
since its originator was induced to make public the secret of its 
composition. 

A dm in istration . 

The persistently bitter taste of Quinine and its salts is best obviated by 
administering them in pill-form, made with glycerin as an excipient, or by 
using liquorice, eriodyction or chocolate to cover the taste if given in solution 
or powder. 

For hypodermic use the best salt is the Hydrobromate, it being the most 
soluble, — gr. xij in ^j of distilled water gives gr. j in ttiv. The Carbamide 
Hydrochlorate is coming into favor for hypodermic administration by reason 
of its solubility and freedom from irritating qualities. 



CINNAMOMUM, Cinnamon, — is the inner bark of the 
shoots of Cinnamomum Zeylanicum (Ceylon), or the bark of the 
shoots of several species of Cinnamomum (nat. ord. Lauraceae) 
grown in China (Cassia Bark). The former occurs in light, yel- 
lowish-brown quills, consisting of several pieces rolled together, 
each very thin, while the Chinese variety comes in single quills of 
irregular form and rougher texture. The taste is warm and aro- 
matic, and the odor very fragrant. The active principle is a 
Volatile Oil, and it also contains a resin, tannic and cinnamic 
acids. Dose, gr. x-xx. 

Preparatio7is, 

Oleum Cinnamomi, — is the volatile oil, a yellowish-colored liquid of sp. 
gr. 1.040 to 1.060, becomes dark by age, of slightly acid reaction. The oil 
of Chinese cinnamon is not so agreeable in odor or taste. Dose, gtt. i-v. 

Aqua Cinnamomi, Cinnamon -Water, — has of the oil 2 parts in 1000, perco- 
lated through cotton. Dose, indefinite. 

Spiritus Cinnamomi, — contains 10 per cent, of the oil. Dose, mv-xxx. 



COCCUS — COLCHICUM. I 5 5 

TlNCTURA Cinn'amomi, — contains 10 per cent, of the powdered bark. 
Dose, ^ss-ij. 

PoLvk Aromaticus, Aromatic Powder, — Cinnamon 35, Ginger 35, Car- 
damom 15. Nutmeg 15, rubbed together in fine powder. Dose, gr. x-xxx. 

Extractum Aromaticum Fluidum, — has of Aromatic Powder 100 
grammes, Alcohol q. s. ad 100 cubic centimeters. Dose, rn. x-xxx. 

Physiological Action and Therapeutics, 

Cinnamon is an agreeable carminative, somewhat astringent 
and stimulant, and highly aromatic. The oil is not astringent 
but is a pleasant stimulant to the nervous and vascular systems, 
and is by some believed to exercise a specific action on the uterus, 
particularly as a hemostatic. 

The various preparations are in general use as flavoring excipi- 
ents. and the aqua is a pleasant vehicle for extemporaneous pre- 
scriptions. The bark and its preparations are used to check 
diarrhoea in combination with opium, chalk, or some vegetable 
-ion. The oil is a good stimulant in flatulence, paralysis of 
the tongue, cramp of the stomach, enteralgia, etc., and is some- 
times used to check nausea and vomiting. Cinnamon was for- 
merly used with success in uterine hemorrhage, generally in 
combination with sulphuric acid which of itself is an efficient 
uterine hemostatic. 



COCCUS, Cochineal, — is the dried female of Coccus cacti, 
an insect of the order Hemiptera, which feeds on the cactus 
plants of Mexico and Central America. Occurs in ovate, plano- 
convex form, of a purple-gray or purple-black color, yielding 
when crushed a dark-red powder, which contains Carminic Acid, 
or Carmine, the red coloring-matter, which is soluble in water 
and alcohol, but not in oils. Cochineal is an ingredient of Tinc- 
tura Cardamomi Composita, and is used in pharmacy solely as a 
coloring material. 

Therapeutics, 

The only therapeutic use of Cochineal is in whooping-cough 
and neuralgia, in which affections it is supposed to have consid- 
erable influence, especially in the former. Its dose to an infant 

-bout gr. *; thrice daily. 



COLCHICUM, Meadow Saffron, — is the corm and seed 
of the Colchicum autumnale* a European plant of the nat. ord. 
Melanthaceae. It contains an alkaloid, Colchicine, C 1T H 19 N0 5 , 



I56 COLCHICUM. 

which by the action of acids is converted into Colchice'ine and a 
resin, — also tannic and gallic acids, resin, starch, sugar, etc. It 
is official in two form?;, namely — 

Colchici Radix, Colchicum Root, — the corm, about 1 inch 
long, white internally, grooved on one side, inodorous, taste 
sweetish, bitter and acrid. Is less active than the seed. Dose, 
gr. ij-viij. 

Colchici Semen, Colchicum Seed, — about j\ inch thick, sub- 
globular, resembling black mustard seed but larger, very hard 
and tough, inodorous, of bitter and acrid taste. Dose, gr. j-v. 

Preparations. 

Extractum Colchici Radicis, — made with Acetic Acid 35 parts to 100 
of the root, and sufficient water. Dose, gr. ^-ij. 

Extractum Colchici Radicis Fluidum, — Dose, ntij-x. 

Extractum Colchici Seminis Fluidum, — Dose, rnj-v. 

Vinum Colchici Radicis, — strength 40 per cent. Dose, titv-xv. 

Vinum Colchici Seminis, — strength 15 per cent. Dose, mx-xxx. 

Tinctura Colchici, — from the seed, strength 15 per cent. Dose, m_x-xxx. 

Colchicina, Colchicine, C 17 H 19 N0 5 (Unofficial), — a white or yellowish, 
amorphous powder, of saffron-like odor and bitter taste, soluble in water and 
in alcohol. Dose, gr. t2o~6V I s suitable for hypodermic injection. 

Physiologica I A ction . 

Colchicum is emetic, diuretic and diaphoretic, a drastic pur- 
gative, a gastro-intestinal irritant and a cardiac depressant. In 
small doses it increases secretion, especially the urine and the 
sweat. In full doses its action is emeto-cathartic, producing 
profuse watery discharges, great nausea and extreme muscular 
feebleness. In large doses it is a powerful irritant of the gastro- 
intestinal tract, causing severe griping, choleraic discharges, 
lowered arterial tension and depression of the heart by reflex 
action over the distribution of the pneumogastric, — then great 
prostration, convulsions and collapse, death occurring from ex- 
haustion, with consciousness preserved until carbonic acid nar- 
cosis sets in. On the excretion of uric acid and urea its influence 
is very much disputed, but it probably increases the flow of bile, 
and certainly unloads the portal circulation. 

Antagonists and Incompatible*. 

Tannic Acid to retard absorption. Emetics and cathartics, also warm de- 
mulcent drinks freely. Morphine hypodermically to antagonize the cardiac 
depression, also Alcohol. 

Therapeutics. 

Colchicum is a specific palliative in gout of acute form, in 
which it should be given with an alkali, and kept short of emeto- 



COLOCYNTHIS. 1 57 

catharsis. It does not prevent relapses, and its power in this 
disorder is weakened by repetition. In ascites from obstructive 
disease of the liver it is most effective, given in full doses to 
establish a profuse drain, with opium to sustain the heart. In 
acute cerebral congestion and in portal congestions it is well 
given as a drastic purgative. It is often used with marked suc- 
cess in acute rheumatism, but frequently fails, and in no case 
should it be continued long in this affection. It has been used 
with good results in the treatment of gonorrhoea and chordee. 
The alkaloid is probably the best preparation for general use, and 
is admittedly superior to the other preparations in acute gout. 



COLOCYNTHIS, Colocynth,— is the fruit of Citrullus 
Colocynthis, deprived of its rind. The plant is a native of Spain 
and Asiatic Turkey, and belongs to the nat. ord. Cucurbitaceae, 
the fruit being of the size of a small orange, white, light, spongy, 
inodorous, very bitter, containing many flat, brown seeds which 
should be rejected before the pulp is used. Its active principle 
is Colocynthin, C 56 H 84 23 , an amorphous but crystallizable bitter 
glucoside, readily soluble in water* It also contains Colocynthein, 
a resin, and Colocynthitin, which is a tasteless, crystalline powder, 
soluble in ether but not in water, and devoid of purgative action. 

Preparations. 

Extr actum Colocynthidis, — alcoholic. Dose, gr. y 2 -\y 

Extractum Colocynthidis Compositum, — contains of the preceding 16 
parts, Aloes 50, Cardamom 6, Resin of Scammony 14, Soap 14, Alcohol 10. 
Dose, gr. v-xx. 

Pilule Cathartics Composite, Compound Cathartic Pills,— each has 
of the preceding gr. 1.3, Abstract of Jalap gr. j, Calomel gr. j, Gamboge gr. 
j^. Dose, j-iij pills. 

Laville's Anti-Gout Remedy, — is a proprietary medicine prepared in 
France and purporting to be " a mixture of prepared Kino-colocynthine." 
The published formula is as follows : Active principle of Colocynth 2^, Qui- 
nine and Cinchonine $, Spanish Wine 800, Alcohol 100, Water to 1000 parts ; 
but there is good reason for believing that it contains Colchicine instead of 
Colocynthin. 

Physiological Action. 

Colocynth is classed among the tonic-astringent and resin - 
bearing purgatives* In moderate doses it increases peristalsis 
and the intestinal glandular secretions, producing bilious, watery- 
evacuations with much colicky griping pain. Its purgative action 
is specific, and may be obtained by its application to the skin 
over the abdomen. In large doses it is a violent irritant of the 
gastro-intestinal tract, and has frequently produced fatal gastro- 



158 CONIUM. 

enteritis. It is popularly supposed to be abortifacient, but this 
is only true of quantities sufficient to endanger life. It is an 
indirect diuretic. 

Therapeutics. 

Colocynth is too severe an agent to be administered alone for 
constipation, but it makes a useful factor in compound purgatives, 
as the compound cathartic pill. In cerebral congestion it may 
be used to produce rapid derivation, and in ascites to set up a 
profuse drain from the intestinal canal. In certain cases of chlo- 
rotic amenorrhcea it stimulates the pelvic nerves and vessels with 
excellent results. There seems to be abundant evidence that in 
very small doses (m ^L- J^ of a tincture) colocynth is an efficient 
remedy in colic, sciatica, ovarian and other neuralgise, as well as 
in the pain of glaucoma. These actions may be due to its two 
non-purgative principles, which may prove to possess powers not 
heretofore suspected, an example of which is seen in the recently- 
discovered cardiac influence of Convallaria, a drug until recently 
only known as a purgative and a diuretic. 



CONIUM, Hemlock, — is the full-grown fruit, gathered 
while green, of Conium tnaculatum, the spotted hemlock (nat. 
ord. Umbelliferae). It is smaller than anise-fruit, of a gray-green 
color, slight odor and taste, and contains 3 alkaloids, namely, — 
Conine, C 8 H ]5 N, liquid and volatile, Methyl-conine, C 8 H U NCH 3 , 
and Conhydrine, C 8 H 17 NO, solid and volatilizable ; — also Coniic 
acid and a volatile oil. Paraconine is an artificial substance pro- 
duced by the reaction between Butyric Aldehyd and an alcoholic 
solution of Ammonia, and isomeric with Conine but not identical 
with it. The leaves of Conium are no longer official. 

Preparations. 

Abstr actum Conii, — made from 200 parts of Conium, 6 of Dilute HC1 
acid, Sugar of Milk and Alcohol to make 100 parts; each grain representing 
2 grains of the powdered drug. Dose, gr. ss-iij. 

Extractum Conu Alcoholtcum, — each grain represents a grain of the 
crude drug. Dose, gr. ij-v. 

Extractum Conii Fluidum,— of the same strength as the alcoholic ex- 
tract. Dose, rnjj-v-xl. 

Tinctura Conii, — strength 15 per cent. Dose, "rnx-gj, beginning with the 
10-minim dose and gradually increasing until physiological effects are mani- 
fest. 

CONINA, Conine, C 8 H 15 N (Unofficial), — an oily, limpid, volatile liquid, of 
acrid taste, alkaline reaction, and an odor compared to that of the urine of 
mice. It is quickly decomposed by heat, and if exposed to the air soon be- 
comes inert. Dose, gr. -gj-t^, or in minim-doses, TUxoHJ- ^ s too irritant 



conium. 159 

for hypodermic use, unless carefully neutralized by acetic acid. The Hydro- 
bromate in watery solution of gr. viij to the £, of this TTLx-i, is a good form 
for subcutaneous or stomachal administration, and may be given in doses of 
gr, T \ to gr. j, as it is not actively toxic. 

All the preparations of Conium are uncertain in action, particularly the 
extract and abstract, as the active principle is very volatile. Any specimen 
must be carefully tested before deciding on its dosage. 

Physiological Action. 

The special action of Conium and Conine is the production 
of motor paralysis without loss of consciousness or sensation. 
It paralyzes the motor nerves, the action commencing at the 
peripheral end-organs and extending upwards, involving the 
nerve-trunks and finally the centres, but the muscular irritability 
remains unaffected. Methyl-conine acts similarly but reversely, 
affecting first the motor columns of the cord. The sensory nerves 
are not affected, but the general sensibility is, a feeling of numb- 
ness being experienced in the extremities. 

Gastric irritation is usually the first sensation produced by a 
full dose of Conium, nausea and vomiting being its symptoms. 
Then weakness of the legs, numbness and fatigue, drooping eye- 
lids, diplopia, slightly dilated pupils, vertigo, impaired utterance, 
slow and labored breathing, and if the dose be a lethal one, par- 
alysis of the voluntary muscles, those of the lower limbs being 
first affected, speech and vision are lost, and finally death occurs 
from paralysis of the muscles of respiration. The heart is not 
affected and the mind remains clear, but torpid and indifferent, 
until carbonic acid narcosis sets in. 

Muscular movement counteracts the effects of the drug to a 
very great extent. 

Conium is believed to have been the state poison of the Athe- 
nians, by the juice of which Socrates and Phocion died. 

Antagonists and Incompatibles. 

Nux Vomica and its alkaloids, Picrotoxin and other tetanizers are antag- 
onistic. Tannic acid and caustic alkalies are chemically incompatible. 

Therapeutics. 

Conium is especially indicated in diseases characterized by 
excessive motor activity. Large doses are required as some phys- 
iological action is necessary. Children bear it well, their constant 
activity preventing its full action. In chorea it palliates by de- 
pressing the motor nervous system. In acute mania and delirium 
tremens to quiet motor, excitement and prevent exhaustion, it is 
remarkably efficient, especially when given conjointly with Mor- 



l6o CONVALLARIA MAJALIS. 

phine. When pain and spasm are present, it will prove a useful 
agent; and in tetanus, blepharospasm, asthma, whooping-cough, 
and other spasmodic affections it is frequently used with great 
benefit. The pain of cancer seems to be especially amenable to 
its influence when locally applied, and Conine-vapor is an ad- 
mirable palliative of the tickling cough of phthisis and the irrita- 
bility of the air-passages in acute bronchitis. In pneumonia and 
pleurisy the hypodermic use of Conine to afford the organs rest 
by inducing a paretic state of the respiratory muscles has been 
followed by a marked decrease in the temperature and pulse-rate. 



CONVALLARIA MAJALIS, Lily of the Valley (Un- 
official), — is a stemless perennial of the nat. ord. Liliaceae, in- 
digenous to Europe, Northern Asia, and the Southeastern portion 
of the United States* All parts of the plant are used, but the 
preparations vary in action according to the quantity of the Resin 
present, it being emeto-cathartic. Convallaria contains two glu- 
cosides, namely, Convallamarin, on which the cardiac action 
depends, and Convallarin, a crystalline, purgative principle, in- 
soluble in water ;— also an acrid Resin which probably contains 
the latter glucoside. 

Preparations. 

Extr actum Convallaria (Unofficial), — prepared from the flowers and 
stalks with y£ of the leaves and root; is a black solid, freely soluble in water 
and alcohol. Dose, gr. v-xxx. 

Extractum Convallaria Fluidum (Unofficial), — as found in the shops 
is an alcoholic preparation of the whole plant, and is likely to contain Con- 
vallarin, which is not present in aqueous preparations being insoluble in water. 
Dose, 3ss-j. 

Infusum Convallaria ( Unofficial )> — prepared from the flowers, leaves 
and stems 25, in water 75. Dose, gss— ij . 

Convallamarinum, Convallamarin, C 2a H 44 O r2 (Unofficial), — an amor- 
phous, white, bitter powder, freely soluble in water and in alcohol, but insolu- 
ble in ether. Dose, gr* %-%. 

Physiological Action. 

Convallaria has long been known as a decided cathartic and 
a prompt and powerful diuretic, but its cardiac action has only 
lately excited attention^ and it is now considered a close analogue 
of Digitalis, while free from the cumulative action which makes 
the latter drug so frequently a dangerous remedy. 

Preparations of the root have a powerful emeto-cathartic action, 
probably due to a preponderance of the resin. Those freed from 
this ingredient correspond in action with Convallamarin, stimu- 
late the appetite without impairing digestion, increase peristalsis 



COPAIBA. l6l 

without producing catharsis, slow the heart and raise the arterial 
tension, also slowing and deepening respiration. Lethal doses at 
first produce irregularity of the cardiac action and spasm of the 
respiratory muscles, high arterial tension and a very rapid pulse, — 
followed by lowered blood-pressure, very slow and deep breath- 
and finally arrest of the heart in systole. Its mode of action 
is by direct stimulation of the pneumogastric, the motor and 
sory nerves retain their irritability, the muscles preserve their 
contractility, and the cerebral functions and the pupil are un- 
affected. 

Convallarin is a drastic purgative in 3-grain doses. Con- 
vallamarin is an emetic even m small quantity, and the pow- 
dered root is sternutatory. 

Therapeutics. 

Convallaria is a heart-tonic like Digitalis, and is indicated in 
the same class of cases as is that drug, with the advantage that 
having no cumulative action it is not dangerous to the heart in 
medicinal doses, and does not disturb the stomach or the func- 
tions of the cerebrospinal axis. In doses of gr. xv-xxv of the 
extract it slows the action of the heart and increases the force of 
its contractions, raises arterial tension, augments the force and 
volume of the respiration, and produces prompt diuresis without 
altering the composition of the urine. It is a most valuable 
remedy in mitral stenosis or insufficiency with venous stasis, dila- 
tation of the heart, palpitation, vehement cardiac action or dis- 
ordered rhythm, and in all valvular affections accompanied hy- 
dropsy and a weak heart. It has also been used with benefit in 
pneumonia, typhoid fever and renal dropsy. Its action is main- 
tained for several days after its use has been suspended. 



COPAIBA, Balsam of Copaiba, — is the oleoresin of Co- 
paifera Langsdorffii, and of other species of Copaifera, a. S. Ameri- 
can tree of the nat. ord. Leguminosae, growing chiefly in the 
valley of the Amazon. It is a translucent, viscid liquid, of yel- 
low color, aromatic odor, acrid and bitter taste, not fluorescent, 
soluble in alcohol and benzol. Is not a balsam as it contains no 
cinnamic acid. Its constituents are a Volatile Oil and a Resin in 
about equal proportions, the latter containing nearly 99 percent, 
of Copaibic Acid. Dose, n£x-3j. 

14 



1 62 COPAIBA. 

Preparations, 

Oleum Copaib^e, C 10 H 16 , — the volatile oil, a pale yellow liquid, of sp. gr. 
0.890, of bitter taste and neutral reaction, soluble in an equal weight of alco- 
hol. Dose, Tn_ x-xv. 

Resina Copaiba, — is the residue left after distilling off the volatile oil 
from Copaiba, a yellowish, brittle body, of acid reaction, soluble in alcohol, 
benzol or amylic alcohol. Consists mainly of Copaibic Acid, which is crys- 
tallizable, also \]/ 2 per cent, of a viscid resin. Dose, gr. j-v. 

Massa Copaib^e, — consists of Copaiba 94, fresh Magnesia 6 parts, mixed 
and set aside to concrete into a pilular mass. Dose, ritx-^j. 

Mistura Copaiba Composita, Lafayette's Mixture (Unofficial), — R. Co- 
paibae sjvij, 01. Cubebae £j, Glyceriti Vitelli £vij. Triturate and add gradu- 
ally while triturating Syrupi Aq. Menth. Piperitae Jfijss. Then add with con- 
stant stirring Liq. Potassae ^ss, Tr. Cardamomi Co. ^ij, Spt. Etheris Nitrosi 
t ^ss, Aq. Menthae Pip. q. s. ad gviij. Dose, 3J-§ss. 

Physiological Action. 

Copaiba is a stimulant diuretic, diaphoretic, expectorant, and 
a gastro-intestinal irritant. Its taste is bitter and nauseous. In 
the stomach it causes heat, unpleasant eructations, heaviness, fre- 
quently anorexia and diarrhoea, and if continued for any length 
of time gastro-intestinal catarrh and desquamative nephritis may 
result. The oil and resin diffuse into the blood and are excreted 
by the bronchial mucous membrane, skin and kidneys, produc- 
ing increased secretion at the points of elimination. The various 
secretions have the odor of the drug, especially the urine. In 
medium doses it increases the quantity of urine and its solid con- 
stituents, but large doses will cause scanty urine, containing al- 
bumen, casts and blood, with pain in the loins and other signs 
of renal congestion. On the skin it often produces itching 
and several forms of eruption. 

Therapeutics. 

Copaiba has been largely used in gonorrhoea after the acute 
symptoms have subsided, also in chronic cystitis, acute and 
chronic bronchitis, and in dropsies, particularly ascites. In all 
these affections it is a useful remedy, but its nauseous taste and 
irritant effects on the stomach are driving it out of fashion espe- 
cially in private practice. One eminent surgeon declares that 
not only is it useless in gonorrhoea but that it does more harm 
than good, often prolonging the disease beyond its natural limit. 
In psoriasis and urticaria, and in cutaneous affections character- 
ized by torpid peripheral circulation, this drug has been admin- 
istered internally with excellent results. In long-standing cys- 
titis in the female Copaiba has been injected into the bladder with 



CORIANDRUM — CORNUS — COTO. 1 63 

great benefit. The resin is the most active ingredient, especially 
for diuretic purposes. 



CORIANDRUM, Coriander, — is the fruit of Coriandrum 
sativum, a European plant of the nat. ord. Umbelliferae. It is a 
minute, globular, brownish-yellow body, finely ribbed, of aro- 
matic odor and taste, and contains a volatile and a fixed oil. 
Dose, gr. x-xx. 

Preparation. 

Oleum Coriandri, — the volatile oil. Dose, "ntij-v. 

Physiological Action and Therapeutics. 

Coriander is stimulant, aromatic and carminative. It is used 
almost wholly as a flavoring to other remedies, or as a corrective 
against the griping effects of certain purgatives. Its flavor covers 
the taste of Senna and Rhubarb, and it is an ingredient of the 
official Confectio Sennae. 



CORNUS, Dog-wood, — is the bark of the root of Cornus 
Jlorida, a small tree of the nat. ord. Cornaceae, indigenous in 
the U. S. Occurs in reddish-brown, curved pieces of astringent, 
bitter taste, and contains a bitter principle named Comin, which 
is crystallizable and soluble in water and alcohol ; also a resin 
and tannic acid. 

Preparation. 

Extractum Cornus Fluidum, — Dose, "ntx-gj. 

Physiological Action and Therapeutics. 

Cornus is a simple bitter, having stomachic and other qualities 
similar to those of Calumba (which see). In addition it is pos- 
sessed of considerable antiperiodic power, and has a good deal 
of reputation in the Southern States as a remedy in malarial fever, 
the physicians of that section considering it as next to Quinine 
in efficiency. Heat destroys its active principle, consequently a 
decoction is a useless preparation. 



COTO, Coto Bark (Unofficial), — is the bark of some un- 
known tree growing in Bolivia, from whence it comes in brownish 
pieces of aromatic odor and acrid, bitter taste. It contains an 
acrid, bitter principle, of yellow color, crystalline and soluble in 
hot water and alcohol, named Cotoin, C 22 H 18 6 ; also Piperonylic 



164 CREASOTUM. 

Acid, C 8 H 6 4 , and a volatile oil, resin, etc., but no tannin. 
Dose, gr. j-xv. 

Paracoto Bark, or False Coto, — is thicker than the true bark, 
has a fainter odor and taste, and is marked by whitish furrows on 
its surface. Its principle, Paracotoin, C ]9 H 12 6 , has a strong simi- 
larity to Cotoin therapeutically, but is less active. 

Preparations. 
A fluid extract of the official strength is prepared, also a tincture (10 per 
cent.), which may be administered in doses of from TUj-xx. Cotoin is used 
in doses of gr. j-iv, and Paracotoin in somewhat larger quantities. 

Physiological Action and Therapeutics. 

The physiological action of Coto has not been studied, all that 
is known about it being that it is decidedly irritant to the skin 
end mucous membranes. After its internal administration the 
urine takes a dark-red color with Nitric Acid. Ferric Chloride 
blackens a dilute solution of Cotoin, but has no reaction with 
Paracotoin. 

The bark and both principles are highly recommended in 
diarrhoeas of various forms, especially those of phthisis, typhoid 
fever, and cholera. In Asiatic cholera Paracotoin has been 
used hypodermically in 3-grain doses with success. Where there 
is any tendency to acute inflammation of the gastro-intestinal 
tract this agent must be used with caution. Small doses of the 
tincture (thJ-v) are said to be very effective in the diarrhoea of 
children. 



CREASOTUM, Creasote,— is a product of the distillation 
of wood-tar, chiefly consisting of the four phenols, Guiacol, Crea- 
sol, Methyl-creasol and Phlorol, in varying proportions. It is 
a nearly colorless, inflammable, oily liquid, of smoky odor, 
caustic taste and neutral reaction, soluble in 80 of water at 59 
F., in 12 of boiling water, and in all proportions in alcohol, 
ether, chloroform and acetic acid. It does not coagulate albu- 
men or collodion, Carbolic Acid does. It was named from its 
remarkably preservative power over meat, xpedq, flesh, and <7a>f>, 
I preserve. Much of the commercial Creasote is an impure Car- 
bolic Acid, or a heavy oil distilled from coal-tar and containing 
Carbolic and Cresylic Acids. Dose, luj-iij, well diluted. 

Preparation. 

Aqua Creasoti, — a 1 per cent, solution, containing ""liv^ in each fluid- 
ounce. Dose, 3J-iv. 



CROCUS. 165 

Physiological Action and Therapeutics. 

Creasote is expectorant, astringent, antiseptic, styptic, eschar- 
otic, anaesthetic and narcotic. Its action is practically the same 
as that of Carbolic Acid (see ante, page 22), especially upon the 
heart, respiration and nervous system. It is eliminated by the 
kidneys and bronchial mucous membrane, which it stimulates 
being quite a good expectorant. It small doses it seems to have 
a selective sedative influence on the terminal nerve-filaments in 
the gastric mucous membrane. In large doses it is a powerful 
poison, resembling Carbolic Acid in its symptoms, except that its 
nervous effects are even more marked. It explodes when com- 
bined with Oxide of Silver in pill, unless previously diluted with 
an inert powder. 

Therapeutics. 

Being a very complex substance of varying composition Crea- 
sote as a therapeutic agent has been almost entirely supplanted 
by Carbolic Acid. It is used internally with success in reflex 
nausea and vomiting, as from sea-sickness, pregnancy, cholera, 
etc., also as an aseptic and expectorant in chronic basilar cavity, 
in which it seems to have greater efficacy than any other remedy. 
As an astringent it has been employed in intestinal hemorrhage, 
gonorrhoea and gleet, and generally in the same affections as 
Carbolic Acid. Externally it is a good application in eczema, 
pruritus, ulcers and scaly skin diseases, and it effectually relieves 
the pain of an exposed dental nerve if applied thereto. It is a 
good agent by inhalation in chronic bronchitis and gangrene of 
the lung. 



CROCUS, Saffron, — the stigmas of Crocus salivus, a plant of 
the nat. ord. Iridaceae, cultivated in Europe, containing a vola- 
tile oil and coloring matter. Occurs as separate stigmas or three 
attached to the style, of orange-brown color, peculiar, aromatic 
odor, and bitter taste. So-called American Saffron is not Crocus 
but the flowers of Carthamus tine tortus. True Saffron is expen- 
sive, as it requires about 60,000 flowers to furnish one pound of 
the stigmas. Dose, gr. v-xx, in infusion. 

Prep a rations. 

Tinctura Croci, — io per cent. Dose, gj-ij. 

Saffron Tea, so much used in domestic practice, is an infusion of Car- 
thamus tinctorius, or Safflower. 



1 66 CUBEBA. 

Physiological Action and Therapeutics. 

Crocus is a stimulant aromatic, having some antispasmodic and 
anodyne qualities. The hot infusion produces diaphoresis, prob- 
ably by virtue of the hot water alone. It is said to have caused 
death with narcotic symptoms. On the continent of Europe it 
is employed as a stimulant and emmenagogue, but in this country 
its only use is as a coloring agent. The miscalled Saffron Tea 
noted above is used in domestic practice for measles and other 
exanthemata. 



CUBEBA, Cubeb, — is the unripe fruit of Cubeba officinalis, 
a plant of the nat. ord. Piperaceae, cultivated in Java. Occurs as 
a blackish-gray, wrinkled, globular body, about the size and shape 
of black pepper, of strong, spicy odor, and aromatic, pungent 
taste. Contains a Volatile Oil, which is official, an acrid resin 
composed in part of Cubebic Acid, also a fatty oil, gum, and 
Cubebin, which is an insoluble, neutral, odorless and tasteless 
body. The volatile oil may be separated into Cubebene a cam- 
phor, and Cubeben a liquid portion. The active principles are 
the volatile oil and the cubebic acid, both of which are contained 
in the oleoresin. Cubeb should be kept whole and not pulver- 
ized until wanted for use. Dose of the powdered drug, gr. x-5ij. 

Preparations. 

Extractum Cubeb^ Fluidum, — alcoholic. Dose, niv-xxx. 

Tinctura Cubeba, — 10 per cent. Dose,tTix-3iij. 

Oleoresina Cubeb^e, — extracted by ether. Dose, ttiv-xxx. 

Trochisci CiJBEByE, — each contains of the Oleoresin gr. i^, Oil of Sassa- 
fras gr. 0,15, Extract of Glycyrrhiza gr. iv, Acacia gr. ij, and Syrup of Tolu 
q. s. to form a mass. Dose, j-iij. 

Oleum Cubeb^e, C 15 H 24 , — is the volatile oil, a colorless or pale greenish- 
yellow liquid, of sp. gr. 0.920, warm, aromatic taste, odor of cubeb and a 
neutral reaction. Is soluble in an equal weight of alcohol. Dose, rriv-xx. 

Physiological Action. 

Cubeb belongs to the pepper family, and like black pepper is 
an aromatic stomachic and a stimulant diuretic in small or 
medium doses, but large doses derange digestion and may act as 
a gastro-intestinal irritant. Its constituents are eliminated by the 
bronchial mucous membrane, the skin and the kidneys, stimulat- 
ing and disinfecting the genito-urinary passages, increasing the 
bronchial mucus, sweat and urine, and frequently causing an urti- 
carial or vesicular eruption, It increases the action of the heart 



CUPRUM. 167 

and of the vascular system, stimulates the venereal appetite, and 
promotes the menstrual discharge. 

Therapeutics. 

Cubeb is particularly useful in affections of the bladder and 
urethra. It is used in the acute stage of gonorrhoea, chronic 
cystitis, prostatorrhcea and chronic bronchitis with excellent re- 
sults. The powder is a good application in hay-fever, chronic 
nasal catarrh and follicular pharyngitis, blown on to the mucous 
membrane by an insufflator. It may also be smoked in cigarettes 
with temporary relief in cases of acute nasal catarrh with 
"stuffed" nasal passages. In some subjects the continued use of 
cubeb produces nausea, hemorrhoids, hematuria and severe head- 
ache. The troches are a useful preparation in chronic irritability 
of the fauces, pharynx and air-passages, and are much employed 
by singers and public speakers for their tonic effect on these 
parts and for the relief or prevention of hoarseness. 



CUPRUM, Copper, Cu, — is not official, but two of its salts 
are, namely the Acetate and the Sulphate. The metal itself is 
inert, but in combination it is actively poisonous. Copper has 
been found in the normal human blood in very minute quantity. 

Salts and Preparations of Copper. 

Cupri Acetas, Acetate of Copper, Cu(C 2 H 3 2 ^ 2 .H 2 0, — forms green, pris- 
matic crystals, efflorescent, of nauseous, metallic taste and acid reaction, 
soluble in 15 of water and 135 of alcohol at 59 F. Its aqueous solution is 
of a blue color. Dose, gr. jq-X- 

Cupri Sulphas, Sulphate of Copper, CuS0 4 .5H 2 0, — blue, translucent crys- 
tals, efflorescent, of nauseous, metallic taste and acid reaction, very soluble 
in water, insoluble in alcohol. Its solution is blue by transmitted light, green 
by reflected light. Dose, as an emetic, gr. ij-v, every 10 or 15 minutes, — as a 
tonic, gr. \-%. 

Solution of Potassio-Cupric Tartrate, Fehling's Solution (Unofficial), 
used as a reagent for glucose, may be made as follows, — Dissolve 70 grains of 
Sulphate of Copper in 400 minims of Distilled Water. Also dissolve 488 
grains of Rochelle Salt (Pot. et Sodii Tart.) in 1600 minims Solution of Soda 
(Liq. Sodae), sp. gr. 1.12. When required for use pour the copper solution 
into the other, and add distilled water to make 2720 minims (£$%)■ 

Cuprum Ammoniatum, Ammoniated Copper (Unofficial), — is made by 
triturating 3 parts of Ammonium Carbonate with 4 of Cupric Sulphate until 
effervescence has ceased, then drying. A deep azure-blue powder, of ammo- 
niacal odor, a styptic, metallic taste, and alkaline reaction, soluble in water. 
Dose, gr. l-j. 

Physiological Action. 

The salts of Copper are gastro-intestinal irritants, producing a 
metallic taste, nausea with greenish vomited matter, purging of 



1 68 CUPRUM. 

blood and mucus, constricted fauces, depressed heart-action, 
hurried respiration and fever. Or, as with Arsenic, gastro- 
enteritis may not occur, but instead profound nervous symptoms, 
as headache, defective coordination, coma and convulsions. The 
symptoms of chronic poisoning are bronchial irritation and 
catarrh, gastro-intestinal catarrh, colic with diarrhoea [Lead 
produces colic with constipation], dysentery, nausea, emaciation, 
anaemia, salivation, and a green line (sulphide) along the margin 
of the gums in those who do not clean their teeth. The nervous 
symptoms above mentioned are also usually well marked. The 
liver becomes atrophied from irritation of its connective tissue 
and fatty degeneration of the hepatic cells. The lungs are con- 
gested, even pneumonic consolidation may be set up, the metal 
seeming to have a selective affinity for the parenchyma of these 
organs. These effects are often produced by the inhalation of 
cuprous fumes, and by eating acid fruits cooked in a copper 
vessel. 

Sulphate of Copper is a simple, irritant emetic, producing 
prompt and continued vomiting with but little nausea or depres- 
sion. In small doses it is a nerve-tonic and astringent to the 
gastro-intestinal tract. Externally applied in solution it is a 
useful stimulant and astringent to diseased mucous surfaces, and 
is mildly caustic if used in substance. The Acetate is possessed 
of the same general action as above described. Its local action 
is stimulant and escharotic. The impure acetate (verdigris) is 
a violent irritant poison. Ammoniated Copper has no special 
action otrTer than above noted. 

Antagonists and Antidotes. 

Ferro- cyanide of Potassium is the antidote to Copper salts, but albumen 
or magnesia may be used. Any chemical antidote should be followed by 
prompt evacuation of the stomach, then Opium and demulcents for gastro- 
enteritis, and Potassium Iodide even to saturation of the system. Alkalies 
and their carbonates, lime-water, iodides, mineral salts except the sulphates, 
are all incompatible. 

Therapeutics, 

The Sulphate is a prompt and efficient emetic, and is so used 
in croup and narcotic poisoning. In phosphorus poisoning it 
forms a comparatively insoluble phosphide of copper besides pro- 
ducing emesis. Fifteen or twenty grains may be dissolved in giv 
of water, and a teaspoonful or more according to age given every 
ten minutes until vomiting is produced. In acute diarrhoea and 
chronic dysentery it is the best metallic astringent in doses of 
gr. y^ to y 1 ^ with Opium, and in gastro-intestinal catarrh it is 



CURARE. 169 

equally efficient. Locally, it is used with benefit in throat affec- 
tions, gonorrhoea, granular lids and corneal ulcers, indolent 
granulations and chronic inflammations of mucous membranes. 
In most of these affections weak solutions (gr. i to ^ to the 5) 
are best, but in granular conjunctivitis the smooth crystal may 
be rubbed quickly over the surface once daily. 

In various nervous diseases, as epilepsy, chorea, hysteria, etc., 
the salts of copper are sometimes beneficial, the Ammoniated 
Copper being considered the most efficient preparation in these 
cases. In Germany a tincture of the Acetate Jpufficial and has 
been used successfully in the treatment of pneumonia. Ammo- 
niated Copper has lately been highly recommended for facial 
neuralgia, but requires pushing to the production of some physio- 
logical action. 

Ointments or lotions of the Acetate are useful applications in 
eczema, herpes, tinea sycosis, mentagra and herpes circinatus. 

Vitiate* s Solution has been successfully used as a local injection 
for the cure of caries. It is composed of Sulphate of Copper, 
Sulphate of Zinc of each 15 parts, Liquor Plumbi Subacetatis 30, 
Vinegar 200. The solution is thoroughly injected into the sinuses 
leading to the carious bone. 



CURARE, Woorara (Unofficial), — is a vegetable extract 
obtained from various members of the Strychnos family and from 
Paulinia curare and other plants. It is used in S. America as an 
arrow-poison under various names, as Caroval, Vao, etc. Its 
active principle is the crystallizable alkaloid Curarine, which con- 
tains no oxygen. 

The dose of Curare is gr. ^-\ hypodermically, — of Curarine, gr. 2 Jo~Too 
hypodermically, or gr. T ^o~4V by tne stomach, but as the samples vary greatly 
in activity they should first be tried on some inferior animal before being ad- 
ministered to man. 

Physiological Action. 

Curare is a paralyzer of the voluntary muscles, affecting them 
through the end-organs of the motor nerves. It does not at first 
act upon the brain or spinal cord, but if life be prolonged by arti- 
ficial respiration the cord, sensory nerves and even the muscular 
tissue all become affected. The heart, at first quickened, becomes 
depressed, and the blood-pressure is lowered, the eyelids droop, 
the eye-balls protrude, vision is disordered, intestinal peristalsis 
and sensibility to stimuli are greatly increased, and an artificial 
glycosuria (curare-diabetes) is set up. The limbs are paralyzed 



I70 CYDONIUM. 

first, death occurring by paralysis of respiration. The absorption 
of the drug by the stomach is very slow, as its active principle 
passes with difficulty through animal membranes, and its elimina- 
tion, which takes place by the kidneys, being more rapid and 
complete than that of any other agent, no marked effect may be 
produced when administered internally. When hypodermically 
injected its action is very prompt. The urine of a curarized ani- 
mal will poison another, and that of the second will paralyze a 
third. 

As compared with other motor depressants Curarine and Conine 
paralyze the end-organs of the motor nerves, Gelsemine and 
Methyl-conine paralyze the motor centres. 

Antagonists and Incompatibles. 

Strychnine, though from a member of the same family, is antagonistic as 
to the action on the heart and respiration. So also is Atropine. Artificial 
respiration is the most efficient antagonist, maintaining life until elimination 
occurs. Evacuation of the bladder repeatedly is important to prevent reab- 
sorption. The caustic alkalies destroy Curarine as they do all other alkaloids. 

Therapeutics, 

Curare is chiefly used for experimental purposes on the lower 
animals. It has an historical interest from its having been the 
means by which Bernard demonstrated the existence of muscular 
contractility as an essential endowment of that tissue. It has 
been used with some success in spasmodic nervous affections, 
particularly in tetanus, both idiopathic and traumatic, in hydro- 
phobia, chorea and epilepsy. It does not promise well as a 
therapeutic agent, but two undoubted cases of hydrophobia are 
reported by high authority as cured by this drug. 



CYDONIUM, Quince Seed, — is the seed of Cydonia vul- 
garis, a tree of the nat. ord. Rosacea^, native in Crete and Aus- 
tria, and cultivated elsewhere. The seeds are about y^ inch long, 
triangularly compressed, covered with a whitish epithelium, and 
in water they swell up forming a mucilaginous mass. The mucil- 
age is the only constituent of importance and is contained in the 
epithelial cells. It has been named Cydonin, and considered to 
be a compound of gum and cellulose. 

Preparation. 

Mucilago Cydonii, — prepared by macerating 2 parts of Cydonium in 100 
of Distilled Water. Dose, indefinite. 



CYPRIPEDIUM DAMI ANA. 1 7 1 

Physiological Action and Therapeutics, 

Cydonium is of value for its mucilage, which is used as a bland, 
demulcent application in conjunctivitis, abrasions of the skin, 
fissures of the mucous membranes, and as a vehicle for injections 
in gonorrhoea. Internally it may be used as a soothing remedy 
for the throat, stomach or intestines. The preparation known as 
Bandoline, used as a hair-dressing, is identical with the mucilage 
of Cydonium. 



CYPRIPEDIUM, Ladies* Slipper,— is the rhizome and 

rootlets of Cypripedium pubescens, and of C. parviflorum, the Moc- 
casin-plant, or American Valerian (nat. ord. Orchidaceae). Is 
dark or orange-brown in color, of strong, heavy odor, and bitter 
pungent taste. It contains a volatile oil, a volatile acid, resins 
and tannin. 

Preparations. 
Extr actum Cypripedii Fluidum, — Dose, lUx-xxx. 
Cypripedin (Unofficial), — is an impure alcoholic extract. Dose, gr. ss-iij. 

Physiological Action and Therapeutics. 

Cypripedium is antispasmodic, tonic, stimulant and diaphoretic, 
possessing the same general properties as Valerian, whence one of 
its common names. 

It is a popular remedy in some parts of the U. S. for nervous 
hyperesthesia unaccompanied by organic lesion, especially mor- 
bid sensibility of the eye. It is reported to have even cured epi- 
lepsy, and to be highly useful in neuralgia, hysteria, nervous 
headache and insomnia. 



DAMIANA (Unofficial),— the leaves of Turnera aphrodis- 
iaca, a plant of the nat. ord. Turneraceae, growing in Mexico and 
Lower California. Several varieties of so-called Damiana are in 
the market, but the true leaf is of a light-green color, small, 
lanceolate, and dentate along the margin. It contains a volatile 
oil and a resin. Dose, ^j daily. 

Prepa rations. 

Extractum Damiana (Unofficial), — Dose, gr. ij-x. 
Extractum Damiana Fluidum (Unofficial), — Dose, -rrix-^j. 

Physiological Action and Therapeutics. 
Damiana is said to be a powerful aphrodisiac in cases of sexual 
atony, but the published reports of its use since its introduction 



172 DATURA TATULA — DIGITALIS. 

vary greatly as to its efficacy. It is probably a stimulant diuretic, 
a bitter tonic, and a purgative in sufficient doses. 

Besides its use as an aphrodisiac Damiana has been adminis- 
tered with benefit in some forms of cerebral exhaustion and general 
atony of the nervous system, also in sick headaches and in some 
few cases of paralysis. It forms the chief stock in trade of the 
numerous charlatans who fill the daily papers with advertisements 
of " manhood-restorers.' ' 



DATURA TATULA (Unofficial), — is an indigenous 
plant of the nat. ord. Solanaceae, resembling Stramonium very 
closely, with which it generally agrees in its physiological action 
and therapeutics. It is distinguished by its purple stem, purple 
flowers and anthers, and the darker green of its leaves. It prob- 
ably contains the alkaloid Daturine (see Stramonium), — and has 
been smoked in asthma, in a few cases giving continued relief 
when Stramonium had failed to render any service. 



DIGITALIS, Fox-glove, — the leaves of Digitalis purpurea , 
nat. ord. Scrophulariaceae, collected from plants of the second 
year's growth. Fox-glove grows wild in Europe, but is cultivated 
in the U. S., especially by the Shakers, and much of their product 
is of very poor quality. The leaves are 4 to 12 inches long, of 
dull-green color above, paler and reticulate on the under surface, 
of faint, tea-like odor, and nauseous, bitter taste. Its active prin- 
ciple has long been known as Digitalin, an amorphous substance, 
probably of complex constitution ; but in 1871 Nativelle obtained 
a crystalline principle to which he gave the same name and the 
formula C 25 H 40 O 15 . Schmiedeberg (1875) affirmed Roucher's 
statement that the Digitalin of Nativelle is a mixture of Digitalin 
with Digitoxin, and states that true Digitalin is amorphous or 
granular. Schmiedeberg's analysis of Digitalis gives the following 
list of principles contained in the plant, viz. — (1) Digitoxin, the 
most active. (2) Digitanin, a substance allied to Saponin. (3) 
Digitalin. (4) Digitalein. The only points settled are that the 
Digitalin of the shops does not represent Digitalis, that the 
activity of the plant is due to more than one ingredient, and 
that the powdered leaves in wafer, pill, or infusion, are the best 
form for obtaining the action of the drug. Dose, gr. ss-iij. 

Preparations. 

Abstractum Digitalis,— rstrength 200 per cent. Dose, gr. %-\). 
Extractum Digitalis, — the leaves yield about 25 per cent, of extract. 
Dose, gr. l /e-%^ 



DIGITALIS. 173 

Extr actum Digitalis Fluidum, — strength 100 per cent. Dose, rnj-nj. 

TlNCTURA Digitalis, — strength 15 per cent. Dose, niv-^j. 

Infusum Digitalis, — strength iy£ per cent. Is flavored with Cinnamon, 
and contains 7^ per cent, of Alcohol. Is the best preparation when made 
from good foreign leaves. Dose, -fss-j twice daily. 

DlGITALINUM, Digitalin (Unofficial), — complex, expensive and varies 
greatly in quality. Dose, gr. gViV 



Physiological Action. 

Digitalis is a cardiac stimulant, an excito-motor, also emetic, 
diuretic, hemostatic, anaphrodisiac, and paralyzant. It irritates 
the mucous membranes, causing sneezing, severe gastric disturb- 
ance, nausea, vomiting, colic and purging, the discharges being 
of a grass-green color. It lowers temperature probably by lessen- 
ing the supply of blood to the tissues, produces headache, irregu- 
larity of cardiac action, vertigo, and an appearance of vibratory 
fringes of color around objects. It produces diuresis, probably 
by specific action on the Malpighian tufts, as well as by increasing 
the blood-pressure. The urea is at first increased, but in some 
cases is afterwards decidedly diminished. It lessens the venereal 
appetite, impairs the sexual function, and stimulates the muscular 
tissue of the uterus. 

The heart is slowed by Digitalis, but its force is at the -same 
time increased. Medium doses stimulate the cardiac motor 
ganglia, the inhibitory apparatus and the vaso-motor centres, 
contracting the arterioles, thereby a great rise of arterial tension 
resulting. Full doses continued exhaust the irritability of the 
motor-ganglia and paralyze the cardiac muscle itself. The 
recumbent posture must be maintained when Digitalis is given for 
its cardiac effect, to prevent exhaustion of the motor-ganglia. 
Lethal doses lessen the reflexes by stimulation of Setchenow's 
centre, and paralyze the muscles and the peripheral nerves, motor 
and sensory. Respiration, at first slowed, becomes rapid and 
feeble, cyanosis, coma and convulsions follow, death occurring 
by sudden paralysis of the heart, which is arrested in systole. 

Compared with Aconite, both it and Digitalis slow the heart, 
but otherwise their actions are antagonistic. Aconite relaxes inhi- 
bition and depresses the cardiac motor ganglia, — Digitalis in- 
creases inhibition and stimulates the motor apparatus. Both drugs 
finally paralyze the cardiac ganglia, Aconite by direct depression, 
Digitalis by over-stimulation. Both depress the cardiac muscle. 
Under Aconite the heart is arrested in diastole, under Digitalis 
in systole. The arterial tension is lowered by Aconite, raised by 
Digitalis. Aconite acts quickly, Digitalis very slowly, — a fact 



1 74 DIGITALIS. 

which makes the latter drug of little value in poisoning by the 
former. 

During the use of this drug for any length of time the motor 
apparatus of the heart is so nearly paralyzed by overstimulation 
that on suddenly assuming the erect position the cardiac energy 
may fail, more especially if the doses used are administered too 
closely together to admit of the elimination of one before the 
ingestion of the next. This is the explanation of the so-called 
cumulative action of Digitalis, which is not now recognized in 
the sense in which the term was formerly applied* 

Antidotes, Antagonists and Incompatible*. 

Tannic Acid is the chemical antidote, but as the tannate is not inert the 
stomach should be evacuated. ACONITE is the best antagonist to the effects of 
large doses, Opium to those of its long-continued use. Saponin and Senegin 
are considered to be its most complete physiological antagonists. Incom- 
patibles are Cinchona, Sulphate of Iron, Tincture of the Chloride of Iron, and 
Acetate of Lead. 

Therapeutics. 

The chief use of Digitalis in disease is based on its property 
as a heart tonic. Its great sphere is in mitral disease, when the 
heart is rapid and feeble, it moderating pulmonary hyperaemia and 
engorgement by giving the auricle time to empty itself through 
the obstructed orifice. In aortic disease it gives relief when the 
compensatory hypertrophy has not set in, otherwise it is contra- 
indicated. It is particularly useful in dilatation of the right side 
of the heart with incompetence of the tricuspid. The rational 
symptoms which indicate its use are — rapid and feeble cardiac 
action, low arterial tension, cough, dyspnoea, pulsating jugulars, 
a dusky face, scanty and high-colored urine and general dropsy. 
In the irritable heart of soldiers Digitalis is frequently curative, 
and palpitation, cardiac failure, and venous engorgement are 
well treated by it. It should not be used in simple hypertrophy 
when compensatory, aortic stenosis with compensatory hyper- 
trophy, pericarditis or fatty heart, except temporarily for some 
special indication. It is a useful remedy in dropsy, both cardiac 
and renal, in the first stage of pneumonia and other inflamma- 
tions, in the early stage of scarlet fever and when the kidneys 
strike work in that disease, in exophthalmic goitre, congestive 
headaches, and hemicrania, in mania, delirium tremens and other 
congestive conditions of the brain. As a hemostatic it may be 
used in hemorrhage from a large surface, in the hemorrhagic 
diathesis, hemoptysis, and menorrhagia. As an antipyretic it has 
been much used in fevers, but a reaction is setting in against this 



DIOSCOREA DITA BARK — DUBOISIA. 1 75 

employment of so powerful a heart-depressant. In rheumatic 
fever it lowers the temperature, shortens the duration of the dis- 
ease, and is particularly indicated for any cardiac complications. 
In spermatorrhoea of the plethoric it may be well combined with 
Potassium Bromide, and when this affection is complicated with 
an atonic condition, shown by feeble erections, frequent emis- 
sions and cold feet and hands, it is a serviceable anaphrodisiac. 
Finally, Digitalis is said by high authority to be particularly 
adapted to blondes and persons of sanguine and indolent tem- 
perament. 



DIOSCOREA, Wild Yam, Colic-root (Unofficial),— is 
the rhizome of Dioscorea villosa, a creeping plant of the nat. ord. 
Dioscoraceae, indigenous to the eastern U. S. It contains an 
acrid Resin, and is reported to be expectorant and diaphoretic in 
action, as well as stimulating to the intestinal canal, and in large 
doses to cause general neuralgic pains with erotic excitement. It 
is used with great success in bilious colic ; and in the cramps of 
cholera morbus, spasmodic hiccough, dysmenorrhoea and noctur- 
nal emissions of sthenic type it is said to be very efficient. A 
powdered extract named Dioscorein is on the market, of which 
the dose is gr. j-iv. A fluid extract made according to the phar- 
macopoeial rule maybe administered in doses of ngxv-xxx. 



DITA BARK (Unofficial),— is the bark of Alstonia scho- 
laris, a tree of the nat. ord. Apocynaceae, growing in the Phi- 
lippine Islands. It contains two active alkaloids, Ditaine and 
Ditamine, the former of which has an action identical with that 
of Curare. The bark is considered tonic and antiperiodic, and 
is used in the East as a remedy for intermittent^. It may be given 
in doses of 3.H V > m powder or as fluid extract. 



DUBOISIA (Unofficial), — is the leaf of Duboisia myopo- 
roides, an Australian tree of the order Solanaceae. It contains a 
poisonous alkaloid, Duboisine, which is believed to be identical 
with Hyoscyamine, and strongly resembles Atropine. 

Preparations. 

Extractum Dubotsi^e (Unofficial), — Dose, gr. \-%. 

Tinctura Duboisi^e (Unofficial), — Dose, tti v-xx. 

Duboisin^: Sulphas (Langenberg's), Unofficial, — Dose, gr. r la~gV 



I76 DULCAMARA. 

Physiological Action, 

The actions of Duboisia are in all respects similar to those of 
its congener, Belladonna, except that Duboisine is more soluble 
in water than Atropine, is less irritating to mucous membranes, 
and more prompt in mydriatic action, but its effects are of shorter 
duration. It is also less of a cerebral excitant and more of a 
calmative and hypnotic. On man its action is said by some 
authorities to be more powerful than that of Atropine, but less 
powerful on frogs. 

Antagonists and Incompatibles. 
These are the same as for Belladonna, for which see ante, page 97. 

Therapeutics. 

Duboisine has not been much used except by ophthalmologists 
who employ it as a mild mydriatic. Its advantages over Atro- 
pine in ocular therapeutics are its more rapid action in paralyzing 
accommodation and effecting mydriasis, the shorter duration of 
its effects and its slight irritation of the conjunctiva. It has been 
well employed in puerperal mania, and may be used in place of 
Atropine in many conditions, especially the night-sweats of 
phthisis, respiratory neuroses and cardiac failure. It is an efficient 
antagonist to Morphine. 

DULCAMARA, Bittersweet, — the young branches of 
Solanum Dulcamara, or Woody Night-shade, a shrub of the nat. 
ord. Solanaceae, growing in Europe and N. America. Occurs in 
short sections j£ inch thick, covered with a pale green bark, of 
slight odor, and taste at first bitter, afterwards sweet. It contains 
the glucoside Dulcamarin, a peculiar principle named Picrogly- 
cion, and the alkaloid Solanine, which exists in the stems of other 
species of Solanum, viz. — S. tuberosum (potato), .S. Lycopersicum 
(tomato), and S. nigrum (black nightshade). Solanine is of bitter 
taste, alkaline reaction, crystalline in minute prisms, soluble in 
125 of boiling alcohol but very insoluble in water. It is a nar- 
cotic poison, but exists in very small quantity in the plant. 

Preparations. 

Extractum Dulcamara Fluidum, — Dose, 3). 

Decoctum Dulcamaras (Unofficial), — maybe made of the official 10 per 
cent, strength and given in doses of ^j-ij. 

Physiological Action. 

Dulcamara is but imperfectly understood. In overdoses it has 
produced nausea and vomiting, vertigo, convulsive muscular 



ELATERINUM, 



177 



movements, pruritus and erythematous eruptions on the skin, 
languid circulation with a dusky color of the face and hands. In 
children who have eaten the berries there have been observed 
signs of severe enteralgia, abdominal tenderness, nausea, thirst, 
heat in the throat and chest, great prostration, rapid pulse, quick 
and painful respiration. In very large doses it is a narcotic poi- 
son, causing paralysis by depression of the central nervous system, 
with lowered activity of the heart and respiration. It is believed 
by some authorities to be anaphrodisiac, diaphoretic and diuretic. 

Therapeutics. 

Dulcamara was formerly used in a variety of affections, as her- 
petic diseases, chronic rheumatism, gout, jaundice, etc. It is 
now chiefly employed in obstinate scaly skin diseases, as psoriasis 
and pityriasis, in which it is unquestionably serviceable. It is 
also serviceable in the diarrhoea of children when produced by 
exposure to cold and damp, in mania with strong venereal pro- 
pensities, chronic bronchitis and whooping-cough. As a diapho- 
retic it has been used with benefit in rheumatic and venereal dis- 
orders, and is often beneficial in nasal, pulmonary and vesical 
catarrhs. It is said to be particularly useful in affections of a 
rheumatic or catarrhal nature when caused by exposure to damp 
weather. 



ELATERINUM, Elaterin, C 20 H 28 O 5 ,— is a neutral prin- 
ciple extracted from Elaterium, a substance deposited by the juice 
of the fruit of Ecballium Elaterium, or Squirting Cucumber, a 
cultivated European plant of the nat. ord. Cucurbitaceae. Elate- 
rium is no longer official by reason of its variable quality. Elate- 
rin occurs in small, colorless scales or prisms, of bitter taste and 
neutral reaction, insoluble in water, soluble in 125 of alcohol and 
in solutions of the alkalies. Dose, gr. sV"tV 

Preparation, 

Trituratio Elaterini, — Elaterin 10, Sugar of Milk 90 parts, thoroughly 
mixed by trituration. Dose, gr. ss-j. 

Physiological Action and Therapeutics. 

Elaterin is the most powerful of the hydragogue cathartics, 
causing profuse, watery stools, and when given in large doses 
great prostration and gastro-intestinal irritation, nausea and 
vomiting. On the lower animals it does not produce purgation, 

15 



I78 ERGOTA. 

but profoundly impresses the nervous system, causing irregular 
breathing, convulsions and death. 

Its chief use is to produce free watery discharges in ascites, 
anasarca, uraemia and cerebral disorders, but while the most effi- 
cient agent we possess for this purpose it must be used with great 
caution in the aged and feeble, as it is very depressant. 



ERGOTA, Ergot, Ergot of Rye, — is the sclerotium (com- 
pact mycelium or spawn, intermediate fibrous stage) of Claviceps 
purpurea (nat. ord. Fungi), growing within the flower and replac- 
ing the grain of Secale cereale, Rye (nat. ord. Graminaceae). It 
occurs in fusiform, curved, grain-like bodies, about an inch long, 
three- furrowed, obtuse at the ends, of purplish-black color, pecu- 
liar and heavy odor, and oily, disagreeable taste. It should be 
preserved in a dry place, and should not be kept longer than a 
year. Dose, gr. x~3j. 

Composition of Ergot. 

The composition of Ergot and the nomenclature of its sup- 
posed constituents is a subject upon which there exists a great 
diversity of opinion, and about which there is nothing settled. 
The following synopsis gives the views of the different persons 
who have examined into the matter. 

Wenzell (1864) named two alkaloids, Ecboline and Ergotine, which he 
claimed to be the active principles, and to be combined with Ergotic Acid, 
a volatile body yielding crystallizable salts. He also claimed the presence of 
Trimethylamine as a Phosphate. 

Tanret (1877) isolated a crystallized alkaloid, which he named Ergoti- 
nine, C 35 H 40 N 4 O 6 (dose, gr. -^q-^-q), also a volatile camphoraceous substance. 

Dragendorff and his pupils (1875-1879) stated the active principles to 
be two in number, Sclerotinic Acid, a very powerful body, yellow-brown, 
amorphous, tasteless and well adapted for hypodermic use in doses of gr. ^V - 
t T q, and Sclero?nucin, a colloid substance, also quite active. Besides these 
they held that Ergot contained various coloring matters (Sclererythrin, Scle- 
roxanthin, etc.), also a non-drying Oil, a peculiar sugar (Mykose), a number 
of alkaloids (Trimethylamine, etc.), and other principles, all inert. 

Kobert (1885) announces that Ergot contains three active principles, viz., 
Ergotinic Acid, the chief constituent of Sclerotinic Acid, having no ecbolic 
action, but affecting the nervous system, the heart and the respiration ; — Sphace- 
linic Acid, which is non-nitrogenous and soluble in alcohol, stimulates the 
vaso-motor centre and is the active agent in producing gangrenous ergotism ; — 
Comutine, an alkaloid, produces convulsions and peristaltic contractions of 
the uterus, and is the active agent in causing convulsive ergotism. 

Tanret' s Ergotinine has been proven to have no action on the 
uterus. The Ergotin of Bonjean, Wiggers and Tanret is not a 



ERGOTA. 179 

fixed compound, but a mixture. The Ecboline of Wiggers is 
also a mixture. Sclerotinic Acid is said by many authorities to 
act on the uterus, but this is positively denied by many others. 
It is probably a very uncertain preparation. For the Ergotin of 
commerce see below. 

Preparations. 

Extractum Ergots Fluidum, — prepared with diluted Hydrochloric 
Acid, Alcohol and Water. Dose, ^ss-ij. 

Extractum Ergots, Extract of Ergot, commonly called Ergotin, — is 
prepared by evaporating 5 parts of the fluid extract at a temperature not above 
122 F. until reduced to I part. Dose, gr. ij-xx. 

Vinum Ergots, — strength 15 per cent. Dose, gj-^j. Is made by an 
improved method and is more reliable than that formerly official. 

Ergotin (Unofficial), — is the name of several watery extracts found on the 
market, and varying much in action both from each other and from the parent 
drug. That made by Squibb is about the same strength as the official extract, 
and represents the general powers of Ergot. It may be used hypodermically 
in doses of gr. %-gr. v. The Ergotin of Bonjean is also an aqueous extract, 
but is very variable in quality and frequently inert. Wiggers' Ergotin is 
insoluble in the ordinary menstrua, and inert on the vascular apparatus, but 
causes colic and gastro-enteritis. 

Physiological Action, 

Ergot is an excito-motor and a hemostatic, chiefly affecting 
the spinal cord, circulation, respiration, intestinal and uterine 
muscular fibres. Its principal actions are the production of an 
artificial anaemia, and tetanic contraction of unstriped muscular 
fibre. Its phenomena are divided into two sets, named respec- 
tively Acute and Chronic Ergotism, according as the drug is ad- 
ministered in large doses, or in small quantity for a considerable 
length of time. 

Acute Ergotism. In large doses Ergot acts as a gastroin- 
testinal irritant, causing nausea and vomiting, gastralgia, colic, 
thirst, difficult micturition and purging. It slows the heart, 
raises the arterial tension greatly, dilates the pupils and produces 
pallor, vertigo and frontal headache. Its action on the circulation 
is due to its inducing arterial anaemia, but whether this is done 
by contraction of the arterioles through direct action on their 
muscular fibres or by central stimulation of the vaso-motor system, 
or by producing active venous dilatation, thus draining the arte- 
rial system, is a much disputed question. It certainly stimulates 
the contraction of unstriped muscular fibre, especially affecting 
the sphincters and the uterus, causing continuous labor pains and 
tonic contraction of the sphincter vesicae, making micturition 
difficult if not impossible. It also produces cerebral and spinal 
anaemia, coldness of the surface, tetanic spasms and violent con- 



1 80 ERGOTA. 

vulsions, but very large doses (several ounces) are necessary to 
such results. As much as giij of the fluid extract has been given 
daily for a week or more, without producing any marked effect. 

Chronic Ergotism occurs in two forms, (1) the Co?ivulsive, 
(2) the Gangrenous, — either usually excluding the other. The 
convulsions are tetanoid spasms of the flexor muscles, the uterus, 
the intestinal fibres, and the muscles of respiration, ending in 
coma and death by asphyxia. The gangrenous form begins with 
coldness and numbness of the limbs, formication of the skin all 
over the body, loss of sensibility and abolishment of the special 
senses, bullae of blood and ichor, followed by dry or moist gan- 
grene of the lower extremities, buttocks and other parts, epilep- 
tiform convulsions, coma and death. Autopsies show changes in 
the posterior columns of the cord, resulting probably from the 
spinal anaemia. 

Experiments with the various derivatives of Ergot show that 
no one of its constituents represents the power of the drug itself. 
Those which come nearest to it in action are the Ergotinine of 
Tanret and Sclerotinic Acid. 

Antagonists ana 7 Incompatibles. 

Amyl Nitrite, Aconite, Veratrum Viride, Tobacco and Lobelia antagonize 
its action on the circulation. Caustic alkalies and metallic salts are chemi- 
cally incompatible. 

Therapeutics. 

Ergot has a wide field of application. Its most familiar use is 
to promote uterine contraction in labor, but as the contractions 
produced by it are continuous instead of the natural intermittent 
ones, it is highly dangerous when there is any obstacle in front 
of the child, the probable results being rupture of the uterus, 
paralysis of the fcetal heart, and severe laceration of the perineum. 
At the end of the second stage of labor is the time for its best 
employment, to promote firm uterine contraction, thereby guard- 
ing against post-partum hemorrhage, as well as to aid in the 
expulsion of the placenta. In many uterine affections, as chronic 
metritis, subinvolution, congestive dysmenorrhoea, menorrhagia, 
fibroids and polypi, it is well employed, producing firm contrac- 
tion of the womb and promoting absorption of inflammatory 
products. It is extremely useful in amenorrhcea due to plethora, 
and in the atonic form of spermatorrhoea. In conjunctivitis, 
gonorrhoea, and inflammations of mucous membranes generally, 
it is of striking benefit, if used both locally and internally. It is 
also an excellent remedy in acute and chronic dysentery, chronic 
diarrhoea, atonic hemorrhages of arterial type, mania due to 



ERIGERON — ERIODYCTION. 1 8 1 

cerebral hyperaemia, headache and migraine of congestive form, 
myelitis, spinal congestion, cerebro-spinal meningitis, splenic 
enlargement, lax sphincters of rectum and bladder, and in incon- 
tinence of urine from paralysis of the sphincter vesicae. Hemor- 
rhoids are well treated by its local application, but here it should 
not be used internally as it promotes venous congestion. In 
aneurism it aids coagulation by slowing the blood-current, and 
in cardiac hypertrophy without valvular lesion it acts well by 
slowing the heart. In diabetes insipidus full doses of Ergot are 
often curative, and it has been used with benefit in diabetes mel- 
litus. 

Hypodermically, the aqueous extract dissolved in water and 
free from alcohol or any other irritating substance, is in many 
cases much more prompt in action than when given per orem, 
especially if injected near to the seat of the affection. This is 
particularly true in post-partum and other hemorrhages, prolapse 
of the rectum, chronic metritis and subinvolution of the womb, 
uterine fibroids, varicocele and varicose veins. When so ad- 
ministered it will frequently so contract the sphincter of the 
bladder as to produce retention of urine, and require the use of 
the catheter. 



ERIGERON, Fleabane (Unofficial),— is the flowering 
plant Erigeron canadense, a. weed of the nat. ord. Compositae, 
growing in N. America. It contains a Volatile Oil, which is 
official, also tannic acid and a bitter extractive. 

Pi-eparation. 

Oleum Erigerontis, Oil of Fleabane, — a pale yellow liquid, of sp. gr. 
about 0.850, becoming darker by age and exposure to air, of peculiar and per- 
sistent odor, pungent taste and neutral reaction, readily soluble in alcohol. 
Dose, rrtx-^ss. 

Physiological Action and Therapeutics* 

Oil of Erigeron has the same action as Oil of Turpentine but is 
less irritant and less efficient. It has considerable reputation as 
a hemostatic, especially in menorrhagia and intestinal hemorrhage 
of passive form, as in typhoid fever. It is also used with benefit 
in diarrhoea and dysentery, and in hemoptysis without fever or 
other evidence of irritation it is a very valuable remedy. 



ERIODYCTION, Yerba Santa (Unofficial),— the leaves 
of Eriodyction glutinosum, a Californian shrub of the nat. ord. 



1 82 ERYTHROXYLON. 

Hydrophyllaceae. They are from 2 to 4 inches long, shining- 
green as if varnished on the upper surface, white and hairy 
beneath, of fragrant odor, aromatic taste, and contain an acrid 
Resin and an aromatic Volatile Oil. 

Preparations. 

Extractum Eriodyctii Fluidum (Unofficial),— Dose, "nixv-^j. 
Extractum Eriodyctii (Unofficial), — Dose, gr. ij--x. 

Physiological Action and Therapeutics. 

Eriodyction is expectorant, and covers the taste of Quinine in 
a remarkable manner. It is used with fair success in bronchial 
and laryngeal affections, and asthma. Combined in syrup with 
Grindelia it is very efficient for coughs. 



ERYTHROXYLON, Coca, Cuca,— the leaves of Ery- 
throxylon Coca, a small shrub of the nat. ord. Erythroxylacese, 
indigenous to the mountains of Peru and Bolivia, and extensively 
cultivated in those and other S. American states. It has numerous 
purplish-brown branches; small, yellowish, 5-petalous flowers, 
and a scarlet*red, oblong fruit, containing a single seed. The 
leaf resembles a large tea-leaf, being 2 to 3 inches long, oval- 
shaped, obtuse at the apex, reticulate on both sides, with a promi- 
nent midrib, on either side of which is seen a curved line on the 
leaf from base to apex; odor tea-like, taste slightly bitter and 
aromatic. It contains a crystalline alkaloid Cocaine, C 17 H 21 N0 4 , 
which when heated with HO is split up into Benzoic Acid, Me- 
thylic Alcohol and another alkaloid E ego nine. Other constituents 
are a volatile, liquid alkaloid of herring-brine odor, alkaline 
reaction and burning taste, named Hygrine, an aromatic Oil, and 
Coca-tannic Acid. Coca should not be confounded with Cocoa, 
the seed of the chocolate-tree, Theobroina Cacao. Dose of the 
leaves, 5J - ^ V * 

Preparations. 

Extractum ErythroxYli Fluidum, — Dose, gss-ij. Leaves of good 
quality are so difficult to be obtained that Dr. Squibb, the well-known phar- 
maceutist, recently omitted the fluid extract from his trade-list, with the explan- 
ation that " it is impossible to get Coca of proper quality for medical use.'* 

Cocaina, Cocaine, C 17 H 21 N0 4 (Unofficial), — crystalline, colorless and of 
bitter taste, very soluble in ether, almost insoluble in water or alcohol, and of 
decided basic properties, combining with acids to form salts. It exists in the 
leaves in very small quantity, viz. — from 0.02 to 0.04 per cent. Dose, gr. 

Cocaine Hydrochloras, Tlydrochlorate of Cocaine, C 17 H 21 N0 4 C1 (Un- 
official), — more properly Chloride of Cocaine, — is used in aqueous solutions 



ERYTHROXYLON. 1 8 3 

of 2 to 5 per cent, as a local anaesthetic to mucous surfaces or by subcutaneous 
injection. Dose, internally, gr. %-\], 

Cocaine Oleas, Oleate of Cocaine (Unofficial), — ajj per cent, solution 
of the alkaloid in Oleic Acid, for external use. 

Wines, Lozenges, Elixirs, Glyceroles, Pastes, etc., of Coca are being manu- 
factured and marketed in great variety. The Citrate and Salicylate of Cocaine 
are recent products of the laboratory and may be obtained in the shops. 

Physiological Action. 

Coca is an aromatic bitter tonic, a diuretic and a cerebral and 
nervous stimulant, though locally used one of the most efficient 
nerve sedatives. Small doses improve digestion, stimulate res- 
piration, increase the heart's action after a brief depression, 
raise- the arterial tension, and increase the excitability of the 
sensory nerves. It stimulates the brain by increasing its blood- 
supply, producing wakefulness, a sense of well-being, and a 
marked diminution of the senses of fatigue, hunger and thirst, 
Under its daily use a considerable amount of labor and want of 
sleep can be borne without suffering. Though diuretic, it lessens 
the quantity of urea eliminated by checking the processes of waste. 
Very large doses produce impaired codrdination, hallucinations 
and delirium. 

Cocaine acts upon the lower animals similarly to Caffeine. It 
tetanizes frogs, and in large doses paralyzes their sensory nerves 
and the posterior columns of the spinal cord. It kills rabbits 
and dogs by paralysis of the respiratory centre. In proper doses 
it raises arterial tension by stimulating the vaso-motor centres 
and the cardiac motor system. On man its action resembles that 
of Cannabis Indica, having a primary stimulating action on the 
brain, and an after narcotic effect. A dose of 22 grains has been 
taken without causing any disturbance of the heart or mind, but 
producing colic, burning and dryness of the mouth, thirst, vom- 
iting, vertigo and feebleness. On the other hand an insufflation 
of 3 grains into the nostrils produced dizziness, sinking sensa- 
tions, dimness of vision, great debility, elevated temperature, 
dyspnoea, difficult articulation and deglutition, nausea but no 
vomiting, mind in a semi-comatose condition from which how- 
ever the patient was easily aroused. It resembles Caffeine in its 
action on the nerve-centres, and Atropine in its effect on the 
respiration, circulation, pupils, intestinal movements, salivary 
and sweat-glands. In full doses it causes intense and persistent 
nausea (but vomiting seems to be impossible), the flow of urine 
is largely increased, the sexual organs are stimulated, the action 
of the heart is increased and the respiration accelerated, the cap- 
illaries of the skin are contracted, producing pallor followed by 



I84 ERYTHROXYLON. 

profuse diaphoresis, the mouth and throat become dry, the pupils 
are dilated, and all the reflexes are exaggerated. On the cere- 
brum the action is one of direct stimulation, the sense of fatigue 
disappears, ideas flow rapidly, speech is exalted, and sleep is 
banished. The lethal dose of Cocaine is not ascertained, but 
would undoubtedly be very large. In sufficient quantity it would 
probably induce epileptiform convulsions, terminating in death 
from exhaustion, or from paralysis of respiration. 

Cocainism, or the Cocaine-habit, is now presenting itself to 
observation, several cases having been lately reported of persons 
addicted to its excessive use. Loss of digestive power, absolute 
insomnia, enfeeblement of the intellect, great emaciation, ascites, 
general marasmus, nausea, decay of the teeth, an excessively 
fetid breath, amblyopia, visual hallucinations and complete anor- 
exia form a consensus of symptoms which rival the worst effects 
of the opium-habit. Some observers report the most extraordi- 
nary mental changes resulting from Cocainism, and exceeding 
those produced by any other drug. The most intense selfishness, 
utter disregard of all social and domestic duties, the most debas- 
ing habits, complete destruction of all noble qualities, and a gen- 
eral condition of depravity are some of the results which are 
being charged to this drug. (See the recent case of Dr. Chas. 
D. Bradley, of Chicago, reported November 30, 1885, by the 
Associated Press ; also article by Dr. Bauduy in College and 
Clinical Record, October 1885.) 

As a local anesthetic to mucous surfaces Cocaine is very 
powerful over a limited area. Applied to the conjunctiva it causes 
profound but temporary anaesthesia of the superficial tissue, 
dilatation of the pupil, paralysis of accommodation, slight lach- 
rymation, and enlargement of the palpebral fissure. Applied to 
the tongue it destroys both taste and tactile sensibility so that 
salt cannot be distinguished from sugar, nor can the prick of a 
pin be felt. Used on the mucous mem Dane of the nasal passages 
it rapidly depletes the venous sinuses ana contracts the membrane 
firmly, causing local anaesthesia as well as loss of the sense of 
smell if applied high enough. Through the unbroken skin it 
does not act so promptly as on mucous membranes, but injected 
hypodermically in the vicinity of the muco-cutaneous junction 
it causes the same local anaesthesia throughout a small space. A 
number of cases have been reported tending to show that after 
the anaesthetic effect has passed away, a severe local congestion 
frequently arises, which in the eye may produce serious inflamma- 
tion. The use of Cocaine is for this reason generally condemned 



ERYTHROXYLON. 1 8 5 

by ophthalmologists whenever the eyeball is to be incised or 
penetrated. 

Therapeutics. 

Coca-leaves are chewed by the Peruvians for the purpose of 
sustaining them during arduous labors and long journeys, and 
were so highly esteemed as to have been represented on the coat- 
of-arms of that nation, by whom they are used much as we do 
tea, coffee or tobacco. This example was imitated by Weston 
the pedestrian, who is said to have been detected chewing the 
coca-leaf during one of his protracted walks. Cocaine is a useful 
stimulant to the brain and the nervous system in many morbid con- 
ditions, particularly cerebral and spinal anaemia, neurasthenia, 
melancholia, hysterical and hypochondriacal insanity, and in pro- 
tracted mental depression with suicidal tendency. A case of insan- 
ity of 15 years' duration in the person of a distinguished Roman 
Catholic prelate has just been reported as cured by Cocaine. It may 
be employed with benefit in wasting diseases to retard waste and to 
stimulate digestion, in convalescence from fevers and other acute 
maladies, and in migraine and neuralgia due to depression of the 
nervous system. It is very beneficial in the vomiting of preg- 
nancy, in stomatitis and gastralgia, and in functional impotence 
due to general atony of the system. The Morphine-habit is most 
effectively combated by the hypodermic administration of Cocaine, 
but care must be taken to conceal the identity of the agent used 
from the patient, lest the Cocaine- habit take the place of the origi- 
nal one, which would be a veritable illustration of "jumping from 
the frying-pan into the fire." A wine of the leaves is found by 
singers and speakers to relieve hoarseness, to tense the vocal 
cords and improve the timbre of the voice. Coca-leaves may be 
smoked in cigars or cigarettes to obtain the exhilarating effects 
of the drug, and for the relief of hay-fever and many irritable 
throat affections. The Oleate of Cocaine is an efficient pallia- 
tive application to painful hemorrhoids, fissures of the anus, burns, 
boils, and irritable ulcers; also in pruritus pudendi et ani and 
skin diseases attended with intolerable itching. 

Hydrochlorate of Cocaine has recently achieved notoriety 
as a local anaesthetic, and promises to be of the greatest value in 
many operations on the eye and ear, nasal passages, uterus and 
urethra. A 2 to 4 per cent, solution is brushed lightly over the 
mucous surface or injected into the urethral canal, the applica- 
tion being repeated within 5 or 10 minutes if profound local 
anaesthesia is required. After about fifteen minutes any super- 
ficial operation may be performed without giving the slightest 

16 



1 86 EUCALYPTUS. 

pain. Its anaesthetic action is so entirely local and generally free 
from unpleasant after-effects that it is considered the most efficient 
and desirable agent of the kind which is known. It has been 
used in the same manner with decided benefit in congestion of 
the nasal passages from acute catarrh and hay- fever ; and has 
been applied to the cervix uteri to relieve the first pains of labor, 
to the ear for tinnitus aurium, and by inhalation to strengthen 
the vocal chords, relieve hoarseness and cough, and to improve 
the quality of the voice. It is injected hypodermically around 
the prepuce to prevent pain during circumcision, into the vicinity 
of the supraorbital and infraorbital foramina to cut short neural- 
gia of those nerves, and into hemorrhoids previous to their liga- 
tion. It may be injected into the bladder before lithotrity, into 
the urethra before the passage of sounds or catheters or to relieve 
chordee, and it is an excellent application to the gums of teething 
infants. To be efficient it must reach the terminal filaments of 
the sensory nerves in sufficient concentration. 



EUCALYPTUS,— the leaves collected from rather old 
trees, of Eucalyptus globulus, or Blue Gum-tree (nat. ord. Myr- 
taceae), a native of Australia, now grown in California, Italy, etc. 
The leaves are 6 to 12 inches long, gray-green, lanceolately 
scythe-shaped, studded with oil-glands ; of camphoraceous odor 
and bitter, aromatic taste. They contain tannic acid, a resin, a 
fatty acid and a Volatile Oil. The latter consists of three different 
oils which distil over at different temperatures, the first product 
being named Eucalyptol, C 12 H 20 O, which by the action of Phos- 
phoric Acid is converted into Eucalyptene, a substance allied to 
Cymene, and Eucalyptolen. 

Preparations. 

Extractum Eucalypti Fluidum, — alcoholic. Dose, ""Ix-^j. 

Oleum Eucalypti, — the volatile oil, distilled from various species of Eu- 
calyptus, that from E. a?jiygdalina being considered wanting in Eucalyptol. 
Dose, rri v-xxx in capsules or emulsion. 

Tinctura Eucalypti (Unofficial), — Dose, gss-ij. 

Physiological A ction. 

The taste of Eucalyptus is warm, aromatic, bitter and cam- 
phoraceous. It increases the flow of saliva, the gastric juice and 
the intestinal secretions, and in small doses promotes appetite 
and digestion, increases the heart's action and lowers arterial 
tension. In large doses it produces eructations, indigestion, 



EUCALYPTUS. 1 87 

diarrhoea, nausea and vomiting, lowered temperature, great mus- 
cular weakness, and if continued will irritate and congest the 
kidneys, and induce a feverish state with symptoms of cerebral 
congestion, and great constitutional disturbance. Toxic doses 
are fatal by paralysis of respiration through direct action on 
the spinal cord. 

It is powerfully antiseptic, and destructive to low forms of 
life, a stimulating expectorant and an efficient diaphoretic. By 
some authorities it is believed to reduce the size of an enlarged 
spleen, and to possess anti-malarial properties by absorbing nox- 
ious germs as well as by draining the soil of its water, and by its 
aseptic emanations purifying the atmosphere in its vicinity. It is 
largely cultivated in malarial districts for these properties, and is 
reported to have rendered habitable a portion of the deadly 
Roman Campagna. 

Eucalyptus is eliminated by the skin, bronchial mucous mem- 
brane and the kidneys, imparts its odor to the breath and the 
urine, and is more or less irritant at the points of its elimination. 

Therapeutics. 

Eucalyptus is an efficient stomachic in atonic dyspepsia, chronic 
gastric and intestinal catarrh, and in conditions of the intestinal 
canal which favor the development of worms. In chronic 
catarrhal conditions of the genito-urinary organs, the broncho- 
pulmonary mucous membrane, and especially the bladder, it is 
very useful, acting as a stimulant and disinfectant to the mucous 
membranes. It is equally beneficial in chronic bronchitis and 
bronchorrhcea, in cachectic states generally, and in convalescence 
from acute diseases. In hysteria, chorea and asthma it is bene- 
ficial, in the latter affection being advantageously smoked in 
cigarettes with Stramonium or Belladonna Leaves. In malaria as 
a reconstructant it is better than Quinine, and it has considerable 
utility in obstinate intermittents where it is desirable to stop the 
use of Cinchona preparations. As an antiseptic it is highly 
valued in dilute solution for application to ulcers, and as a substi- 
tute for Carbolic Acid on gauze in the antiseptic treatment of 
wounds. It is also used in dilute solution locally as a stimulating 
disinfectant in stomatitis and in the subacute stages of pharyngitis 
and tonsillitis. An aqueous preparation is highly recommended 
as a vehicle for alkaloids in solutions for hypodermic use, to pre- 
vent the development of the penicillium which rapidly destroys 
the alkaloid present. 



I 88 EUONYMUS— EUPATORIUM. 

EUONYMUS, Wahoo, — is the bark of Euonymus atro- 
purpureus, a shrub of the nat. ord. Celastraceae, growing in the 
U. S. Occurs in quills or curved pieces, about 7 l inch thick, 
of ashy-gray color and acrid, sweetish taste. It contains an 
amorphous, bitter principle named Euonymin, also Resins, Euonic 
Acid, and Asparagin, fixed oil, etc. 

Preparations. 

Extractum Euonymi,— Dose, gr. j-v. 

Euonymin (Unofficial), — the eciectic preparation, consists of the fixed oil 
and resin, and is given in doses of gr. ss-v. 

Physiological Action and Therapeutics, 

Euonymus is classed with Rhubarb, Jalap, Aloes, etc., as a 
tonic-astringent and resin-bearing purgative. It is said to be also 
diuretic and expectorant, and a very efficient cholagogue. Its 
cathartic action is similar to that of Rhubarb but milder. It has 
been employed with benefit in some cases of dropsy, also in 
habitual constipation, torpid liver, and pulmonary affections. In 
overdoses it will set up considerable gastro-intestinal irritation. 



EUPATORIUM, Thorough - wort, Boneset, — the 

leaves and flowering tops of Eupatorium perfoliatum, an American 
plant of the nat. ord. Composite, having lanceolate leaves, two 
united at the base, each 4 to 6 inches long, of weak, aromatic 
odor and bitter, astringent taste. It contains a neutral, bitter 
principle, named Eupalorin, tannic acid, a volatile oil etc. 

Preparation. 
Extracti Eupatorii Fluidum,— Dose, rrix-^j. 

Physiological Action and Therapeutics. 

Boneset is a bitter tonic and efficient diaphoretic, also in full 
doses emetic and aperient. It has been supposed to have anti- 
periodic and taeniafuge powers. A warm infusion (Boneset tea) 
is a popular diaphoretic in remittent and typhoid fevers, and at 
the onset of an attack of acute catarrh or general cold. As a 
bitter tonic it may be used with advantage in dyspepsia and gen- 
eral debility. Its common name is derived from its supposed 
power to relieve the bone pains of dengue or the " break-bone 
fever.' ' 

Another variety of Eupatorium, E. purpureum, or Gravel-root, 
is reputed to have decided power over the uric acid diathesis. 



EUPHRASIA — FEL BOVIS — FERRUM. 1 89 

EUPHRASIA, Eye-bright,— is a small annual plant of 
the nat. ord. Strophulariaceae, growing in Europe and the U. S., 
odorless, of astringent taste, and containing Euphrastic. Acid, 
tannin, etc. It was formerly of great repute in various eye-affec- 
tions, and maybe of utility as a mild astringent in catarrhal con- 
junctivitis. Its chief value, however, is to abort an attack of 
acute nasal catarrh with lachrymation, for which purpose a few 
drops of the tincture every two hours is remarkably efficient. In 
hay-fever also it is of decided utility in mitigating the catarrhal 
symptoms, and in the acute coryza of measles it will be found an 
excellent remedy. A tincture (1 to 9) of the fresh plant should 
be used, and given in doses of mj-v. 



FEL BOVIS, Ox-gall,— the fresh gall or bile of Bos Taurus, 
is a dark-green, viscid liquid, of peculiar odor, bitter taste, and 
neutral or faintly alkaline reaction. Sp. gr. 1.018 to 1.028. It 
contains Glycocholate of Sodium, Taurocholate of Sodium, 
Cholesterin and coloring matter. 

Preparations. 

Fel Bovis Inspissatum, Inspissated Ox-gall, — 100 parts of fresh Ox-gall 
evaporated to 15 parts, after straining. Dose, gr. v-xv. 

Fel Bovis Purificatum, Purified Ox-gall, — 3 of Ox-gall and 1 of Alcohol 
evaporated to pilular consistence, after standing 24 hours, decanting, filtering, 
etc. Dose, gr. v-xv. 

Physiological Action and Therapeutics. 

Bile is tonic, antiseptic and purgative, it assists in the emulsifi- 
cation of fats, and stimulates the absorbent powers of the mucous 
membrane. In the stomach it neutralizes the gastric juice, pre- 
cipitating the pepsin, and is apt to cause nausea and vomiting. 
Recently it is found to act well in stimulating the resolution of 
hypertrophies when locally applied to the part, as the mammae, 
tonsils, pannus, etc. It is used as a laxative in constipation 
when the natural secretion of bile is deficient, but has no advan- 
tage over other purgatives. 



FERRUM, Iron, Fe, — is metallic Iron in the form of fine, 
bright and non-elastic wire. 

Ferrum Reductum, Reduced Iron, — consists of metallic Iron 
in fine powder, obtained by reducing the Sesquioxide by hydro- 
gen at a dull red heat. It is a very fine, gray-black, lustreless 
powder, odorless, tasteless, and insoluble in water or alcohol, but 



I9O FERRUM. 

soluble in dilute sulphuric acid with the evolution of nearly odor- 
less hydrogen gas. Dose, gr. j-v, after meals. 

Iron Compounds and their Preparations. 

Liquor Ferri Acetatis, — is an aqueous solution of Ferric Acetate, con- 
taining 33 per cent, of the anhydrous salt. A dark red-brown transparent 
liquid, of acetous odor, sweetish and faintly styptic taste, reaction slightly 
acid. Action, — stimulant, ferruginous, little if any astringency. Used to 
prepare the following tincture. 

Tinctura Ferri Acetatis, — has of the preceding 50 parts, Alcohol 30, 
Acetic Ether 20. A clear, dark red-brown liquid, of acetous odor, acidulous 
and slightly astringent taste, and slight acid reaction. Miscible with water in 
all proportions. Dose, Tiix-^ij. 

Syrupus Ferri Bromidi, — is a syrupy liquid containing 10 per cent, of 
Ferrous Bromide, FeBr 2 . A pale-green, odorless liquid, of sweet ferruginous 
taste and neutral reaction. Action, — a sedative chalybeate tonic, especially 
recommended in nervous disorders, and by Da Costa in chorea. Irritant in 
large doses. Dose, tri v-xxx. 

Ferri Carbonas Saccharatus, — has at least 15 per cent, of ferrous car- 
bonate. A greenish-gray powder, of sweetish taste at first, changing to ferru- 
ginous. Partially soluble in water, but soluble in dilute hydrochloric acid 
with evolution of C0 2 . Action, — slightly stimulant to digestive tract. Dose, 
gr. ij-x with food. 

Massa Ferri Carbon atis, Vallet's Mass, — Sulphate of Iron 100, Carbo- 
nate of Sodium no, Honey 38, Sugar 25, Syrup, Distilled Water, each q. s. 
ad 100 parts. Has 42 per cent, of ferrous carbonate. Action, — non-astrin- 
gent, unirritating, ferruginous tonic. Dose, gr. iij-v after food. 

Mistura Ferri Composita, Griffith's Mixture, — Sulphate of Iron 6, Myrrh 
18, Sugar 18, Carbonate of Potassium 8, Spirit of Lavender 50, Rose-water 
900 parts. Is really a solution of the carbonate, with sulphate of potassium to 
suspend the iron salt. Is an excellent mixture, but disagreeable. Dose, ^ss. 

Pilule Ferri Composita, Griffith's Pills, — Sulphate of Iron gr. }£, Car- 
bonate of Sodium gr. 3^, Myrrh gr. jss, Syrup q. s. in each pill, answering 
in composition to the preceding. Dose, ij-vj. 

Ferri Chloridum, Perchloride of Iron, FeCl 6 .i2H 2 0, — orange-yellow, 
deliquescent, crystalline pieces, of styptic taste and acid reaction, freely soluble 
in water, alcohol or ether. Action, — strongly astringent, hemostatic. Never 
used internally. 

Liquor Ferri Chloridi, — an aqueous solution of the preceding, contain- 
ing 37.8 per cent, of the anhydrous salt, with some free HC1 acid. Action, — 
strongly astringent and styptic. Rarely used internally. Dose, iHij-x, well 
diluted. 

Tinctura Ferri Chloridi, — has of the preceding 35 parts in 65 of Alco- 
hol. A bright, brownish liquid, of ethereal odor, styptic taste and acid reaction. 
Is used in Mistura Ferri et Ammonii Acetatis. One of the best preparations 
of iron. Action, — ferruginous tonic. Dose, niv-xx, in water, syrup or 
glycerin. 

Ferri Citras, Fe 2 (C 6 H 5 7 ) 2 .6H 2 0, — garnet-red, transparent scales, slowly 
soluble in water, not in alcohol. Action, — mildly stimulant. Dose, gr. ij-v. 
Formed by evaporating the following : 

Liquor Ferri Citratis, — is an aqueous solution of the preceding, contain- 
ing about 35% P er cent, of the anhydrous salt. A dark-brown liquid, of 



FERRUM. IQI 

slightly ferruginous taste and add reaction. Action, — as Ferri Gtras. Dose, 

TTlv-xv. 

Vinum Ferri Citratis, — made from the Citrate of Iron and Ammonium 
ncture of Sweet ::ge-peel 12, Syrup 12, stronger White Wine 72 parts. 
An iron elixir. Dose, ^j-ij. 

Ferri Hypophosphis, Fe : H P0 ; 6 . Ferric Hypophosphite, — a white or 
grayish- white powder, odorless, tasteless, slightly soluble in water, freely so 
in HO acid or in a solution of sodium citrate. Action, — ferruginous tonic. 
Dose, gr. v-x. 

Ferri Iodidum Saccharatum, — a yellowish-white powder, very hygro- 
scopic, odorless, of sweetish, ferruginous taste, and slightly acid reaction, 
soluble in 7 of water at 59 F., insoluble in alcohol. Action, — ferruginous 
tonic. Dose, gr. v-xxv in pill or elixir. 

Pilule Ferri Iodidi, — made with Reduced Iron, Iodine, Licorice, Sugar, 
Acacia and Water, covered with a coating of Balsam of Tolu in Ether. 
u Blancard's Pills " only differ from these by being covered with a coating of 
reduced iron to protect the interior from oxidation, but it also protects them 
from the solvent action of the gastric juice. Dose, 1 or 2 pills ter in die. 

Syrupus Ferri Iodidi, — is a syrupy liquid containing 10 per cent, of fer- 
rous iodide. A transparent, pale-green liquid, of sweet, ferruginous taste and 
neutral reaction. Action, — ferruginous tonic. Dose, ttiv-xxx. 

Firri Lactas, Fe{C 3 H 5 3 ) 2 .3H 2 0, Ferrous Lactate, — pale, greenish- 
white, crystalline grains, soluble in 40 of water at 59 F., freely in citrate of so- 
dium, almost insoluble in alcohol. Action, — feebly ferruginous tonic. Dose. gr. 
j-iij in pill or syrup. Is a constituent of Syrupus H)-pophosphitum cum Ferro. 

Liquor Ferri Nitratis, — is an aqueous solution of Ferric Nitrate, 
Fe^j NOj)^ containing about 6 per cent, of the anhydrous salt. A transparent, 
amber-colored liquid, of acid, styptic taste, and acid reaction. Action, — 
medium as to irritation, astringent and hemostatic. Dose, ttiv- :; •-. well diluted. 

Ferri Oxaias, Ferrous Oxalate, FeC 2 4 .H 9 0, — a pale yellow, crystalline 
powder, very slightly soluble in water. Dose, gr. ij in pill. 

Ferri Oxidum Hv: :- latum. Ferric Hydrate, Fe(HO) 6 , — is a brown-red 
magma wholly soluble in HC1 acid without effervescence. Should be freshly 
prepared from the Solution of Tersulphate of Iron 10 parts and Water of 
Ammonia 8 parts. Is the chemical antidote for Arsenic. Dose, a teaspoonful 
in water frequently repeated. The solutions should be kept ready for use. 

Ferri Oxidum Hydratum cum Magnesia, — is made by mixing when 
required for use (1) Solution of Tersulphate of Iron 1000 grains. Water 2000 
.5. (2) Magnesia 150 grains, Water gxxxij. This should be adminis- 
tered as directed under the preceding head. It is a more convenient and a 
mere efficient antidote for Arsenic than the simple ferric hydrate, as the 
excess of the alkaline precipitant is non-irritant and is itself an antidote to 
arsenic. 

Emplastrum Ferri, Strengthening Plaster, — has of Hydrated Oxide of 
Iron, dried, 10 parts, Canada Turpentine 10, Burgundy Pitch 10, Lead Plas- 

70- 

Trochisci Ferri. — each has of Hydrated Oxide of Iron, dried, gr. v, 
Vanilla gr. ^, Sugar, and Mucilage of Tragacanth. Dose, j-iij, ter die. 

Ferri Phosphas, — Bright-green, transparent scales, of acidulous, saline 
taste, soluble in water, not in alcohol. Used as an adjuvant to laxative pills 
to prevent the after reactionary constipation. Dose, gr. v-x. Made by reac- 
tion between the Citrate of Iron and the Phosphate of Sodium. 

Ferri Pyrophosphas, — Green, transparent scales, of acidulous taste, 



I92 FERRUM. 

soluble in water but not in alcohol. Is almost tasteless and unirritating, and 
non-constipative. Dose, gr. ij-v. Made by reaction between the Citrate of 
Iron and the Pyrophosphate of Sodium. 

Ferri Sulphas, Ferrous Sulphate, FeSO + .7H 2 0, — large, pale bluish-green 
prisms, efflorescent, of saline, styptic taste, and acid reaction, soluble in 1.8 
of water at 59 F., insoluble in alcohol. Is chiefly used to make the Dried 
Sulphate and other preparations. 

Ferri Sulphas Exsiccatus, Dried Ferrous Sulphate, FeS0 4 .H 2 0, — a 
grayish --white powder, nearly soluble in water, consisting of the preceding 
salt, heated gradually to 300 F., until it ceases to lose weight. The most 
astringent and irritating ferrous salt, but an excellent one in small doses. Is 
a constituent of Pil. Aloes et Ferri. Dose, gr. ss-ij in pill. 

Ferri Sulphas Pr^ecipitatus, Precipitated Ferrous Sulphate, FeS0 4 7H 2 0, 
— is the same salt as above described, precipitated by Alcohol from solution 
in dilute sulphuric acid. Dose, gr. ss-ij. 

Liquor Ferri Subsulphatis, MonsePs Solution, — is an aqueous solution 
of Basic Ferric Sulphate, Fe 4 0(S0 4 ) 5 , containing 43.7 per cent, of the salt. 
A dark reddish-brown, almost syrupy liquid, of very astringent but not caustic 
taste, and acid reaction, mixing with water or alcohol in all proportions with- 
out decomposition. Is but slightly irritating, and powerfully astringent, chiefly 
used locally as an astringent and hemostatic, but may be given internally in 
doses of miij-x, well diluted. 

Liquor Ferri Tersulphatis, — is an aqueous solution of Normal Ferric 
Sulphate, Fe 2 (S0 4 ) 3 , containing 28.7 per cent, of the salt. Has the same 
properties as described for the preceding, but a less sp. gr. Is used to make 
other preparations of Iron. 

Ferri Valerianas, Fe 2 ('C 5 H 9 2 ) 6 , — a dark, tile-red, amorphous powder, 
of faint, valerianic odor, and mildly styptic taste, insoluble in cold water, de- 
composed by hot water, readily soluble in alcohol. Of doubtful value as a 
valerianate. Dose, gr. j-iij in pill. 

Preparations of Compound Iron Salts. 

Ferri et Ammonii Citras, Ammonio-ferric Citrate, — prepared from Solu- 
tion of Citrate of Iron 3 parts, Water of Ammonia 1, mixed and evaporated. 
Transparent, garnet-red scales, deliquescent, soluble readily in water, insoluble 
in alcohol. Dose, gr. ij-v. 

Ferri et Ammonii Sulphas, Ammonio-ferric Alum, — pale, violet crystals, 
efflorescent, of styptic taste and slightly acid reaction, soluble in 3 of water 
at 59 F., insoluble in alcohol. Is the least astringent of the sulphates of 
iron, but more so than any of the salts formed by vegetable acids. Dose, 
gr. iij-xv. 

Ferri et Ammonii Tartras, Ammonio-ferric Tartrate, — made from Liq. 
Ferri Tersulphatis 90, Tartaric Acid 60, Aq. Ammoniae 72, Ammonium Car- 
bonate, Water q. s. Transparent, reddish-brown scales, slightly deliquescent, 
of sweetish and slightly ferruginous taste, very soluble in water, insoluble in 
alcohol. Contains an equivalent of about 25 per cent, of Ferric Oxide, and 
has but slight irritant qualities. Dose, gr. v-xx. 

Ferri et Potassii Tartras, Potassio -ferric Tartrate, — made from Liq. 
Ferri Tersulphatis 12, Potassii Bitart. 4, Aq. Destil. 32, Aq. Ammoniae, et 
Aquae q. s. Transparent, garnet-red scales, slightly deliquescent, of sweetish 
and slightly ferruginous taste, very soluble in water, insoluble in alcohol. Is 
the least disagreeable in taste of all the iron preparations, and contains a little 



FERRUM. I93 

more ferric oxide than the preceding salt. Is but slightly astringent and is not 
constipating. Dose, gr. v-x. 

Ferri et QUININE Citras, — prepared from Ferri Citras 88, Quinine, dried, 
12, Aq. Destil. q. s. ad 100, mixed and evaporated. Thin, transparent, yel- 
lowish-brown scales, slowly deliquescent, of bitter taste, slowly soluble in 
water, slightly soluble in alcohol. Contains 12 per cent, of dry quinine. 
Action, — astringent and stimulant to the digestive tract. Dose, gr. iij-v. 

Liquor Ferri et Quinines Citratis, — made directly from Ferri et Am- 
monii Citras 65, Quinine, dried, 12, Ac. Citric. 28, Alcohol 30, Aq. Destil. 
q. s. ad 200. A greenish-browm liquid, of bitter taste and slightly acid reac- 
tion. Contains 6 per cent, of quinine. Is very slowly soluble and of doubtful 
value. Dose, nxv-xv. 

VlNUM Ferri Amarum, Bitter Wine of Iron, — has of the preceding 8 
parts, Tinct. Aurantii Dulcis 12, Syrup 36, Stronger White Wine 44. May 
replace the various "elixirs of iron and calisaya." Dose, ^j-iv. 

Ferri et Strychnine Citras, — Ferri et Ammonii Citras 98, Strychninae 
I, Ac. Citric. I, Aq. Destil. 120, mixed and evaporated. Transparent, garnet- 
red scales, deliquescent, readily soluble in water, slightly so in alcohol. Con- 
tains I per cent, of Strychnine. Action, — astringent and stimulating. Dose, 

gr. 1-iij. 

Syrupus Ferri, Quinine et Strychnine Phosphatum, Syrup of the 
Phosphates of Iron, Quinine and Strychnine. [Described under Phosphorus.] 

Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with 
Iron. [Described under Phosphorus.] 

Mistura Ferri et Ammonii Acetatis, Basham's Mixture, — is properly a 
Liquor, and is prepared from Tr. Ferri Chloridi 2, Ac. Acet. Dil. 3, Liquor 
Ammonii Acet. 20, Elixir Aurantii 10, Syrup 15, Water 50 parts. An elegant 
and agreeable preparation, having some power as a diuretic and a diaphoretic. 
Dose, ^ij-v, well diluted. 

Unofficial Preparations of Iron, 

Ferrum Dialysatum, Dialysed Iron, — composition varies from 
Fe 2 Cl 6 .i2Fe 2 3 to Fe 2 Cl 6 .95Fe 2 3 , and is a 10 per cent, solution of Ferric 
Oxychloride in water. Prepared by treating a solution of Chloride of Iron 
with Ammonia, ferric hydrate being precipitated, this being dissolved by agi- 
tation is placed in a diaiyzer and suspended in water, which is renewed as 
long as it shows a trace of HC1 acid. It is a reddish-browm liquid, free from 
astringent, styptic taste, but is a very feeble chalybeate, incapable of absorp- 
tion except by change into a hydrated sesquioxide in the alimentary canal. Is 
used as a chalybeate, and as an antidote to Arsenic, but is not considered an 
eligible preparation. Dose, ntx-xxx. 

Ferri Arsenias, Ferrous Arseniate, Fe 3 As 2 8 , — a green, tasteless powder, 
insoluble in water, soluble in HC1 acid. Its activity is due to the arsenic 
alone. Dose, gr. ^§~\- 

Syrupus Ferri et Manganesii Iodidi, Syrup of the Iodide of Iron and 
Manganese, — is a pale, straw-colored liquid, containing a little sulphate of 
potassium, and in each fluid ^ has 50 grains of the mixed iodides in the pro- 
portion of Iodide of Iron 3 parts, to 1 of Iodide of Manganese. Dose, tti x- 
xxx-^j. 

Syrupus Ferri et Manganesii Phosphatis, Syrup of the Phosphate of 
Iron and Manganese, — as used by Dr. Simpson of Edinburgh, contains in 
each 3 of syrup 2 grains of the Phosphate of Iron and 1 grain of Phosphate of 
Manganese. Dose, 3J. 



194 FERRUM. 

MiSTURA Ferri Aromatica, — Pale Bark 4, Calumba 2, Cloves 1, Iron 
wire 2, Tr. Cardamomi Co. 12, Tr. Aurantii Cort. 2, Aq. Menth. Pip. 50, — 
Macerate the first 4 in the last one for 3 days, filter, add the tinctures and 
make up to 50. Dose, ^j-ij. 

MiSTURA Ferri Laxans, — Ferri Sulph. gr. ij, Magnesii Sulph. 3J, Ac. 
Sulphurici Dil. nxiij, Spt. Chloroformi r»ixx, Aq. Menth. Pip. ad ^j. 

Mistura Ferro-salina, — Magnesii Sulph. %], Potassii Bitart. £j, Ferri 
Sulph. Exsic. gr. x, Aquae quart j. Dose, a wineglassful. 

Notes on the Preparations. 

Oxides and Carbonates, including Ferrum Reductum, Ferri 
Carbonas Saccharatus, Mistura Ferri Composita, Pil. Ferri Comp., 
Massa Ferri Carb., Ferri Oxidum Hydratum, Ferri Oxidum Hyd. 
cum Magnesia, and Mist. Ferri Aromatica, — possess the haema- 
tinic action of iron with but little astringency, and are therefore 
selected to restore the blood in anaemia, chlorosis and amenor- 
rhcea, with tendency to dyspepsia and constipation. The Hy- 
drated Oxides are only used as antidotes in arsenical poisoning. 
Ferrum Reductum is one of the best forms for internal use, but 
gives rise to sulphuretted or phosphoretted eructations which are 
very disagreeable. The Subcarbonate is little more than the 
Red Oxide, but in the Massa Ferri Carb. the oxidation is pre- 
vented by the sugar. 

Mineral Acid Salts and their preparations comprise the 
Sulphate in its 3 forms, the solutions of the Subsulphate and Ter- 
sulphate, the Phosphate, Pyrophosphate and Hypophosphite, 
the Chloride and its preparations and the Liquor Ferri Nitratis. 
They are characterized by their astringent and corrugating action, 
and are used locally especially as hemostatics, the Solution of the 
Subsulphate being preferred for topical use as it is powerfully 
styptic but not corrosive. The Tincture of the Chloride is one 
of the best preparations for internal use, and is most agreeable 
in the form of Creuse's tasteless preparation, which is made as 
follows, — Liq. Ferri Chloridi gj, Acidi Citrici 544 grains, Sodii 
Carb. 1000 grains or q. s., Aquae Destil. ^j, Alcoholis q. s. Dis- 
solve the citric acid in the distilled water and heat to the boiling 
point, gradually adding sodium carbonate until the acid is sat- 
urated ; mix this with the iron solution and make up to §iv with 
alcohol. Of the Phosphates the best is the Pyrophosphate, which 
is easily assimilated, readily soluble and entirely unirritating. 

Vegetable Acid Salts and their preparations comprise the 
Lactate, Citrate and its preparations, Oxalate, and the prepara- 
tions of the Acetate and the Tartrate. They are the least irritat- 
ing to the stomach but are also the least efficient as chalybeates. 



FERRUM. I95 

They may be administered in white wines, or with alkalies and 
vegetable acids in effervescing mixtures. 

Other Compounds are those in which Iron is combined with 
bodies equally active, as the Syrup of the Bromide, the prepara- 
tions of the Iodide, those with Quinine, Strychnine, etc. Gen- 
erally these preparations are used for a two-fold purpose, namely 
to relieve anaemia and at the same time act upon the specific 
ailment on which the anaemia depends. 

Physiological Action. 

Metallic Iron is not inert, for in the stomach it acquires mo- 
lecular activity through its oxidation, setting hydrogen free. It 
is a normal constituent of the blood (1 part to 230 of red cor- 
puscles), existing probably as an oxide in combination with 
haematin, which is not formed without it. It is also found in the 
bile, lymph, chyle, gastric juice, in the pigment of the eye, in 
the milk and the urine. Given medicinally in small doses it 
promotes appetite and digestion, and improves the quality of the 
blood, increasing the number of the red corpuscles. In the 
stomach all the salts of iron are converted into the Chloride and 
in the duodenum into an alkaline albuminate, entering the blood 
along the whole length of the alimentary canal. Large doses, 
or small ones long-continued are directly unfavorable to digestion, 
nausea and vomiting are produced by the soluble preparations, 
the per-salts are actively irritant, the Icdide, Chloride, Nitrate 
and Sulphate being active poisons, highly astringent, and act in- 
juriously on the teeth. Only a small portion of iron is absorbed, 
the rest being eliminated by the intestinal canal, blackening the 
faeces by conversion into a sulphide. Of the portion absorbed 
from the alimentary canal, only a small part reaches the systemic 
circulation and is eliminated by the kidneys, the greater part 
being excreted by the liver with the bile. 

Locally most of the iron salts are more or less constringing to 
the tissues and the mucous membranes, acting as hemostatics and 
astringents by virtue of their power to coagulate albumen, and 
acting injuriously on the teeth. The Tincture of the Chloride is 
considered diuretic. 

Incompatibles. 

Alkalies and their carbonates, acids, acidulous salts and vegetable astrin- 
gents are incompatible with most preparations of iron, the latter group being 
so by virtue of their tannic and gallic acids which form a deep blue-black 
precipitate (tannate of iron) with the per-salts. 



I96 FERRUM. 

Therapeutics. 

The chief indication for the internal administration of Iron is 
anaemia; when plethora exists it is contraindicated. It should 
always be given after meals, and occasionally suspended for a 
time, to avoid deranging the stomach. When appetite and diges- 
tion are promoted by Iron it will do the greatest amount of good, 
many authorities holding that the principal benefit derived from 
its use, even in anaemia, is due to its stimulating digestion and 
the primary assimilation. The Sulphate is here probably the most 
efficient salt and is well used in combination with aloes when 
there exists any intestinal torpor. In pseudo-leucocythaemia, 
chorea of anaemic girls at the age of puberty, epilepsy and neu- 
ralgia of the anaemic, amenorrhcea and other menstrual disorders 
of the same class of subjects, and in acute rheumatism of pale, 
cachectic persons, the chalybeates are generally very efficient 
remedies, especially the Tincture of the Chloride. The same 
preparation is extensively employed in erysipelas and diphtheria 
with good results. In albuminuria with chronic disease of the 
kidneys the Tinctures of the Chloride and of the Acetate are 
useful as chalybeate diuretics. In many cardiac diseases of the 
anaemic, fatty heart, weak heart, dilatation, mitral disease, etc., 
ferruginous preparations are often of signal advantage. In the 
syphilitic cachexia, chancroid, and sloughing phagedena, the 
Iodide gives good results, particularly when the subject is one of 
debilitated constitution. In the nocturnal incontinence of chil- 
dren the Syrup of the Iodide is one of the most efficient remedies. 
In all chronic affections of the respiratory organs, when hemor- 
rhage is not existing or threatened, the Phosphate of Iron, 
Quinine and Strychnine is used with much benefit. In passive 
hemorrhages, especially when due to anaemia, the Tincture of the 
Chloride is very effective, and in all active bleeding the Solution 
of the Subsulphate locally used is a prompt and efficient hemo- 
static. A weak solution of this preparation (3j ad ^viij) used 
in the form of spray is the most serviceable astringent in obsti- 
nate epistaxis, and in hematemesis the same solution may be 
swallowed in small quantities at short intervals. In chronic 
diarrhoea and dysentery the Solution of the Nitrate is an efficient 
astringent, and a weak solution of the Chloride is used as a rectal 
injection against thread-worms. 

In arsenical poisoning the most effective antidote is the 
Hydrated Oxide, which forms with Arsenious Acid an almost 
insoluble compound. The solutions used in its preparation 
should be kept on hand and only mixed when wanted for use. 



FICUS FGENICULUM — FRANGULA. 1 97 

FICUS, Fig, — is the fleshy receptacle of Ficus Carica, bear- 
ing fruit upon its inner surface. The fig-tree is a member of the 
nat. ord. Urticaceae and a native of the shores of the Levant, but 
is cultivated in Southern Europe and in other warm countries. 
Figs contain about 62 per cent, of grape sugar, also gum, fat, 
etc., and are a constituent of the official Confectio Sennse. 

Physiological Action and Therapeutics . 

Figs are demulcent, laxative and nutritious. They are used in 
their fresh state as an aliment, but if eaten in quantity may pro- 
duce flatulence, enteralgia and diarrhoea. They are chiefly used 
as an article of diet in habitual constipation, but may be employed 
as an ingredient of demulcent decoctions, and locally as a poul- 
tice to gum-boils. 



FCENICULUM, Fennel, — is the fruit of Fceniculum vul- 
gare, a European cultivated plant of the nat. ord. Umbelliferae. 
It is yi to y$ of an inch long, oblong, slightly curved, separable 
into 2 mericarps, and having 5 ribs, and several oil-tubes, odor 
and taste aromatic. It contains a volatile oil, united with a ter- 
pene, and is a constituent of Pulvis Glycyrrhizae Compositus. 

Preparations. 

Oleum Fceniculi, — the volatile oil, a light-yellow colored liquid, having 
the odor of fennel, a warm taste and neutral reaction, soluble in alcohol. It 
is an ingredient of Spiritus Juniperi Compositus. Dose, tti ij-v. 

Aqua Fceniculi, — contains 2 parts of the oil in 1000 of distilled water 
percolated through cotton. Dose, 3ss-gj. 

Physiological Action and Therapeutics. 

Fennel is an aromatic stomachic and a mild stimulant. It is 
chiefly used as an agreeable carminative in flatulence and colic, 
and as a corrigent to Senna, Rhubarb, and other disagreeable 
medicines. An infusion is often used as an enema to expel flatus 
in infants. 



FRANGULA, Buckthorn, — the bark, collected at least 
one year before being used, of Rhamnus Frangula, or Alder 
Buckthorn, a European shrub of the nat. ord. Rhamnaceae. 
Occurs in quilled pieces -^ inch thick, outer surface of gray- 
brown color, with numerous small warts. It contains several 
principles, of which the only important one is Frangulin, or 



I98 FUCHSIN FUCUS VESICULOSUS. 

Rhamnoxanthin, a lemon-yellow, odorless and tasteless glucoside, 
insoluble in water and but sparingly so in alcohol or ether, and 
thought to be identical with Cathartin, the active principle of 
Senna. Another species of the genus Rhamnus is described 
under the title Cascara Sagrada, see ante, p. 128. 

Preparation. 
Extr actum Frangul^e Fluidum, — Dose, gss-ij. 

Physiological Action and Therapeutics. 

Frangula-bark when fresh is a violent irritant to the gastro- 
intestinal tract, producing vomiting, purging, and much pain. 
The old dried bark is a safe purgative without irritant qualities, 
and is much used in the constipation of pregnancy, and other 
conditions requiring purgation. The fluid extract is the best 
form for administration. 



FUCHSIN, Roseine, Magenta, Anilin Red (Unoffi- 
cial), — is the Hydrochlorate of Rosanilin, C 20 H 10 N 3 .HC1, occur- 
ring in brilliant, elongated crystals having a green lustre, readily 
soluble in water and therein making a bright red solution. 
Given internally it has produced salivation, vomiting, and diar- 
rhoea ; and when injected intravenously it has caused trembling, 
staggering, albuminuria and fatty degeneration of the kidneys, 
symptoms which are thought to be possibly due to the presence 
of Arsenic or Anilin as impurities. It imparts a magenta color 
to the urine, and is excreted by the kidneys, liver and salivary 
glands. It has been found to be very efficient in reducing albu- 
minuria, in many instances having entirely arrested it. It is best 
administered in pill with a vegetable extract as Licorice or Gen- 
tian, and in doses of gr. J^-iv, according to age. 



FUCUS VESICULOSUS, Bladder-wrack, Sea- 
wrack (Unofficial), — is a perennial plant of the nat. ord. Algae, 
growing on the shores of the Atlantic and Pacific Oceans as a 
sea- weed. It has a flat leaf, with a midrib throughout its length, 
and small spherical vesicles, filled with air, in the leaf. It con- 
tains mucilage and much Soda in saline combination, also Iodine, 
but less of the latter than other algae growing in deeper water. 
A decoction of the fresh plant is the best form for administration. 

Fucus Vesiculosus is one of a number of marine plants which 



GALB ANUM — GALLA. 1 99 

are used in various parts of the world as food for man and cattle 
and as manure. The species under consideration is considered 
alterative and tonic, and has, been employed in goitre, glandular 
and joint enlargements and psoriasis, but especially to produce 
absorption of adipose tissue in the obese. An extract is sold 
under the title " Anti-fat.' ' 



GALBANUM, — is a gum-resin obtained from Ferula galba- 
niflua, an Asiatic plant of the nat. ord. Umbelli ferae, and proba- 
bly from other allied plants. It occurs in minute tears, aggluti- 
nated into a hard mass, of balsamic odor and acrid, bitter taste. 
It contains a Volatile (9// isomeric with Turpentine, a Gum, and 
a mixture of Resins which yield by dry distillation a blue oil and 
Umbelliferon, a tasteless substance in satiny crystals. Dose, gr. 
x-xx, in pill or emulsion. 

Preparations. 

Pilule Galbani Composite, — each pill contains of Galbanum \ x / 2 grain, 
Myrrh 1^ grain, Asafetida y^ grain, and Syrup. Dose, ij-iij. 

Emplastrum Galbani, — Galbanum 16, Turpentine 2, Burgundy Pitch 6, 
and Lead-plaster 76 parts. 

Galbanum is also an ingredient of Emplastrum Asafoetidae. 

Physiological Action and Therapeutics. 

Galbanum is stimulant, expectorant and antispasmodic, acting 
much like Ammonia and Asafetida, and usually given with either 
of these substances. It is used in chronic bronchitis and catarrh 
of mucous membranes generally, in amenorrhoea and chronic 
rheumatism. The plaster is used as a stimulant application to 
indolent swellings. 



GALLA, Nutgall, — is an excrescence on Quercus lusitanica, 
the Dyer's Oak, a shrub of the nat. ord. Cupuliferae, growing in 
Western Asia, and is caused by the puncture and deposited ova 
of the insect Cynips Galloz tinctorice. Galls are hard, globular 
bodies, from y 2 to ^ inch in diameter, of blackish-gray color, 
tuberculated on the surface, having a central cavity, and an in- 
tensely astringent taste. They contain from 15 to 75 per cent, 
of Tannic Acid, about 5 per cent, of Gallic Acid, and other un- 
important constituents. Dose, gr. v-xv. 

Preparations. 

Tinctura Gall^e, — strength 20 per cent. Dose, ^ss-iij. 
Unguentum Gall^e, — strength 10 per cent. 



200 GAULTHERIA GELSEMIUM. 

Physiological Action and Therapeutics. 

The action of Nut-galls is powerfully astringent, due to the 
Tannic and Gallic Acids contained "in them. Having no special 
action or use of their own, their qualities may be learned by con- 
sulting the articles Acidum Tannicum and Acidum Gallicum, 
ante, pages 37 and 25. 



GAULTHERIA, Wintergreen,— is the leaf of Gaulthe- 
ria procumbensy an American evergreen plant of the nat. ord. 
Ericaceae, having a peculiar flavor, a fragrant odor, and an aro- 
matic and astringent taste. Its active principle is the Volatile 
Oil, which is official. It also contains Tannic Acid, Arbutin, Ur- 
son, Ericolin, etc. 

Preparations. 

Oleum Gaultheria, Oil of Wintergreen, — is the volatile oil, a liquid of 
peculiar and aromatic odor, sweetish, warm taste, and a slightly acid reaction. 
It is readily soluble in alcohol, and consists of Methyl Salicylate 90 per cent., 
and Ganltherilene, a hydrocarbon, 10 per cent. Dose, lUiij-x. 

Spiritus Gaultheri^:, — has of the oil 3 per cent., dissolved in 97 of alco- 
hol. Used for flavoring. Dose, 3 ss-ij . 

Physiological Action. 

Gaultheria is stimulant and slightly astringent. Its chief value 
is as one of the sources of the oil named after it, which is also found 
in the sweet birch and many other plants, and, containing so large a 
proportion of Methyl Salicylate or Methylsalicylic Acid, is power- 
fully antiseptic and antipyretic. In large doses it is irritant to the 
stomach, in one case §j having caused death by violent gastritis. 

Therapeutics. 

Oil of Gaultheria is used successfully as a substitute for Sali- 
cylic Acid in many conditions, especially in rheumatic and gouty 
disorders. The plant has been used as an emmenagogue and a 
galactagogue, but its principal employment is in the form of the 
spirit as an agreeable flavoring agent. 



GELSEMIUM, Yellow Jasmine, — is the rhizome and 
rootlets of Gelsemium sempervirens, a climbing plant of the nat. 
ord. Loganiaceae, with showy yellow flowers, which grows in the 
forests of the southern U. S. forming festoons from one tree to 
another. The rhizome is cylindrical, long, about an inch thick, 
of a light yellowish-brown color, an aromatic, heavy odor and a 



GELSEMIUM. 201 

bitter taste. 'It contains a volatile oil, a resin and an alkaloid 
Gelsemine in combination with Gelsemic Acid. Dose, gr. ij-xx. 

Preparations. 

Extractum Gelsemii Fluidum, — alcoholic. Dose, -mjj-xx. 

Tinctura Gelsemii, — strength 15 per cent. Dose, ttiv-xxx. 

Gelsimina, Gelsimine, C n H 19 N0 2 (Unofficial), — an amorphous, colorless, 
inodorous, nearly insoluble solid, of intensely bitter taste, and strong basic 
properties, neutralizing the strongest acids and with them forming soluble 
salts. Dose, gr. ^nfo, 

Physiological Action. 

Gelsemium is a powerful motor-depressant, causing paralysis 
of motility and depression of sensibility by central action on the 
spinal cord. It is also antispasmodic and diaphoretic. In 
moderate doses it produces languor, slowing of the cardiac rate, 
enfeebled muscular action, impaired sensibility, drooped eyelids 
and dilated pupils, with some diaphoresis. In toxic dose, as a 
teaspoonsful of the fluid extract, it produces vertigo, diplopia, 
drooped eyelids and dilated pupils (paralysis of 3d nerve), labored 
respiration, slow and feeble heart, dropped jaw, staggering gait, 
extreme muscular weakness and almost complete anaesthesia, pro- 
fuse diaphoresis, loss of articulation, and death by asphyxia from 
paralysis of the muscles of respiration, consciousness being pre- 
served until C0 2 narcosis sets in. Convulsions occur in animals 
with backward movements, but not in man. Motion is affected 
before sensibility in warm-blooded animals, sensibility before 
motion in frogs. 

Gelsemium is not an arterial depressant, although it lowers the 
heart-rate, and is not irritant to the gastro-intestinal tract, but it 
produces a decided lowering of the body temperature. The 
effects of a moderate dose pass off in about three hours. 

Antagonists and Incompatibles. 

Morphine is the most complete antagonist, so are also Digitalis, Ammonia, 
Alcohol, and to some extent the tincture of Xanthoxylum fraxineum. Emetics, 
heat, faradization of the respiratory muscles and artificial respiration are 
measures of prime importance. The caustic alkalies and tannic acid are 
chemically incompatible. 

Therapeutics. 

Gelsemium is indicated in all conditions of exalted nerve 
function, and contra-indicated whenenever there is a weak heart. 
It is best used in cerebro-spinal meningitis, mania w r ith great 
motor excitement and persistent insomnia, delirium tremens, 
many forms of sleeplessness, pneumonia and pleurisy if the heart 
be strong, coughs of convulsive and spasmodic character, neural- 

17 



202 GENTIANA. 

gia of the fifth nerve, remittent fever, after-pains," ovarian neu- 
ralgia, dysmenorrhoea, irritable bladder of women, and inconti- 
nence of urine from spasm of the vesical muscular fibres. In 
most of these affections the remedy must be pushed to the induc- 
ing of some physiological symptoms, but its action should not be 
carried beyond the production of drooped eyelids, diplopia and 
muscular debility. It has also been used with varying success in 
intercostal neuralgia, myalgia, sciatica, spasmodic asthma, sick 
headache, eczema, pruritus and tetanus. Its especial field how- 
ever is in remittent and typho-malarial fevers and cerebro-spinal 
meningitis. It is not suitable to low fevers and has not sufficient 
power as a cardiac depressant to be of much use in sthenic forms. 



GENTIANA, Gentian, — is the root of Gentiana lutea, 
the Yellow Gentian, one of a numerous family of plants (nat. ord. 
Gentianaceae), which inhabit the mountainous districts of Europe. 
An American species, G. Catesbcei, Blue Gentian, is considered 
nearly equal in value to the official species. Gentian occurs in 
cylindrical pieces or longitudinal slices of the root, which is y^ 
to i inch thick and several inches long, brown externally, 
yellowish-brown within, of faint, peculiar odor, and taste at first 
sweetish, afterwards persistently bitter. It contains an active, 
bitter glucoside, Gentopicrin or Gentianin, C 20 H 30 O 12 , which is 
crystalline and soluble in water, also an inert, amorphous body 
Gentianic or Gentesic Acid, gum, considerable sugar, and a trace 
of a volatile oil, but no tannin. 

Preparations. 

Extractum Gentians, — aqueous. Dose, gr. j-v. 
Extractum Gentians Fluidum, — Dose, .^ss-j. 

Tinctura Gentians Composita, — Gentian 8, Bitter Orange Peel 4, Car- 
damom 2, Diluted Alcohol to 100. Dose, £ss-ij. 

Unofficial Preparations. 

Infusum Gentians Compositum, — contains Gentian 10, Bitter Orange 
Peel 2^, Coriander 2^, Alcohol 40, Water to 320. Dose, ^j-^j. 

Mistura Gentians Alkalina, — Ac. Hydrocyan. Dil. TriHj, Sodii Bicarb, 
gr. xv, Infusum Gentianae Co. to gj. One dose. 

Mistura Gentians et Senn^e, — Infusum Sennae^iijjTr. Cardamomi Co. 
gj, Infusum Gentianae Co. £vj. One dose. 

Physiological Action. 

Gentian is a simple bitter without astringency or aroma, its 
action corresponding to that of Calumba (see ante, page 1 14), but 



GERANIUM GLYCERINUM. 203 

it is more apt to disagree with the stomach. In addition, like 
Cornus, a member of the same class, it has considerable repute as 
an antiperiodic and febrifuge. 

Therapeutics. 

Gentian has been considered a valuable tonic throughout all 
Europe from the earliest historical times. It is highly esteemed 
as a stomachic tonic in dyspepsia connected with a gouty diathesis, 
in hysteria, jaundice, and in convalescence from acute diseases 
and from malarial fever. The compound tincture is an excellent 
vehicle for cod-liver oil, and the now unofficial infusion is a good 
vehicle for the administration of chalybeates, mineral acids and 
neutral salts. The discoloration which iron salts make with gen- 
tian preparations is probably due to Gentesic Acid and not to 
tannin, as it contains none of the latter. 



GERANIUM, Cranesbill-root, — is the rhizome of the 
indigenous perennial Geranium maculatum (nat. ord. Gerania- 
ceae). It is 2 or 3- inches long, horizontal, contorted and tuber- 
culated, with thin, fragile rootlets, inodorous, taste astringent. 
Its active constituents are tannic and gallic acids. 

Preparation. 
Extract™ Geranii Fluidum, — Dose, iilv-^j. 

Physiological Action and Therapeutics, 

Geranium is an efficient astringent, and its action corresponds 
with that of Tannic Acid (see ante, page 38). Having no un- 
pleasant taste it is a useful agent for infants and others having 
delicate stomachs, and is a very popular domestic remedy in 
many parts of the country. It is especially used in diarrhoeas, 
dysentery, cholera infantum, hemorrhages, relaxed conditions of 
mucous membranes, gleet and leucorrhcea. 



GLYCERINUM, Glycerin,— is a liquid obtained by the 
decomposition of fats or fixed oils, containing not less than 95 
per cent, of absolute Glycerin, C 3 H 3 (HO) 3 , which exists in fats 
and fixed oils in combination with the fatty acids. 

Glycerin is clear and colorless, of syrupy consistence, hygroscopic, non- 
drying, odorless, of warm and very sweet taste, neutral reaction, sp. gr. 1.250, 
soluble in water and alcohol, but insoluble in ether, chloroform and fixed oils. 



204 GLYCERINUM. 

It dissolves tannin, gallic acid, carbolic acid, salicylic acid, bromine, iodine, 
etc., and with the aid of heat metallic salts and oxides, alkaloids, etc. With 
strong Nitric Acid it forms Nitro-glycerin, and it reduces potassium perman- 
ganate, chromic acid and chlorinated lime with great violence. An impurity 
frequently present in it is Acrolein, formed by the use of too high a heat in 
its manufacture, and which is very acrid and poisonous. Glycerin is a con- 
stituent of Glyceritum Amyli, Glyceritum Vitelli, Pilulse Phosphori, Mucilago 
Tragacanthse, Massa Hydrargyri, and several extracts and fluid extracts. 
Dose, 3J-ij, diluted. 

Physiological Action, 

Glycerin is highly antiseptic, abstracts water from tissues with 
which it comes in contact, and unless pure is often very irritating 
to the skin. It is freely absorbed by all surfaces, cutaneous and 
mucous, and is decomposed in the system passing out as formic 
and other acids. On the stomach it has no particular action, 
but in large quantities it is laxative and is said to cause the solu- 
tion of the red blood-corpuscles and haemoglobinuria. The urine 
of persons using glycerin contains a body which acts like sugar 
in the copper and fermentation tests, but is not sugar. Glycerin 
is a good emollient and is considered nutritive by many authori- 
ties. 

Therapeutics. 

Glycerin has been used as a substitute for Cod-liver Oil in 
wasting diseases, but with little benefit. It has also been tried 
as a remedy in diabetes, but with unsatisfactory results so far as 
reported, except as a sweetening substitute for sugar in the dietary 
of those afflicted with that disease. It is said to be fatal to intes- 
tinal trichinae, and to be an efficient internal remedy in acne and 
flatulence. As a vehicle it is used for many drugs, and is a good 
ingredient of solutions for hypodermic use, promoting the solu- 
bility of many alkaloids and acting as an antiseptic. It is also 
employed to preserve and aid the action of the digestive fer- 
ments, Pepsin and Pancreatin, as well as to prevent the decompo- 
sition of vaccine lymph. 

Locally it is valuable in many cutaneous affections as an emol- 
lient and softening agent. In acute coryza it gives great relief 
if applied by a brush or as a spray to the nasal mucous membrane. 
It is used on cotton to the cervix uteri as a depleting agent, and 
mixed with an infusion of flaxseed as an enema to relieve tenes- 
mus in acute dysentery. With tincture of Benzoin it is an ex- 
cellent application to chapped hands or lips and fissured nipples. 
In the external auditory canal it is usefully employed to soften 
cerumen, diminish the secretion of pus, deplete the tissues, and 
keep the surface moist. [For other uses of Glycerin in combina- 



GLYCYRRHIZA. 205 

ion see Glyceritum Vitelli, Glyceritum Amyli, and Glyceritum 
Acidi Tannici, under the titles of their respective bases.] 



GLYCYRRHIZA, Liquorice Root,— is the root of Gfy- 
cyrrhiza glabra, a plant of the nat. ord. Leguminosae, native in 
southern Europe and Asia, but largely cultivated in many other 
parts. It occurs in long pieces, | to i inch thick, longitudinally 
wrinkled, of a grayish-brown color externally, tawny-yellow in- 
ternally, pliable and tough, and of a somewhat acrid, sweet taste. 
It contains a yellow, amorphous glucoside, Glycyrrhizin, C 24 H 36 9 , 
also Glycyrrhizic Acid, Asparagin, sugar, resin, gum, etc. Gly- 
cyrrhizin when boiled with dilute acids yields glucose and a 
very bitter substance named Glycyrretin. 

Preparations. 

Extractum Glycyrrhiz^:, — is the commercial extract of the root, occur- 
ring in glossy-black rolls, of sweet, peculiar taste. Not less than 60 per cent, 
of it should be soluble in cold water. 

Extractum Glycyrrhiza Purum, — made with Aqua Ammonia and 
Water, by percolation and evaporation to a pilular consistence. Dose, in- 
definite. 

Extractum Glycyrrhiza Fluidum, — made with Aqua Ammonia and 
diluted Alcohol. Dose, indefinite. 

Mistura Glycyrrhiza Composita, Brown Mixture, — has of the Pure 
Extract 3 parts, Sugar 3, Acacia 3, Tr. Opii Camph. 12, Vinum Antimonii 6, 
Spt. ^Etheris Nitrosi 3, and Water 70. Dose, Jjj-Jfss. 

Pulvis Glycyrrhiza Compositus, — Senna 18, Glycyrrhiza 16, Fennel 8, 
Washed Sulphur 8, Sugar 50 parts. Dose, a teaspoonful. 

Trochisci Glycyrrhiza et Opii, — each has of Extract of Glycyrrhiza gr. 
ij, Extract of Opium gr. ^, Acacia, Sugar and Oil of Anise. Dose,j-ij 
every hour. 

GLYCYRRHIZINUM AmmonIATUM, Ammoniated Glycyrrhizin, — the sweet 
principle of Liquorice rendered soluble and therefore tasteable by Ammonia, 
believed to be the form in which Glycyrrhizin exists in the root. Occurs in 
brownish-red scales, very sweet, and soluble in water or in alcohol. Dose, 
gr. v-xv. 

Physiological Action and Therapeutics. 

Liquorice is demulcent and mildly laxative. It has an agree- 
able taste, and increases the flow of saliva and mucus when slowly 
chewed or sucked, the increased secretions acting as emollients 
to the throat. It is used in many pharmaceutical preparations, 
covering the taste of Senna, Senega, Hyoscyamus, Turpentine, 
Chloride of Ammonium, bitter Sulphates, and to some degree 
the bitterness of Quinine. The powdered extract or root is used 
as an excipient in pills and troches. The Compound Mixture is 
an efficient expectorant, much employed in acute bronchitis and 



206 GOSSYPIUM. 

catarrhal laryngitis, but owing its power over cough mainly to 
the Opium contained in it. The Compound Powder is a gentle 
laxative, of which Senna is the most active ingredient. The 
Troches are used for cough, but must be carefully prescribed to 
children as they contain gr. ^ of Extract of Opium in each. 



GOSSYPIUM, Cotton,— is the hair of the seed of Gossyp- 
ium herbaceu?n, and of other species of Gossypium (nat. ord. 
Malvaceae), freed from adhering impurities and deprived of fatty 
matter. In this form it is known as Purified ox Absorbent Cotton, 
is insoluble in water, alcohol or ether, but is soluble in an ammo- 
niacal solution of Cupric Sulphate. Cotton-fibre is familiar in 
appearance to every one, but when examined microscopically it 
shows as flattened, hollow and twisted bands, spirally striate, 
and slightly thickened at the edges. It is a modification of Cel- 
lulose, C 12 H 10 O 10 , and corresponds therewith in all its ordinary 
chemical properties. 

Preparations of the Cotton Plant. 

Gossypii Radicis Cortex, Cotton Root Bark, — -thin bands or quilled 
pieces, brownish-yellow exteriorly, white interiorly, of slightly acrid and 
astringent taste. Dose, gr. xxx-^j. 

Extractum Gossypii Radicis Fluidum, — made with Glycerin and Alco- 
hol, by maceration and percolation. Dose, TTtxxx-gj. 

Oleum Gossypii Seminis, Cotton-seed Oil, — the fixed oil expressed from 
the seeds and purified. Is yellow, odorless, of bland taste and neutral reac- 
tion, soluble in ether, but slightly soluble in alcohol. Is introduced into the 
pharmacopoeia for the reason that it constitutes most of the " Olive Oil " sold 
in foreign-shaped bottles and under foreign appearing labels. It is directed 
to be used in the official Liniments of Ammonia, Lime, Camphor, and Sub- 
acetate of Lead. 

Pyroxylinum, Pyroxylin, Soluble Gun-cotton, — is official for the purpose 
of making Collodium. It is prepared by macerating Cotton in a mixture of 
Sulphuric and Nitric Acids, washing, draining and drying. 

Collodium, Collodion, — made by dissolving Pyroxylin 4, in Ether 70 and 
Alcohol 26 parts. 

Collodium Flexile, Flexible Collodion, — Collodion 92, Canada Turpen- 
tine 5, Castor Oil 3 parts. 

Collodium StypticUM, Styptic Collodion, — Collodion 55, Ether 20, Alco- 
hol 5, Tannic Acid 20 parts. 

Collodium cum Cantharide, Cantharidal Collodion, — Cantharides 60, 
Flexible Collodion 85, Chloroform q. s. 

Physiological Action. 

Cotton-root is believed to be an efficient emmenagogue and 
oxytocic by southern practitioners, also somewhat of a galacta- 
gogue, but experiments on pregnant animals have not confirmed 



GOSSYPIUM. 207 

this view of its action. The Oil of the seed is very bland and 
may be applied to all the purposes for which Olive Oil is used. 
Cotton itself, when freed from oily matter, is remarkably absorb- 
ent of water, and is a good agent for excluding air from injured 
surfaces. Pyroxylin is highly inflammable, and explosive at 
300 F. Collodion is also inflammable, and rapidly dries on 
exposure to the atmosphere by evaporation of its ether, leaving a 
transparent film of Pyroxylin on the surface to which it has been 
applied ; which film, if the flexible collodion be used, does not 
contract on drying or readily crack, making it an excellent pro- 
tective application. Styptic Collodion is a solution of Tannin, 
and is an excellent hemostatic. Cantharidal Collodion is a 
convenient blistering agent, suitable for cases where the patient 
is inclined to remove a blister if applied in the ordinary way. 

Therapeutics. 

Absorbent Cotton is a valuable agent in surgical practice, 
being employed as an application in burns and scalds, erysipelas, 
articular rheumatism, etc., to exclude the atmosphere, allay pain, 
and when covered with oiled-silk or rubber cloth to keep up local 
perspiration. It may be carbolated, borated or salicylated by 
soaking in the respective solutions, and then used as an antiseptic 
dressing for wounds, ulcers, etc. It is employed by the pharma- 
cist in funnels to filter oils, and for the preparation of the official 
waters. 

Cotton-root Bark is much employed by the negroes of the 
southern states in decoction as a supposed abortifacient, oxytocic 
and emmenagogue. It is used in the south for intensifying 
uterine action in normal labor, in dysmenorrhcea and amenor- 
rhcea. A decoction of §iv in a quart of water boiled to a pint 
is the favorite preparation, administered in vvineglassful doses. 

Collodion is used as a protective covering for superficial burns, 
ulcers and wounds, slight cuts, cracked nipples, anal fissures, and 
erysipelas. For these affections the flexible collodion should be 
used, but where it is desirable to produce pressure on the part 
the ordinary form is best, as it contracts in drying with con- 
siderable force. This property makes it highly useful in drawing 
the edges of wounds together, bringing pressure on buboes, in- 
cipient boils, carbuncles, etc. 

Styptic Collodion has many uses as a hemostatic and pro- 
tective which will suggest themselves, and the Cantharidal form 
is a convenient epispastic for uneven surfaces, the therapeutics 
of which are detailed under Cantharis. (See ante, page 121.) 



208 GRANATUM — GRINDELIA. 

GRANATUM, Pomegranate,— is the bark of the root of 
Picnica Granatum, a small tree of the nat. ord. Granataceae, cul- 
tivated in sub-tropical countries. It occurs in thin quills of 
yellowish-gray color, warty or ridged on the external surface, 
inodorous, of astringent and slightly bitter taste. It contains 
Tannic and Punico-tannic Acids, Mannite and an active liquid 
alkaloid Pelletierine, C 8 H 13 NO, which is soluble in water, alcohol, 
ether, chloroform, etc., and has strong basic properties. There 
are no official preparations. 

Unofficial Preparations. 

Extractum Granati Fluidum, — Dose, gss-jss. 

Decoctum Granati, — .^xvij of bark from the fresh root in ^ xvij of boiling 
water, boiled down to ^xij and strained. Dose, ^iv-vj every hour, preceded 
and followed in a few hours,by a brisk cathartic. The decoction of the Br. 
Phar. is of i to 8 strength and is given in doses of ^ij-iv. 

Pelletierine Tannas, Tannate of Pelletierine, — Dose, gr. ss-j, taken 
fasting and followed in 15 minutes by a sharp purgative. 

Physiological Action and Therapeutics. 

Granatum and its alkaloid are tseniafuge, and very efficiently 
so, rarely failing to bring away the whole worm. The decoction 
is usually employed, but lately Pelletierine has been coming into 
fashion, a proprietary form being sold as " Tanret's Pelletierine M 
in bottles containing one adult dose at three dollars each. The 
decoction, in full doses, causes nausea and vomiting, flatulence, 
purging, and sometimes cramps in the legs, giddiness, dimness 
of vision, general numbness of the limbs and increase of the 
quantity of urine. 

For the expulsion of tape-worm a mixed treatment by Pome- 
granate-root bark, Pumpkin seeds and Oleo-resin of Male-fern is 
preferred by many practitioners. The following formula has 
proved very efficient. R. Granati gij, Aquae Ojss, boiled to 
gvij ; Pepinis §j, deprived of outer coats and beaten to a paste 
with finely-powdered sugar ; Oleoresinae Aspidii, gr. xxx, made 
into emulsion with Acacia and the above decoction of Granatum, 
then added to the paste of Pepo, and flavored with Syrups up to 
§ix, one-third of this to be taken in the morning after a light 
diet and a laxative on the previous day. If not successful the 
second and third portions may be taken at intervals of 3 hours. 
The worm should be passed sitting in a tepid sitz-bath to prevent 
the expelled portion tearing off the head by its weight. 



GRINDELIA, — the leaves and flowering tops of Grindelia 
robusta, an herbaceous California!! plant, of the nat. ord. Com- 



GUAIACUM. 209 

positae, having a branched stem, lower leaves spatulate and taper- 
ing at the base, upper leaves oblong, pointed and have broad 
bases, flowers yellow, odor balsamic, taste pun gently aromatic and 
bitter. It contains a resin, a volatile oil, and an alkaloid with 
basic properties. 

Preparation. 

Extractum Grindeli^e Fluidum, — Dose, IUX-3J. 

Physiological Action. 

Grindelia is antispasmodic and a motor-depressant, inducing 
paralysis in small animals beginning in the hind extremities. It 
slightly slows the heart and respiration, and produces mydriasis 
and hypnotic effects if given in sufficient quantity, with reduced 
cutaneous sensibility and sluggish reflexes. It has a pungent taste, 
creates a sense of warmth in the stomach, and in small doses pro- 
motes appetite and digestion. It is eliminated by the pulmonary 
mucous membrane and the kidneys, and is markedly diuretic. 

Therapeutics. 

Grindelia has been used chiefly in spasmodic asthma, bronchitis 
and whooping-cough, which it greatly relieves. It is a useful 
remedy in spasmodic coughs, dyspnoea of various pulmonary and 
cardiac affections, hay-fever, and chronic cystitis. Locally it is 
highly efficient as a sedative lotion (1 part of the fluid extract to 
10 of water) in poisoning by Rhus toxicodendron, and in skin 
diseases attended with itching and burning sensations. 



GUAIACUM, Lignum Vitse, — is official in two forms, 
Guaiaci Lignum, the heart-wood, and Guaiaci Resina, Guaiac, 
the resin of the wood of Guaiacum officinale, a large West Indian 
tree of the nat. ord. Zygophyllaceae. The Resin is the important 
constituent, and itself consists of three resins, namely, — Guaia- 
conic Acid, C 19 H 20 O 5 , 70 per cent., Guaiac Acid, C 6 H 8 3 , resem- 
bling Benzoic Acid, and Guaiarec Acid, C 20 H 26 O 4 ; also an indif- 
ferent resin. The wood also contains a yellow coloring matter, 
gum, etc. 

Guaiaci Lignum, Guaiacum Wood, — generally used in the 
form of raspings of greenish-brown color containing whitish 
particles, of resinous odor, taste slightly acrid. Is a constituent 
of Decoctum Sarsaparillae Compositum. 

Guaiaci Resina, Guaiac, — occurs in large masses of a greenish- 
brown or reddish-brown color, feebly aromatic, taste somewhat 

18 



2IO GUARANA. 

acrid, fracture having a glassy lustre, insoluble in water, soluble 
in alcohol, ether, chloroform and alkaline fluids. Dose, gr. 
v-xxx, in wafer. 

Preparations. 

Tinctura Guaiaci, — Guaiac 20 per cent. Dose, nrv-^j, in mucilage or 
syrup, as the resin is precipitated by water. 

Tinctura Guaiaci Ammoniata, — Guaiac 20, Aromatic Spirit of Ammo- 
nia 80 parts. Dose, triv-gss. 

Physiological Action. 

Guaiac is diaphoretic, expectorant and alterative. Its taste is 
acrid and very disagreeable. Internally it is a local stimulant, 
producing salivation, an acrid sensation in the throat, warmth 
in the epigastrium, increase of the gastric and intestinal secre- 
tions and the flow of bile, and reflex stimulation of the heart. 
Its continued use causes gastric catarrh, and in large doses it is a 
gastro-intestinal irritant, causing vomiting, purging and severe 
congestive headache. Though a colloidal body it enters the 
blood, stimulates the liver and other excretory glands and the 
production of bronchial mucus, and causes increased circulation 
and diaphoresis. Sometimes it fails to act on the skin and then 
is markedly diuretic. 

Incompatibles. 

Mineral Acids and Spirit of Nitrous Ether are chemically incompatible 
with Guaiac preparations. 

Therapeutics. 

Guaiacum was first used as an antisyphilitic, being used in de- 
coction and in large quantity, with a spare diet and external 
warmth. It acquired a great reputation in this disease during 
the 1 6th century, but it is now abandoned for this purpose except 
as an ingredient of the Compound Decoction of Sarsaparilla. It 
is a very efficient remedy in tonsillitis, given in 3ss doses of the 
tincture in emulsion with mucilage or yolk of tgg, to abate the 
inflammation and abort the disease. It has considerable reputa- 
tion in neuralgic dysmenorrhea, amenorrhcea, chronic rheuma- 
tism, gout, lumbago and sciatica. The ammoniated tincture in 
water makes a cleanly and not very disagreeable gargle. 



GUARANA, — is a dried paste prepared from the crushed 
or ground seeds of Paullinia sorbilis, a climbing plant of the 
nat. ord. Sapindaceae, growing in Brazil. It occurs in brown 
cakes or sticks, having an odor of chocolate and a bitter, astrin- 
gent taste, partly soluble in water and in alcohol. It contains 25 



GURJUN BALSAM — GUTTA-PERCHA. 211 

per cent., of tannic acid, gum, albumen, starch, and a greenish 
fixed oil, also an alkaloid Guaranine (5 per cent.), which is 
identical with Caffeine. The specimens of Guarana in the market 
are very untrustworthy, unequal in quality and expensive, it being 
a secret mixture prepared in Brazil. Hence it has been omitted 
from the list of Squibb' s preparations, and a fluid extract of green 
coffee substituted in its place. 

Preparation. 
EXTRACTUM GUARAN^E FLUIDUM, — Dose, TllX-^ij. 

Physiological Action and Therapeutics. 

Guarana has similar actions to those of Coffee, the active prin- 
ciples of both plants being identical, both chemically and physio- 
logically. It is chiefly employed in the treatment of nervous 
sick-headache (migraine) administered in half-drachm doses of 
the fluid extract when the attack is developing. It has been used 
in the diarrhoea of phthisis, convalescence from acute diseases, 
and generally in conditions requiring tonic treatment. 



GURJUN BALSAM, Wood Oil, Balsamum Diptero- 
carpi (Unofficial;, — is an oleoresin obtained from incisions in 
various trees of the genus Dipterocarpus, growing in India. It 
is thick, opaque and grayish-brown by reflected light, soluble in 
chloroform and partly so in alcohol, ether and volatile oils, odor 
balsamic, taste bitter. It contains from 40 to 70 per cent, of a 
Volatile Oil, a Resin and Gurjunic Acid. Dose, ""ix-jij, in 
emulsion, or in capsules. 

Physiological Action and Therapeutics. 

The properties of this balsam are similar to those of Copaiba, 
but it is less disagreeable and less apt to upset the stomach, also 
less actively diuretic. It has been used with good success in 
leprosy, given internally in full doses and used locally at the same 
time. Mixed with 4 parts of Lime-water it is well applied in 
chronic eczema, lupus and psoriasis. 



GUTTA-PERCHA, — is the concrete exudation of Isonan- 
dra Gutta, a large tree of the nat. ord. Sapotaceae, growing in the 
Malay peninsula and adjoining islands. Occurs in tough but 
somewhat flexible pieces, of grayish or yellowish color, plastic 



2 1 2 H^EMATOXYLON. 

above 140 F., soft at 212 F., insoluble in water or alcohol, 
soluble in chloroform, oil of turpentine, carbon bisulphide, benzin 
and benzol. It contains a hydrocarbon Gutta, C 10 H l6 (80 per 
cent.)? two Resins named Fluavil and Albau y also a volatile oil, 
salts, fat and coloring matter. 

Preparations. 

Liquor Gutta-Percha,— a solution of Gutta-Percha 9, Carbonate of 
Lead 10, in Chloroformum Venale 91 parts. Used as a protective application 
to eruptions and slight wounds, the evaporation of the menstruum leaving 
behind a thin adhesive and non-irritating pellicle. 

Traumaticine (Unofficial), — is the name given to a 10 per cent, solution 
of Gutta-percha in Chloroform, which forms on drying a permanent, unirri- 
tating, adhesive, flexible and non-contractile skin for the treatment of skin 
affections and slight wounds. It forms an excellent basis for the application 
of Chrysarobin to psoriasis. 

Uses. 

Gutta-Percha has neither physiological action nor therapeutics, 
being used for its physical qualities alone. In surgical practice 
it has several applications, making a good material for splints, as 
it can be softened in hot water and adapted to any surface while 
pliable. From it are manufactured pessaries, specula, stetho- 
scopes and other instruments. The solution may be used as a 
protective covering for excoriations and slight wounds, to prevent 
pitting in small-pox, and to paint over the line of suture after 
post-mortem examinations. 



HiEMATOXYLON, Log-wood,— is the heart-wood of 
Hozjtiatoxylon campechia?ium^ tree of the nat. ord. Leguminosae, 
native of tropical America, but naturalized in the West Indies. 
It occurs in chips or powder of a dark brown-red color, often 
with a greenish lustre, of feeble and agreeable odor, taste sweet 
and astringent, and colors the saliva a dark pink when chewed. 
It contains tannic acid, and a sweet, crystalline coloring principle 
named Hematoxylin, C 10 H u O 6 , which is colorless when pure, but 
turns red on exposure to light. 

Preparations. 

Extractum H^matoxyli, — Dose, gr. v-xx. 

Decoctum H^ematoxyli (Unofficial), — strength 1 in 17. Dose, ^j-ij. 

Physiological Action and Therapeutics. 

Logwood is mildly astringent, its properties depending on the 
tannin contained in it. As it is devoid of irritating qualities it 



HAMAMELIS. 213 

is well adapted to the diarrhoeas and hemorrhages of young chil- 
dren. It does not produce constipation nor disorder the bowels, 
but colors the urine and stools blood-red, and has caused phle- 
bitis. It has been used as an hemostatic in bleeding of the lungs, 

aa.al heraarrlaa^es frirr.rhe a:e:ai aaa iaaresrines. and 15 a a. a.5:::::- 
gent in leucorrhoea. 



HAMAMELIS. Witch-hazel.—::- leaves, collezred ::: 

c~ ...'.'.'.'..".. , . . SZ ..7 ' / ".' .7 '''.' ;'. 7 ." 7 7 ^',"7 '. 7 .'..? , „ ?7-T .7 - _ - 1 7771 e 1- .:. . ■ . 7' ... . 77V ... 1771 3.- 

e. griwing- ::\ the United Stares, having yell :-.v nrwers ana 

cval-shaned leaves a: :a: a inches 1:7 r whi:h are in:d:r:ns. :*at 

c i a 1 7 1 7 e r a n a a ; t r i a a e a t 5 1 e 1 n e v at n t am a 7 7 a t 7 a e r Iran 

_ 

of tannic acid, a bitter principle and probably some volatile mat- 
ters, but the chemistry of the plant has not been fully studied. 

Preparations. 

Extractcm Hamamelidis Tujtditm, — Dose, tiu _ 3J» ^ the only official 
preparation, and is prepared from the leaves. 

Hamameun I Unofficial), — is an uncertain extract of very indefinite com- 
position. Dose, gr. j-ij. 

Distilled Extracts, so-called, bnt really Waters distilled from the bark, 
are sold by various manufacturers, and are said by the vendors to contain the 
v :* ?.r.'_ e zr.7.:.z t- : : :':.■= 7I.1-:. r >.~a'£ Zan.Ai: :« « u 7 7 1 z7zZ2.r:.:i:~. : :.\i 
t:< :e :z::. : t :y ii«ril".izc :r.t ':;.:>. \~ : .-'z :■. ~±rj :...:.\t il;:l;l. -i: is 1 -7:7-7:.;- 
tary medicine of uncertain composition. 

Physiological Action and Therapeutics. 

No trustworthy experimentation has yet been made with this 
drug. It is tonic, astringent, styptic and sedative, owing most 
of its properties to its tannin, but appears to possess some special 
influence over the venous circulation similar to that of Aconite 
on the arterial system. In full doses it may produce severe throb- 
bing pain in the head. It is used both internally and locally with 
great benefit in hemorrhoids, particularly those of the bleeding 
variety, varicose veins and ulcers, varicocele, venous congestions 
and threatening local inflammations. It is highly recommended 
in hemorrhages from the nose, stomach, lungs, rectum and kid- 
neys, threatened abortion, and externally for sprains and bruises, 
foul ulcers, the pruritus of eczema, leucorrhoea and gonorrhoea. 
An Ointment of Witch-hazel is found in the shops, and supposi- 
tories maybe prepared extemporaneously by evaporating the fluid 
extract and incorporating the residue with cocoa-butter. 



2 1 4 HEDEOMA — HELLEBORUS. 

HEDEOMA, Pennyroyal,— the leaves and tops of He- 
deoma pulegioides, a plant of the nat. ord. Labiatse, common to all 
parts of the U. S., having a four-sided, hairy stem, pale blue 
flowers, leaves y 2 inch long, glandular on the under surface, odor 
strong and mint-like, taste pungent. Its only important con- 
stituent is the Volatile Oil, which is official. 

Preparations. 

Oleum Hedeom^e, Oil of Pennyroyal, — is the volatile oil, readily soluble 
in alcohol. Dose, tti ij-x. 

Spiritus Hedeom^e (Unofficial), — contains I part of the oil in 9 of alcohol. 
Used externally or as spray. 

Physiological Action and Therapeutics. 

Hedeoma is a stimulant aromatic, also somewhat carminative 
and emmenagogue. Its odor is extremely repulsive to insects, 
especially fleas and mosquitoes. In warm infusion it is a popular 
remedy for amenorrhcea and flatulent colic. It may be used as 
a corrective with other medicines, and the spirit is well employed 
on the hands and face to keep away mosquitoes. The writer has 
known death by narcosis to result from an overdose of the oil 
taken to produce an abortion. 



HELLEBORUS, Hellebore (Unofficial),— the rhizome 
and rootlets of Helleborus niger (Black Hellebore) and Helleborus 
viridis (Green Hellebore), plants of the nat. ord. Ranunculaceae, 
natives of Europe. A third variety, Helleborus occidentalism 
growing in Greece, is probably the true Hellebore of the ancients. 
The rhizome is 1 to 3 inches long, knotty, with transverse rings, 
of rancid odor when freshly bruised, and bitter, acrid taste. Its 
most important constituents are two glucosides, Helleborin and 
Helleborein, both crystalline and very poisonous. 

Preparations. 

Extractum Hellebori Nigri (Unofficial), — Dose, gr. j-x, cautiously. 

Extractum Hellibori Nigri Fluidum (Unofficial), — Dose, niij-xv. 

Helleborin, C 36 H 42 6 (Unofficial), — crystalline, insoluble in water, 
soluble in alcohol and chloroform. 

Helleborein, QgH^Oj- (Unofficial), — crystalline, very soluble in water, 
slightly so in alcohol, insoluble in ether. Dose, gr. T ^-xV- 

Physiological Action. 

Black Hellebore is a drastic, hydragogue cathartic, and an 
emmenagogue. In overdoses it is 3 violent gastro-intestinal irri- 
tant, producing vomiting, hypercatharsis, vertigo, cramps and 



HUMULUS. 215 

convulsions, which may result fatally. Locally applied, the fresh 
root is violently irritant to the skin, producing inflammation and 
vesication. 

Helleborin is an active poison, acting on the tongue like 
Aconite, and on the nervous system as a narcotic, producing in 
animals paresis of motion and sensation, cerebral and spinal 
congestion, dilated pupils and death. It is less irritant than 
Hellebore'in to the mucous membranes. 

Hellebore'in is less actively toxic to animals, but is very irri- 
tant, producing conjunctivitis, sneezing, salivation, nausea, vomit- 
ing and purging. It affects the heart like Digitalis, small doses 
frequently repeated slowing its action, but large ones quicken it 
and then suddenly paralyze it through* the pneumogastric nerve. 
Respiration is at first accelerated, then slowed and rendered labo- 
rious. Diuresis is a constant result, the kidneys and uterus are 
congested, gradual paralysis and severe convulsions follow, and 
death occurs by paralysis of the heart. 

Therapeutics. 
Black Hellebore is an old remedy, having been highly 
esteemed by the early physicians in insanity, dropsies, worms, 
cutaneous affections and amenorrhoea. It is at present gone out 
of fashion, but might be usefully employed in dropsies and as a 
revulsant in acute cerebral affections. Recently Hellebore'in has 
come into notice as a substitute for Digitalis in cardiac affections, 
as being of less bulk and more definite composition. Its action 
on the heart is obtained by doses much smaller than those neces- 
sary for its irritant effects on the gastro-intestinal canal. Its solu- 
bility in water and the freedom with which it can be used hypo- 
dermically are important qualities to recommend it. 

HUMULUS, Hops, — the strobiles (fruit-cones) of Ha- 
mulus LupuluSy a cultivated creeping plant of the nat. ord. Urti- 
caceae. They are ovate, 1 to 1^ inch long, and consist of a 
hairy, undulating axis and several membranous, greenish scales, 
odor aromatic, taste bitter, aromatic and slightly astringent. Its 
constituents are wax, resins (50 per cent.), tannin (5 per cent.), 
a liquid volatile alkaloid Lupuline, a Volatile Oil (2 per cent.) 
which consists in part of Valerol and Trimethylamine, and a crys- 
talline, bitter principle Lupulinic Acid (n per cent.). These, 
except tannin, are more abundant in the glandular powder of the 
strobiles, which is named Lupulin. 

A narcotic alkaloid, said to be almost as powerful as Morphine, 
has recently been discovered in the wild American hop, and named 
Hopeine. 



2l6 HYDRANGEA. 

Preparations, 

Tinctura Humuli, — strength 20 per cent. Dose, gj-ij, 

Infusum Humuli (Unofficial), — gss to the pint. Dose, Jj-iv. 

Lupulinum, Lupulin, — is the glandular powder separated from the stro- 
biles, of bright brownish-yellow color, aromatic and bitter taste. The Volatile 
Oil resides in the Lupulin grains, and contains Valerol, which is changed into 
Valerianic Acid by long exposure, giving a disagreeable odor to old hops. 
Dose, gr. v-xv. 

Extractum Lupulini Fluidum, — alcoholic. Dose, £ss-ij. 

Oleoresina Lupulini, — an ethereal extract. Dose, gr. ij-v. 

Tinctura Lupulini (Unofficial), — strength y % . Dose, ^ss-ij. 

Physiological Actions, 

Humulus is a bitter tonic, a feeble hypnotic, and somewhat 
diaphoretic, astringent and anaphrodisiac. It increases the car- 
diac action and the cutaneous circulation. After slight cerebral 
excitement it produces calm and a soporific disposition, espe- 
cially if the solution administered be strongly alcoholic. The 
stomachic and tonic effects are due to the bitter principle, lupu- 
linic acid, and are found in bitter ale. The primary stimulant 
and secondary sedative effects are due to the volatile oil and are 
also possessed by ales and beer. 

Incompatibles. 

Mineral acids and metallic salts are chemically incompatible with prepara- 
tions of Hops. 

Therapeutics. 

Hops are used as a tonic and calmative in delirium tremens, in 
which a combination of the tincture with Tr. Capsici is very effi- 
cient and is an excellent substitute for alcohol. In dyspepsia of 
atonic form Humulus is an excellent stomachic tonic, and in 
nervous irritability the fluid extract of Lupulin may be used as a 
calmative and hypnotic, or the hop-pillow, which certainly exer- 
cises considerable influence, imaginary or otherwise. A poultice 
of hops is a favorite domestic application in inflammations and 
pain. Lupulin has been used with benefit in irritable bladder, 
alcoholism, and as an anaphrodisiac in the treatment of chordee, 
gonorrhoea, spermatorrhoea and other affections of the genito- 
urinary organs. 



HYDRANGEA (Unofficial),— is the root of Hydrangea 
arborescens, a plant of the nat. ord. Saxifragaceae, growing in the 
southeastern U. S. It is a white, tough root, having a thin 
brown bark which peels off in spots, inodorous, taste insipid, 



HYDRARGYRUM. 2 1 7 

afterwards pungent. It contains gum, albumen, starch, resin, 
and a ferrous salt, with other salts. Dose, 3 SS ~3U> best in fluid 
extract. A decoction of the root may be used in doses of Sj-ij. 
Hydrangea has been long used by the Cherokee Indians in 
calculous affections, and reports of cases by competent observers 
show that it is of unquestionable utility in this class of disorders, 
promoting the removal of gravel from the bladder, and relieving 
pain during the passage of renal concretions through the ureters. 
Large doses produce vertigo, oppression of the chest, and con- 
siderable cerebral disturbance. 



HYDRARGYRUM, Mercury, Quicksilver, Hg,— is a 

shining, silver-white metal, fluid and slowly volatile at ordinary 
temperatures, solidifies at — 40 F., boils at 662 F., volatilizes 
without residue, insoluble in ordinary solvents, wholly soluble in 
nitric acid, of sp. gr. 13.5, odorless and tasteless. 

Preparations of Mercury. 

Hydrargyrum cum Creta, Mercury with Chalk, Gray Powder, — has of 
Mercury 38, Sugar of Milk 12, Prepared Chalk 50, Ether and Alcohol, tritu- 
rated together to a uniform gray powder. Dose, gr. ss-x. 

Massa Hydrargyri, Blue Mass, Blue Pill, — contains of Mercury 33 parts, 
Liquorice 5, Althaea 25, Glycerin 3, Honey of Rose 34. Each grain contains 
gr. y^ of Mercury. Dose, gr. ss-xx. 

Unguentum Hydrargyri, Mercurial Ointment, Blue Ointment, — Mercury 
450, Lard 225, Suet 225, Compound Tincture of Benzoin 40, Old Mercurial 
Ointment 100 parts, triturated until globules of Mercury cease to be visible 
under a magnifying power of 10 diameters. 

Emplastrum Hydrargyri, Mercurial Plaster, — Mercury 30, Olive Oil 10, 
Resin 10, Lead Plaster 50 parts. 

Emplastrum Ammoniaci cum Hydrargyro, — see ante, page 59. 

Chlorides and their Preparations. 

Hydrargyri Chloridum Corrosivum, Corrosive Chloride of Mercury, 
Bichloride, Mercuric Chloride, Corrosive Sublimate, HgCl 2 , — heavy colorless 
crystals, of acrid, metallic taste, acid reaction, soluble in 16 of water and 3 of 
alcohol at 59 F., in 2 of boiling water, 1.2 of boiling alcohol and in 4 of 
ether. Dose, gr. ^"tV- 

Hydrargyri Chloridum Mite, Mild Chloride of Mercuiy, Subchloride, 
Mercurous Chloride, Calomel, Hg 2 Cl 2 , — a heavy, white, impalpable powder, 
insoluble in water, alcohol or ether, odorless and tasteless. Is an ingredient 
of Pil. Antimonii Co. and Pil. Catharticae Co. Dose, gr. ^-x. 

Hydrargyrum Ammoniatum, Ammoniated Mercury, White Precipitate, 
Mercur-ammonium Chloride, NH 2 HgCl, — is a white, insoluble powder, odor- 
less and tasteless. Only used externally. 

Unguentum Hydrargyri Ammoniati, White Precipitate Ointment, — Am- 
moniated Mercury 10, Benzoinated Lard 90 parts. 



2 1 8 HYDRARGYRUM. 

Oxides and their Preparations, 

Hydrargyri Oxidum Flavum, Yellow Oxide of Mercury, Precipitated 
Oxide, HgO, — an orange-yellow, heavy, impalpable powder, odorless and 
tasteless, insoluble in water or alcohol, but wholly soluble in nitric or hydro- 
chloric acid. Used to prepare : 

Unguentum Hydrargyri Oxidi Flavi, — strength i to 9 of Ointment. 

Oleatum Hydrargyri, — Yellow Oxide 10, Oleic Acid 90. 

Hydrargyri Oxidum Rubrum, Red Oxide of Mercury, HgO,— a heavy, 
orange-red crystalline powder, having the same properties as the yellow oxide, 
from which it differs only in being crystalline and not in such a minute state 
of subdivision. Dose, gr. -^-xV 

Unguentum Hydrargyri Oxidi Rubri, — strength 1 to 9 of Ointment. 

Iodides and their Preparations, 

Hydrargyri Iodidum Rubrum, Red Iodide of Mercury, Biniodide, Mer- 
curic Iodide, Hgl 2 , — a scarlet-red, crystalline powder, almost insoluble in 
water, soluble in 130 of alcohol, in solution of iodide of potassium or of mer- 
curic chloride. Prepared by double decomposition between Iodide of Potas- 
sium 11 parts and Mercuric Chloride 9 parts. Dose, gr. ^- T V 

Liquor Arsenii et Hydrargyri Iodidi, Solution of Iodide of Arsenic 
and Mercury, Donovan's Solution, — see ante, page 85. 

Hydrargyri Iodidum Viride, Green Iodide of Mercury, Protiodide, 
Mercurous Iodide, Hg 2 I 2 , — a dull green or greenish-yellow powder, insoluble 
in alcohol or ether and almost so in water. Dose, gr. y^— J. 

Acid Combinations and their Preparations. 

Liquor Hydrargyri Nitratis, Solution of Mercuric Nitrate, — a liqui£ 
containing in solution about 50 per cent, of Mercuric Nitrate, Hg(N0 3 ) 2 , with 
some free Nitric Acid. Prepared from the Red Oxide of Mercury 40, by 
Nitric Acid 45, and Distilled Water 15 parts. Used as a caustic. 

Unguentum Hydrargyri Nitratis, Citrine Ointment, — prepared by dis- 
solving Mercury 7, in Nitric Acid 17, and adding Lard Oil 76. 

Hydrargyri Subsulphas Flavus, Yellow Subsulphate of Mercury, Basic 
Mercuric Sulphate, Turpeth Mineral, Hg(HgO) 2 S0 4 , — a heavy, lemon-yellow 
powder, insoluble in water or alcohol, soluble in nitric acid and in 20 parts of 
hydrochloric acid without residue. Dose, as an emetic, gr. ij-v. 

Sulphide and Cyanide. 

Hydrargyri Sulphidum Rubrum, Red Mercuric Sulphide, Cinnabar, 
HgS, : — Red, crystalline masses, or a fine, scarlet powder, insoluble in ordinary 
solvents, but soluble in nitro-hydrochloric acid with separation of sulphur. 
Used only for mercurial fumigation. 

Hydrargyri Cyanidum, Mercuric Cyanide, Hg(CN) 2 , — colorless, pris- 
matic crystals, of bitter, metallic taste, soluble in 12.8 of water and in 15 of 
alcohol at 59 F. Dose, gr. yfo-yV 

Triturations. 

These may be prepared according to the general formula under " Tritura- 
tiones " in the Pharmacopoeia, 10 parts of the substance to 90 of Sugar of 
Milk. Mercury itself or any of its salts may be so treated with excellent 



HYDRARGYRUM. 2 1 9 

results, the particles being much finer and therefore more easily absorbed than 
if rubbed up with any other agent. 

Unofficial Preparations, 

Lotio Hydrargyri Flava, Yellow Wash, — prepared by adding Corrosive 
Sublimate gr. xviij to Lime-water Jjx, producing the yellow oxide, a favorite 
application for syphilitic sores. 

Lotio Hydrargyri Nigra, Black Wash, — prepared by adding Calomel 
gr. xxx, to Lime-water ^x, producing the black oxide, and used as an appli- 
cation to syphilitic sores. 

Unguentum Hydrargyri Nitratis Rubrum, — Red Ointment of Mer- 
curic Nitrate, Brown Citrine Ointment, — differs from the official ointment only 
in being made with Cod-liver Oil, which gives it a brown color, and a more 
agreeable odor. 

Physiological Action. 

Mercury is tonic, purgative, alterative, antiphlogistic and sorbe- 
facient, but not directly cholagogue. Some of its salts are corro- 
sive poisons, others are local caustics, all produce by long-con- 
tinued administration the peculiar cachexia termed Hydrargyrism. 
The metal itself is inert, but by combination with the acids and 
fluids of the body becomes active, and is easily absorbed in any 
form, passing into the blood from the skin, mucous membranes, 
lungs and stomach, in each case probably as an Oxyalbuminate 
of Mercury. Entering the stomach in any form it is first con- 
verted into a double Chloride of Sodium and Mercury, then 
uniting with the albuminous juices to form a complex molecule 
of Mercury, Sodium, Chlorine and Albumen, which being soluble 
in an excess of sodium chloride or albumen, exists in solution, 
and is easily absorbed, being decomposed in the blood and 
changed to the oxyalbuminate. Entering the intestines a purga- 
tive action is soon set up, of more or less severity according to 
the preparation used, a small portion only is absorbed, the rest 
being converted into a Sulphide and excreted with the faeces, 
unless combined with opium which delays its progress through 
the intestines and permits of its greater absorption. In the blood 
its effects are tonic in small doses, but in quantity it indirectly 
produces impoverishment thereof, impairs the ozonizing function, 
diminishes the red corpuscles, and consequently disorders nutri- 
tion and deranges digestion. From the blood it enters the 
tissues, where it remains for an indefinite period, exerting a pe- 
culiar influence, termed "alterative" on all processes character- 
ized by growth of young cells, but not producing any definite 
anatomical changes either in the viscera or the nervous tissue, 
though in the latter a low form of inflammation arises, resulting 
in loss of coordination-power. It stimulates most of the glands 



220 HYDRARGYRUM. 

of the body, especially the salivary glands and the pancreas, to the 
production of pathological secretions, and is excreted with com- 
parative slowness by all the secretory organs, being found in the 
saliva, sweat, milk, urine and bile. It tends to accumulate in the 
liver, while stimulating its cells, and is not cholagogue, though 
stimulating the flow of bile already secreted by reflex action on 
the bile-ducts due to its direct purgation of the duodenum. Its 
excretion is hastened and completed by the use of the iodide of 
potassium. 

In small doses administered for a short time the mercurial 
preparations are blood-tonics, improving its general condition, 
increasing the number of red corpuscles and the body weight. 
They soon begin to promote waste by stimulating the lymphatic 
system, and if the small doses are long continued or the quantity 
is increased, symptoms of mercurial poisoning begin to manifest 
themselves. 

The first symptoms of Hydrargyrism are fetid breath, swollen 
and spongy gums having a bluish line along their margins, stoma- 
titis, sore and loosened teeth, inflamed and tender salivary glands 
pouring out a peculiar, thin saliva of foul odor in large quantity, 
and a metallic taste in the mouth. Anorexia, diarrhoea and fever 
follow, also ulceration and in some cases even gangrene of the 
lips and tongue. If the use of the drug be continued nutrition 
will be greatly impaired through the extreme promotion of ret- 
rograde metamorphosis, and various nervous disturbances will 
follow, the effects being emaciation, pallor, oedema, ulcerated 
skin, erythematous, vesicular or pustular eruptions, headache, 
insomnia, neuralgia, tremor through paresis of the muscles of the 
head and extremities, epilepsy, coma and convulsions. In preg- 
nant women abortion will occur by reason of the impoverishment 
of the blood. Indeed, as Dr. Ringer said in the earlier editions 
of his Handbook of Therapeutics, the phenomena produced by 
mercury are singularly similar to those which will result from 
syphilis, and the serious symptoms known as secondary and ter- 
tiary syphilis can be produced both by syphilis and by mercury. 
The drug is probably a true vital antidote against the syphilitic 
virus, and is capable of bringing about a radical cure of the dis- 
ease, if introduced into the system in considerable quantity and 
its use protracted over a very long time, the action of the drug in 
all cases being kept short of ptyalism or any pronounced physio- 
logical effects. 

Salivation is most readily produced by Blue Mass, next by 
Calomel, and less easily by Gray Powder. Individuals differ 
greatly in their susceptibility to the action of mercury, some per- 



HYDRARGYRUM. 2 2 1 

sons having been affected after a single moderate dose. Children 
are not easily salivated. Inhalation of mercurial vapors is apt to 
affect the nervous system most, its internal administration and 
that by inunction are more likely to produce salivation. 

The observations on the antiphlogistic and sorbefacient actions 
of Mercury are clinical rather than physiological, but it is gen- 
erally agreed that exhibited in inflammation mercurials antagonize 
the increase of the hsemic fibrin which is so constant an effect of 
the inflammatory process, and that in chronic diseases attended 
by the formation of semi-organized deposits, a mild mercurial 
course will almost insensibly remove the new-formed material. 

A not uncommon result of full doses of Blue Pill is an acute 
coryza of very severe character, which the writer has frequently 
observed to follow on neglect of the old-fashioned precaution to 
" work off" the mercurial by a saline cathartic. The symptoms 
produced are those of a severe attack of influenza, epistaxis, con- 
junctivitis and obstinate muco-purulent discharge from the nasal 
passages being especially marked. Similar effects have been 
observed during physiological experiments with mercury on ani- 
mals by Overbeck and Bennett. 

Notes on the Action of the Preparations. 

Metallic Mercury is not used internally except in the finely- 
divided form obtained in Blue Pill and Gray Powder, which are 
capable of producing all the effects above described. Mercurial 
Ointment is the preparation generally used for inunction, a piece 
the size of a small nut being daily rubbed into the soft skin at 
the flexures of joints. The Oleate painted over the surface is a 
more cleanly method of making the same application. Both 
these preparations are efficient parasiticides. 

The Bichloride is the most actively toxic of the mercurial 
salts. It is probably the most active zymoticide and parasiticide, 
a solution of i part in 2000 being efficiently antiseptic for use as 
injections or dressings, and one of 1 to 250 being the usual 
strength for use against epizoa and parasitic skin affections. It 
is a very active gastro-intestinal irritant, in toxic dose producing 
nausea, retching and vomiting, a metallic taste, constriction of 
the fauces, burning pain in the stomach, suppression of urine, 
bloody diarrhoea, collapse and death often preceded by convul- 
sions. It affects specifically the lower bowel [Calomel preferring 
the upper intestine], and produces inflammation and ulceration 
of the rectum. It is, however, one of the most manageable and 
efficient of the mercurials when used in proper doses. 

The Subchloride (Calomel) is very insoluble and unirritating, 



222 HYDRARGYRUM. 

tasteless, laxative in grain-doses, decomposed by the alkaline con- 
tents of the intestines, the Oxide of Mercury being formed, and 
acts especially on the excrementitious glandular appendages of the 
upper intestine, stimulating the liver by indirect reflex action as 
a duodenal purgative. In the presence of alkaline chlorides it is 
converted into the Bichloride, but not in sufficient quantity to 
render it dangerous in the gastro-intestinal canal. Externally 
applied it is very sedative to the mucous membranes and the skin. 

Ammoniated Mercury is an Ammonio-Chloride, and a useful 
stimulant and parasiticide when used locally in the form of oint- 
ment. 

The Iodides are actively poisonous, the Red being much the 
most irritant, in overdoses producing symptoms and results very 
similar to those caused by the Bichloride. The Cyanide is also 
actively poisonous. The Yellow'Subsulphate is a prompt and 
usually harmless emetic, but has occasionally produced fatal re- 
sults by local irritant action. The Oxides are irritant, the Red 
being the most so, and are rarely used internally. The Acid 
Nitrate is a good escharotic, the pain caused by it being tran- 
sient though severe, and its caustic action being comparatively 
superficial. The Ointment of the Nitrate (Citrine Ointment) is 
more irritant than that of the Ammoniated Mercury, and gener- 
ally needs dilution. All these preparations may produce the 
constitutional effects of mercury, and their administration should 
be carefully watched for the first symptoms of mercurialization. 

Antidotes and Inco??ipatibles. 

Albumen in some form, the white of one egg to gr. iv of the bichloride, 
forms the albuminate, which must be at once evacuated by emesis or the 
stomach-pump, as it is soluble in excess of albumen or in the alkaline con- 
tents of the intestines. 

The Chlorides are incompatible with very many agents, and the Bichloride 
should be administered in distilled water or pill by itself, being easily decom- 
posed. The combination of Calomel with Hydrocllpric Acid or Chlorides is 
apt to produce Corrosive Sublimate. In the " mixed treatment " of syphilis, 
a mercurial is combined in solution with Iodide of Potassium, and the Red 
Iodide is the preparation usually selected, as the Bichloride is decomposed by 
the Potassic Iodide, Red Iodide of Mercury being precipitated. All trouble 
regarding incompatibility can be avoided by using sugar of milk triturations 
according to the general official formula. In this form, says Piffard, " a larger 
proportion of the drug is utilized for specific purposes, while but a small 
amount remains to give rise to local irritation." 

Therapeutics. 

Mercury is undoubtedly a specific in syphilis, but is not appli- 
cable to the tertiary form of that disease. It is best administered 



HYDRARGYRUM. 223 

in very small doses carefully watched and stopped just short of 
ptyalism, but renewed and so continued for a long time. Fumiga- 
tion by Calomel volatilized by heat, or inunction by the Oleate or 
by Mercurial Ointment may be used when the stomach will not 
bear any mercurial. The hypodermic method is also used, 
employing a solution of the Bichloride gr. j to 3 j each of glycerin 
and distilled water, of which the dose is mx once daily ; or the 
Albuminate in solution with Sodium Chloride. The Green Iodide 
in doses of gr.j\ to ^ thrice daily with Opium is the best preparation 
for internal use. Accuracy of diagnosis is an absolutely necessary 
preliminary to the administration of Mercury, for where there is 
no syphilitic virus to be antagonized the constitutional effects of 
mercurials will become manifest sooner and may do great harm in 
feeble subjects, besides the risk of mistaking them for the results 
of the disease supposed to be present. 

Tonsillitis, parotitis and other acute glandular inflammations 
of the throat and neck may often be rapidly cured by Calomel 
gr. ^ or Gray Powder gr. ^ every two hours. In irritable 
stomach with obstinate vomiting the same small doses of Calomel 
every half hour are very efficient. The dysentery of adults with 
slimy and bloody stools is best treated by small doses (gr. T £o) of 
the Bichloride, and in the diarrhoea and dysentery (ileo-colitis) 
of infants Gray Powder gr. -£- or Calomel gr. -£$ will be found 
very effective. In gastric ulcer and in the first stage of hepatic 
cirrhosis, the Bichloride in doses of gr. ^ to ^ thrice daily is a 
good remedy. Typhoid fever is treated in Germany by daily 
doses of Calomel, gr. x, for three days as an antipyretic. Diph- 
theria is by many practitioners considered to be best antagonized 
by Calomel in large doses, and in this affection the Cyanide has 
many advocates, given in doses of gr. T ^- ? V every hour, a weak 
solution being at the same time used as a gargle. Asiatic cholera 
is frequenly treated by small, repeated doses of Calomel with 
Opium from the start. Inflammations of sthenic character in the 
stage of exudation, especially when affecting serous membranes, 
are considered by many authorities to be best met by the free 
use of mercurials, but this treatment is fast going out of favor, 
excepting in cases of iritis, which, however, is very often of 
syphilitic causation, and pneumonia, which is frequently treated 
according to the best American authorities with sedative doses 
(gr. xv-xx) of Calomel. 

In the general condition known as " biliousness,' ' manifested 
by whitish or clay-colored stools, constipation, nausea, anorexia, 
coated tongue, slight jaundice, etc., mercurial purgatives have 
long been a routine remedy, but mild saline purgatives are by 



224 HYDRASTIS. 

many authorities considered equally efficient. As an antiseptic 
to the gastro-enteric tract in many forms of stomach and intesti- 
nal disorders (dyspepsia septica), the administration of minute 
doses of the Yellow Oxide of Mercury will be found remarkably 
efficient. It is best used in trituration with sugar of milk, i to 
iooo, and in daily doses of gr. ^"sV By the use of these small 
doses failing digestion and nutrition may almost certainly be 
improved. 

In membranous laryngitis or true croup the Subsulphate as an 
emetic is by many considered to have some specially beneficial 
influence. 

Locally, an ointment of Calomel 3j to §j of Lard is an excellent 
antipruritic, and ointments of the Chlorides and Iodides are 
much used in skin diseases, particularly psoriasis, herpes, acne, 
and pityriasis. In parasitic affections a lotion of the Bichloride, 
gr. ij to g j of distilled water, or a 5 per cent. Oleate with ^th 
part of Ether, are very efficient. The Oleate is a serviceable 
application to syphilitic indurations, but is not deemed advisable 
when ulceration exists. In conjunctivitis Calomel may be used 
as a sedative application, or still better an Ointment of the Yellow 
Oxide, gr. x to §j of Vaseline, triturated to the utmost fineness 
before mixing. Goitre and enlarged spleen are often speedily 
reduced by rubbing into the skin covering them the Ointment of 
the Red Iodide somewhat diluted and applied before a hot fire 
or in the direct sunlight. The Acid Nitrate Solution is one of 
the best caustics for destroying chancroid and syphilitic warts 
and vegetations. Black and Yellow Wash are used as applica- 
tions to syphilitic erosions and ulcerated indurations. 

As an antiseptic injection or application to dressings a solution 
of the Bichloride, gr. vijss in a quart of hot water (^oVo)? is prob- 
ably the most efficient that can be used, and still weaker solutions 
GoW) ar e sufficiently antiseptic for most purposes. 

HYDRASTIS, Golden Seal,— the rhizome and rootlets of 
Hydrastis canadensis, a small plant of the nat. ord. Ranunculaceae 
growing in most parts of the U. S. The rhizome is ij£ inch 
long, rough, bent and branched, externally of a yellowish-gray 
color, internally a bright reddish-yellow, having numerous thin, 
brittle rootlets, a slight odor and a bitter taste. It contains an 
unnamed Resin and 3 alkaloids, Hydrastine, C 22 H 23 N0 6 , white 
and crystalline, soluble in alcohol, ether, etc., Berberine, 
C 20 H 17 NO 4 , yellow crystals soluble in hot water and alcohol, but 
not in ether (see page 100), and Xanthopuccine y also yellow and 
crystalline. All these alkaloids unite with acids to form salts. 



HYDRASTIS. 225 

Preparations. 

Extractum Hydrastis Fluidum, — Dose, rriv-xxx. 

Tinciura Hydrastis, — strength 20 per cent. Dose, gss-ij. 

Hydrastin (Unofficial), — an impure extract precipitated by Hydrochloric 
Acid from the alcoholic solution, chiefly consisting of Muriate of Berberine. 
Dose, gr. ij-v. 

Physiological Action. 

Hydrastis is a simple bitter and a stomachic tonic. It pro- 
motes appetite and digestion and increases the secretions of the 
gastro-intestinal tract and the flow of bile, but if long used it will 
derange digestion and produce constipation. It is possessed of 
antiperiodic powers, and is a protoplasmic poison, arresting the 
movements of the white blood-corpuscles. By many observers 
it is also considered alterative to the mucous membranes, deob- 
struent to the glandular system, cholagogue, diuretic and anti- 
septic. The alkaloid Hydrastixe produces effects on the nervous 
system somewhat similar to those caused by Quinine, but seems to 
be devoid of toxic power, large doses only producing a sense of 
warmth in the epigastric region, and noises of a rushing character 
in the ears. 

Incompatibles. 

Tannic Acid, Hydrochloric Acid and the Alkalies are chemically incom- 
patible with preparations of Hydrastis. 

Therapeutics. 

Hydrastis is chiefly used as a stomachic tonic, an antiperiodic, 
a mild laxative and an antiseptic. Its alkaloid (Hydrastine) and 
extract (Hydrastin) are ranked high in the treatment of inter- 
mittents and chronic malaria, though much less efficient than 
Quinine. It is an excellent remedy locally and internally in all 
forms of catarrh, especially that of the stomach, duodenum, gall- 
ducts, bladder, uterus and vagina. Internally it is efficient in 
many glandular swellings, in chronic constipation due to a slug- 
gish state of the liver or deficiency of the other intestinal secre- 
tions, in chronic dyspepsia, and as a substitute for alcohol in 
dipsomaniacs when a catarrhal state of the stomach has been in- 
duced. In gonorrhoea, gleet, and chronic nasal catarrh it is 
locally employed with much benefit, also in syphilitic affections 
of the mouth, throat and nares. As a local alterative and anti- 
septic application it is highly recommended for unhealthy ulcers 
and sores, cancerous ulcerations, mercurial and aphthous stoma- 
titis, rectal fissure, fistula and prolapse, internal and external 
hemorrhoids, cracks, fissures and abrasions of the nipples, erosion 
and ulceration of the cervix uteri, and in conjunctivitis with 

19 



226 HYDROCOTYLE — HYOSCYAMUS. 

mucopurulent discharge. In gonorrhoea a very efficient injection 
is an infusion of Hydrastis, 5j of the powdered root to |viij of 
boiling water, or the fluid extract diluted in the proportion of 
5ss or 3j to the pint of water, but it should not be used until the 
acute stage has subsided. 



HYDROCOTYLE, Pennywort (Unofficial),— is the leaf 
of Hydrocotyle asiatica, a small plant of the nat. ord. Umbelli- 
ferae, a native of southern Africa and India. It contains a pecu- 
liar, oleaginous substance Vellari?ie, which has a bitter, persistent 
taste, and is thought to be the active principle. It has long been 
used in its native countries as an alterative to purify the blood, 
and has lately been found of great service in eczema, lupus, pso- 
riasis, syphilitic and scrofulous sores, and in leprosy. An ounce 
of the dried plant or leaves is given daily in infusion. It causes 
great itching over the whole body, ovarian pain in females, and 
urinary irritation. In one case in which the drug was being given 
for lupus of the hand a severe orchitis was set up without any 
other apparent cause. It certainly exerts a markedly special in- 
fluence on the genito-urinary tract. 



HYOSCYAMUS, Henbane,— the leaves, collected from 
plants of the second year's growth, of Hyoscyamns niger, a bien- 
nial plant of the order Solanaceae, growing in Europe and the 
northern U. S. The leaves are ovate, often 10 inches long and 
4 broad, of grayish-green color, glandular-hairy, midrib promi- 
nent, odor heavy and narcotic, taste bitter and acrid. It con- 
tains an alkaloid PTyoscyamine, C 17 H 23 N0 3 , which is isomeric with 
Atropine and identical with Daturine and Duboisine, occurring 
as an oily liquid or in tufted crystals of silky lustre and yellow 
color, soluble in hot water, alcohol or ether. Another substance, 
Hyoscine, is by some authorities considered a derivative of Hyos- 
cyamine, by others a second alkaloid. It is semi-liquid, isomeric 
with Atropine, and yields Tropic Acid and Pseudotropine. Hyos- 
cyamus leaves also contain a fatty Oil and much Potassic Nitrate, 
while from their destructive distillation an empyreumatic Oil is 
obtained which is a powerful narcotic. 

Preparations. 

Abstractum Hyoscyami, — Dose, gr. iij-v. 

Extractum Hyoscyami Alcoholicum, — Dose, gr. j, when active. 

Extractum Hyoscyami Fluidum, — Dose, ttlv-xx. 



HYOSCYAMUS. 227 

Tinctura Hyoscyami, — strength 15 per cent. Dose, 3J-iv ; as a hypnotic 
§ss-j is necessary. 

All the preparations of Hyoscyamus are uncertain in strength and in ac- 
tivity, so much so that the effective dose of the extract (no longer official) 
ranged from 2 to 250 grains. 

Hyoscyamine Sulphas, Sulphate of Hyoscyamine (C 17 H 23 N0 3 ) 2 .H 2 S0 4 , 
— occurs in small, yellow scales or crystals, which are deliquescent, of bitter 
taste, and very soluble in water and in alcohol. It varies much in purity of 
the base and consequently in activity. A grain of the commercial article, 
which was formerly very impure, has been given with impunity, but gr. ^ of 
the pure alkaloid has produced violent poisoning. Dose, hypodermically, 
should not exceed gr. -£$; by the mouth gr. *^-j maybe given in urgent cases. 

Hyoscyamine of good quality is difficult to procure and is very expensive, 
while Duboisine is easily obtained in any quantity, so that if these alkaloids 
prove to be physiologically as well as chemically identical as is now claimed, 
the latter will be used to the exclusion of the former. 

Hyoscin^e Hydrobromas, Hydrobromate of Hyoscine (Unofficial), — 
Merck's is the only reliable preparation on the market. Dose, hypoder- 
mically, gr. T ^ ; by the mouth gr. ^WV 

Physiological Action. 

Hyoscyamus has similar action to that of Belladonna, Duboisia 
and Stramonium, except that it is the least powerful and irritant 
of the group, but the most calmative and hypnotic. The delirium 
produced by it is never furious and is without hyperemia, but is 
accompanied by insomnia. It is more stimulant to the vaso- 
motor system and to the cardiac accelerator apparatus than is 
Stramonium, but is less active on the pneumogastric. It has 
decidedly laxative and carminative effects on the intestines and a 
very marked sedative influence on the urinary passages. 

Hyoscyamine corresponds in action to the plant and its con- 
geners, being considered by many authorities as almost identical 
with Atropine, but less powerful. No death has directly resulted 
from it. Except in very large doses it is more an anodyne or 
anaesthetic than a narcotic or soporific. It is a mydriatic, ex- 
cites the cerebral functions and depresses the spinal. Many 
observers deny that it has any soporific influence. 

Hyoscine is a powerful hypnotic, lowers the pulse-rate and 
lessens the frequency of the respirations. It especially affects 
the motor tract of the spinal cord and the cerebral cortex, slightly 
depresses the heart, but paralyzes respiration. It is free from 
irritant qualities and may be used hypodermically. Its habitual 
use brings on muscular paralysis and delirium of violent charac- 
ter. It is coming into use as a hypnotic by alcoholics and ner- 
vous subjects, and will probably ere long be responsible for many 
deaths. As a mydriatic its reputation is doubtful, some observers 
claiming greater power for it in this respect than that of Atro- 



228 ICHTHYOCOLLA. 

pine, while others say that mydriasis may follow its use but is not 
always produced by even large doses. 

Antagonists and Incompatibles. 

These are the same as for Belladonna (see ante page 97). Liquor Potassse 
though incompatible is frequently prescribed in combination with Hyoscyamus. 
All the fixed caustic alkalies decompose its alkaloid as also those of the allied 
plants. 

Therapeutics. 

Hyoscyamus is a valuable narcotic and is chiefly used as a 
hypnotic and anodyne when Opium is contraindicated, and for 
children. It is by far the best agent to use in acute mania with 
high motor excitement, obstinate insomnia and varied hallucina- 
tions. Chronic mania has been more benefited by it than by 
any other drug, and it is very efficient in insanity characterized 
by frequent delusions. In delirium tremens and the delirium of 
fevers it is an excellent hypnotic, and the monomania of hypo- 
chondriacs is alleviated and often cured by it. Whooping-cough, 
nervous coughs, and especially a dry, tickling night-cough, are 
greatly alleviated by full doses of Hyoscyamus. It is also efficient 
in colic of various forms, to palliate the trembling of paralysis 
agitans and mercurial tremor, and to relieve the pains and disor- 
dered coordination of locomotor ataxia. In constipation it is a 
good remedy, the extract being much employed in combination 
with other purgatives to render them more efficient and less 
drastic, but the quantity used is generally too small to be of any 
particular benefit. The tincture is an efficient remedy in irrita- 
bility of the bladder from any cause. 

Hyoscyamine may be used for the same purposes as Atropine, 
but being liable to considerable variation in purity and activity, 
it is not a popular agent with the profession. 

Hyoscine has been used in neuralgia, whooping-cough, in- 
somnia from cerebral excitement, delirium tremens, asthma and 
enteralgia, also in ophthalmic practice as a mydriatic. Doses of 
gr. ^y are given by the stomach, gr. y^ hypodermically. 



ICHTHYOCOLLA, Isinglass,— is the swimming-bladder 
of Acipenser Huso, and of other species of A ripens er (Sturgeon). 
It occurs in horny sheets, semi-transparent, iridescent, soluble in 
24 parts of boiling water, forming on cooling a transparent jelly. 
It is the purest form of Gelatin known. 



IGNATIA. 229 

Preparation. 

Emplastrum Ichthyocoll^, Court Plaster, — consists of Isinglass 10, Gly- 
cerin 1, Alcohol 40, Water and Tincture of Benzoin, spread on taffeta and 
allowed to dry. 

Physiological Action and Therapeutics. 

Isinglass is slightly nutritious, but has no advantage over any 
other form of gelatin. It is used for clarifying liquids, and in 
solution as a test for tannin. The plaster is a common protective 
application. 



IGNATIA, St. Ignatius' Bean, — is the seed of Strychnos 
Ignatii, a small tree of the nat. ord. Loganiaceae, native in the 
Phillipine Islands, and also called Ignatia Amara. The seed is 
about an inch long, ovate, irregularly angular, hard and horny, 
enclosing an irregular cavity containing an oblong embryo, in- 
odorous, taste very bitter. It contains the alkaloids Strychnine 
and Brucine, about 1 per cent, of each, for a description of 
which see the title Nux Vomica. 

Preparations. 

Abstr actum Ignatls, — Dose, gr. ss-j. 

Tinctura IgnatitE, — strength io per cent. Dose, Tnjj-x. 

Physiological Action. 

Ignatia closely resembles Nux Vomica in action, a poisonous 
dose producing the same exaltation of the spinal functions, mus- 
cular writhing, tetanic spasms, and death by asphyxia through 
tetanic fixation of the respiratory muscles, but containing a 
greater quantity of Strychnine than the latter it is more powerful 
in the same dose. It especially exalts the susceptibility of the 
sensory neves, and of the nerves of special sense, for a time, but 
an opposite condition soon succeeds, manifested by numbness 
and torpor with great mental depression. It causes a feeling of 
constriction about the throat and a sensation of intense anguish 
at the pit of the stomach. Its antagonists and incompatibles are 
the same as for Nux Vomica. 

Therapeutics. 

Ignatia is recommended for hysteria, to control the general 
hyperaesthesia, insomnia, clavus hystericus, mental excitement or 
depression, aphonia, diseased appetite, convulsive crying or laugh- 
ing, etc. It will often remove the intercostal neuralgia of hy^- 



23O ILLICIUM — INULA. 

terical subjects and the sensation as of a ball rising to the throat 
(globus hystericus). Cerebro-spinal irritability is diminished by 
small doses though excited by large ones, Ignatia being probably 
the most efficient controller of functional phenomena of the cere- 
bro-spinal axis. In the convulsions of children from intestinal 
irritation without cerebral congestion, and in insomnia from ner- 
vous erethism, small doses of Ignatia are used with the happiest 
results. It is by many practitioners preferred to Nux Vomica as 
a stomachic tonic, and is useful in the treatment of dyspepsia, 
hypochondriasis and various nervous affections. 

ILLICIUM, Star Anise, — is the fruit of Illicium anisatum, 
an Asiatic shrub of the nat. ord. Magnoliacese, and is formed by 
8 boat-shaped carpels arranged in a star-shaped whorl around a 
central axis which is the top of the stalk. Each carpel contains 
a single seed, flat, oval, glossy, and of a brownish-yellow color. 
It contains a Volatile Oil which is chemically and practically iden- 
tical with the Oil of Anise. Another species, Illicium religiosum, 
is very poisonous, causing vomiting, epileptiform convulsions, 
dilated pupils and cyanosed countenance. Its carpels are more 
woody, shrivelled and wrinkled, and end in a curved beak. Illi- 
cium is recognized officially as a source of the Oil of Anise, and 
has similar actions and uses to those of Anisum (see ante, page 68). 



INULA, Elecampane, — is the root of Liu la Helenium, a 
plant of the nat. ord. Compositae, growing in Europe and N. 
America. It occurs in slices or sections, externally grayish-brown, 
internally white, fleshy and full of resin cells, of peculiar, aro- 
matic odor, pungent and bitter taste. It contains a volatile oil, 
a resin, a crystalline substance named Helenin, C 6 H 8 0, and a 
peculiar principle resembling starch, Inulin, C 6 H 10 O 5 , which is 
found in Arnica, Taraxacum and other plants. Having the same 
chemical composition as starch, Inulin differs from the latter 
in being colored yellow by iodine, and depositing from its solu- 
tion in hot water as the solution cools. It is contained in Ele- 
campane in large quantity, from 19 to 44 per cent., the latter in 
autumn. There are no official preparations, but a decoction 
(gss to Oj) may be given in doses of 2j-ij. Dose of the powdered 
root, gr. xx-3j. 

Physiological Action and Therapeutics. 

Inula is a gentle stimulant to the secretory organs, and is said 
to be expectorant, diaphoretic and diuretic. In large doses it 



IODUM. 23I 

causes nausea and vomiting. It was formerly supposed to be 
emmenagogue and was much used in amenorrhcea. It is now 
chiefly employed as a domestic remedy in chronic bronchitis and 
dyspepsia, and to promote the eruption in exanthematous fevers. 



IODUM, Iodine, I, — is a non-metallic element, existing 
in sea-weed, sea-water, some fresh waters and fresh-water plants, 
also in sponge, oysters, eggs, cod-liver oil, rock salt and several 
ores. It occurs in bluish-black rhombic plates, of metallic lustre, 
peculiar odor, acrid taste and neutral reaction, sparingly soluble 
* * in water (1 in 7000), readily so in ether, and in 11 of alcohol 
at 59 F., also in a solution of potassic iodide or sodic chloride. 
It volatilizes slowly at ordinary temperatures, and produces a 
dark-blue color with gelatinized starch in a cold solution. Inter- 
nally it is generally administered in the form of an Iodide or as 
the Compound Solution of Iodine. Dose, gr. ss-j. 

Preparations of Iodine. 

Tinxtura Iodi, — strength 8 per cent. Dose "mj-v, but it is generally used 
as a local application or for injection into cavities. 

Liquor Iodi Compositus, Lugol's Solution, — is a Solution of Iodine 5 
and Iodide of Potassium 10 in Distilled Water 85 parts. Dose, rrij-x, well 
diluted. 

UNGUENTUM Iodi, — has of Iodine 4, Iodide of Potassium I, Water 2, Ben- 
zoinated Lard 93 parts. 

AMYLUM Iodatum, Iodized Starch, — consists of Starch 95, Iodine 5, Dis- 
tilled Water q. s. ad 100 parts, triturated together, dried, and rubbed to a fine 
powder. Intended to enable Iodine to be given without irritating the stomach. 
Dose, 3J-5- 

Iodized Phenol, Carbolate of Iodine (Unofficial), — a mixture of Iodine 
and crystallized Carbolic Acid in varying proportions, generally I of the former 
to 4 of the latter, for local use. 

Iodides and their Preparations. 

AMMONll Iodidum, NH 4 I, — a deliquescent, granular, white salt, soluble in 
I of water and in 9 of alcohol at 59 F. Dose, gr. ij-x. 

Potassii Iodidum, KI, — a colorless, deliquescent, crystalline salt, of saline 
and bitter taste, soluble in 0.8 of water and in 18 of alcohol at 59 F. Dose, 
gr. v-gj. 

Unguentum Potassii Iodidi, — has of the Iodide 12, Hyposulphite of 
Sodium 1, Boiling Water 6, Benzoinated Lard 81 parts. 

Sodii Iodidum, Nal, — deliquescent, minute crystals, soluble in 0.6 of water 
and in 1.8 of alcohol. Dose, gr. v-^ij. 

Iodoformum, Iodoform, Iodide of Formyl, — small lemon-yellow crystals, 
of saffron-like and penetrating odor, unpleasant and iodine-like taste, sp. gr. 
2000, soluble in 80 of alcohol at 59 F., and in chloroform, ether, benzol, 
benzin, carbon bisulphide, fixed and volatile oils, not perceptibly soluble in 
water. Its solutions have a neutral reaction. To remove its odor without 



232 IODUM. 

forming a compound the best agents are Thymol (gtt. ij ad ^j), Oil of Mir- 
bane (gtt. vj ad gr. xv), Oil of Bitter Almonds, or Oil of Rose (gtt. j ad £j). 
Dose, gr. j-v. 

Unguentum Iodoformi, — Iodoform, finely pulverized, 10, Benzoinated 
Lard 90 parts, thoroughly mixed by trituration. 

Other Iodides and preparations thereof are — Argenti Iodidum, Arsenii 
Iodidum, Liquor Arsenii et Hydrargyri Iodidum, Hydrargyri Iodidum Ru- 
brum, Hydrargyri Iodidum Viride, Syrupus Ferri Iodidi, Pilulae Ferri Iodidi, 
Plumbi Iodidum, Sulphuris Iodidum and Zinci Iodidum. As these prepa- 
rations are allied in action and uses less to Iodine than to the other elements 
in their composition, they are described under other titles. (See Argentum, 
Hydrargyrum, etc.) The Iodide of Ethyl or Hydriodic Ether is described 
under yEther (see ante page 43.) 

Preparation of Hydriodic Acid. 

Syrupus Acidi Hydriodici,— contains 1 per cent, of absolute Hydriodic 
Acid, HI. Dose, 3J-iv, well diluted. 

Physiological Actio?i. 

Iodine is irritant to the mucous membranes and to the skin. 
Applied to the latter it stains a deep yellowish-brown color and 
combines with the albumen of the tissue, causing considerable 
pain and subsequent exfoliation of the epidermis. Vesication 
may be quickly produced if the quantity used be large. Inhaled 
its vapor irritates the respiratory mucous membrane, producing 
sneezing, cough, dyspnoea, also pain in the chest and over the 
frontal sinuses. In the gastro-intestinal canal it is equally irri- 
tant, but is gradually converted into the iodide or iodate of sodium, 
in which form or as an albuminate it is absorbed into the blood. 
Iodine decomposes organic molecules, and in the presence of 
phosphoretted or sulphuretted gases it acts like chlorine but 
more feebly, uniting with their hydrogen and thus breaking up 
these noxious compounds it is disinfectant and deodorant. 

The Iodides of Sodium, Potassium, etc., are very diffusible 
and are as rapidly excreted ; setting free nascent oxygen (Ozone) 
and Iodine at the points of their elimination, they are remotely 
irritant to the mucous membranes, setting up violent coryza, with 
soreness of the throat, acute conjunctivitis, profuse mucous dis- 
charges, headache and irritation of the kidneys and the skin. If 
used for any length of time they induce great waste and rapid 
elimination of waste products, causing anaemia, emaciation and 
mental depression. They combine with certain poisons in the sys- 
tem, particularly Lead, Mercury and the products of the syphilitic 
disease, hastening their elimination. Iodism is the term applied 
to the general condition produced by "these agents, and comprises 
the symptoms above noted together with frontal headache, ptya- 



IODUM. 233 

lism, a saline taste in the mouth, dysphagia, temporary impotence, 
and an acneform eruption on the face and limbs. Sometimes the 
eruption is furuncular or even purpuric. Copiously diluting these 
salts with water promotes their excretion and to a great extent 
prevents the development of these results. 

Iodoform contains from 94 to 97 per cent, of Iodine and 
naturally resembles the latter in action. Locally its action is 
anaesthetic and powerfully antiseptic. It is the best agent to pre- 
vent decomposition and to destroy the germs of putrefaction and 
of disease, but must be carefully employed, as when used in 
quantity on an extensive raw surface it has often produced fatal 
results with symptoms of narcotic poisoning. The first sign of 
its dangerous absorption is increase of temperature, which may 
reach 104 or more, then headache, quick and feeble pulse, 
marked anxiety and restlessness, and suddenly collapse and death 
may supervene. The quantities which have produced fatal results 
from local absorption have varied from 525 to 4500 grains. In 
small doses internally it is considered to be a tonic and alterative, 
wasting does not occur, but the body weight increases and the 
general condition improves. In these respects its action markedly 
differs from that of Iodine or the Iodides. 

Ethyl Iodide (see ante, pages 43 and 46) is used by inhala- 
tion to bring the system rapidly under the influence of Iodine. 
It is a good antispasmodic and general stimulant and a very slow 
anaesthetic. 

Antagonists and Incompatibles. 

Restorative agents and vaso-motor tonics, Quinine, Digitalis, etc., are thera- 
peutically antagonistic. Starch is the antidote to free Iodine, but the stomach 
must be evacuated as the Iodide of Starch is not inactive. The mineral acids, 
metallic salts, ammonia and vegetable alkaloids are incompatible with Iodine, 
and if the Potassium salt be prescribed with Potassium Chlorate a poisonous 
compound will result. In chronic poisoning by the iodides a free salivary 
flow by chewing Pyrethrum root will hasten the elimination of the drug. 

Therapeutics of Iodine. 

The tincture or the compound solution are much employed 
locally as counterirritants and by injection into cavities as altera- 
tive applications, instances of which are their use in glandular 
tumors, hypertrophied tonsils, cervical and ovarian cysts, empy- 
ema, hydrocele, etc. In various skin diseases, as chloasma, lentigo, 
lupus, etc., the tincture or a glycerite is well applied, and in 
many splenic and hepatic disorders of chronic type the ointment 
or tincture is a favorite counterirritant application. In sores, 
ulcers, fissures, etc., the Iodide of Starch or a mixture of Iodo- 

20 



234 IODUM. 

form and Tannin, are strongly recommended, and the tincture 
is much used locally to promote absorption of the products of 
acute inflammations. In acute catarrh and hay-fever inhalations 
of iodine-vapor, or that from Iodized Phenol are very serviceable, 
and in the vomiting of pregnancy drop-doses of the tincture 
every hour are often efficient. The compound solution well 
diluted is given thrice daily in typhoid fever with good results in 
many cases, and in malarial fevers the same preparation combined 
with Carbolic Acid has remarkably curative power. In strumous 
conditions Iodine internally is much more efficient than any of 
the Iodides. 

Therapeutics of the Iodides. 

The Iodide of Potassium is the most frequently used, and is 
the form in which Iodine is generally administered internally. 
It is usually administered in simple solution or in the compound 
infusion or syrup of Sarsaparilla. Though its mode of action has 
never been explained satisfactorily, it is known by clinical experi- 
ence to counteract many pathological conditions, to promote the 
absorption of morbid products, and the elimination of several 
metallic poisons. It is almost of specific rank in tertiary syphilis 
and its results, as neuralgiae, paralyses from gummata, ulcerations, 
syphiloma of the internal viscera, lupus, chronic rheumatism and 
sciatica, in all of which when of syphilitic origin this iodide in 
large doses (50 to 150 grains daily) to saturation of the system 
will speedily cause improvement. So in mercurial poisoning and 
other chronic metallic toxaemiae, the best treatment is by rapid 
saturation with Potassic Iodide. The products left behind by 
pneumonia, pleurisy and pericarditis often yield to moderate 
doses (5 grains), which if used for a prolonged period seem to 
retard the changes of chronic nephritis. It is the best remedy 
for the early stage of hepatic cirrhosis, and acts as a most efficient 
expectorant in chronic bronchitis. Aneurisms are often cured 
by large doses (20 to 30 grains) of Potassic Iodide, the sac be- 
coming perfectly solid by fibrinous deposit. In acute catarrh and 
hay-fever, it is useful with Arsenic, the Iodized Phenol being at 
the same time used locally in weak solution. In tonsillitis and 
simple sore throat a weak solution (gr. ij-v ad 3J) is a good gargle, 
and in large doses it is often very efficient in spasmodic asthma 
when induced by bronchial catarrh. 

The Iodide of Ammonium in grain dose repeated frequently is 
an excellent remedy in acute catarrh, hay fever, duodenal catarrh 
and its accompanying jaundice, in chronic and capillary bron- 
chitis, and in catarrhal pneumonia to prevent caseation of the 



IPECACUANHA. 235 

products. In the first stage of hepatic cirrhosis and in chronic 
malarial poisoning it is equally efficient administered in conjunc- 
tion with Arsenic. Being somewhat more irritating than the 
other iodides it is usually given in smaller quantity, but being 
less stable it is more energetic in action. 

The Iodide of Sodium may be used instead of the potassium 
salt, and the same may be said of the Syrup of Hydriodic Acid 
if freshly prepared. 

Hydriodic Acid is used as a substitute for Iodine and the Io- 
dides. As an alterative it is believed by some to possess all the 
powers of Iodine while it is much less offensive to the taste and 
the stomach. It has been used with benefit in asthma and bron- 
chitis. The acid itself is not now official, as it is liable to change 
by the development of free Iodine. 

Therapeutics of Iodoform. 

Iodoform is chiefly employed in local diseases as an antiseptic, 
anaesthetic and alterative agent. It may be dusted in fine powder 
over a wound or sore, or used in ethereal solution to saturate 
gauze or absorbent cotton. It is particularly useful as an applica- 
tion to sloughing and phagedenic ulcers, gunshot wounds, chan- 
croids, fistulse, sinuses and painful affections of the rectum or 
uterus. Internally it may be used as a general tonic and altera- 
tive in syphilis and other cachexias, also for neuralgia, and is fre- 
quently prescribed with Iron. Triturated with Tannin it forms a 
useful application to the cervix uteri in erosions and ulcerations 
thereof, or an Iodo-tannin may be prepared by saturating the 
Tincture of Iodine with Tannic Acid, and applied on a cotton 
tent to the uterine mucous membrane in many chronic affections 
of that organ. 



IPECACUANHA, Ipecac,— is the root of Cephaelis Ipe- 
cacuanha, a small shrubby plant of the nat. ord. Rubiaceae, grow- 
ing in Brazil. The root is of the thickness of a small quill and 
about 4 inches long, of dull gray-brown color, contorted and 
finely wrinkled, internally white, tough and ligneous \ odor slight 
but nauseous, taste acrid, bitter and nauseating. It contains 
starch, gum, a trace of volatile oil, a crystalline alkaloid, Emetine ', 
C 20 H 30 NO 5 , and a glucoside named Ipecacuanhic Acid. Dose of 
the powdered root, as an expectorant gr. ss-ij, as an emetic gr. 
xv-xxx. 



236 IPECACUANHA. 

Preparations, 

Extract um Ipecacuanha Fluidum, — Dose, mj-v. 

Syrupus Ipecacuanha, — strength 5 per cent. Dose, 3J-jfss. 

Vinum Ipecacuanha,— strength 7 per cent. Dose, "Nlj-^j. 

Trochisci Ipecacuanha, — each contains gr. % of Ipecac. 

Trochisci Morphina et Ipecacuanha, — each contains of Morphine 
Sulphate gr. ? * ff , of Ipecac gr. T ^, with oil of Gaultheria, Sugar, etc. 

Pulvis Ipecacuanha et Opii, Dover's Powder,— consists of Ipecac 10, 
Pulvis Opii 10, Sugar of Milk 80 parts. Dose, gr. ij-xv. 

Tinctura Ipecacuanha et Opii, — Deodorized Tincture of Opium 100 
parts evaporated to 85, Fluid Extract of Ipecac 10, Alcohol q. s. ad 100. 
Dose, TTLv-xxx. 

Emetina, Emetine (Unofficial), — a crystalline alkaloid, white becoming 
yellow, odorless, bitter, nearly insoluble in water, but forming with acids salts 
which are readily soluble. Is powerfully poisonous in large doses. Dose as 
an expectorant, gr. T J^- ? 1 ff ; as an emetic, gr. \-\. 

Physiological Action. 

Ipecac is nauseant, emetic, expectorant, cholagogue, diapho- 
retic, hemostatic, sternutatory and counterirritant. Applied to 
the skin it produces pustulation, used as snuff it excites violent 
sneezing and reflex mucous secretion, in some persons the smallest 
inhalation of the dust exciting an asthmatic paroxysm. Internally 
small doses (gr. yi-%.) act as a stomachic tonic and increase 
the gastric secretions ; larger doses (gr. v-xx) are nauseant and 
emetic in from 20 minutes to half an hour, but the emesis pro- 
duced is not violent nor is it followed by much depression. If 
these doses are repeated a tolerance of the stomach to the drug 
becomes established and a cathartic action is produced, the stools 
having a peculiar bilious character. The circulation is only 
slightly affected by Ipecac, but it relaxes the skin and increases 
the broncho-pulmonary mucus, being diaphoretic and expecto- 
rant. In large doses it is decidedly irritant to the intestinal 
canal, but here also it is capable of the same tolerance as in the 
stomach. In poisonous doses it has frequently produced hemop- 
tysis and other hemorrhages. 

Emetine, the active principle, causes death in animals by par- 
alysis of the muscles of respiration, and the autopsies show evi- 
dences of gastro-intestinal irritation and hyperaemic lungs with 
patches of hepatization. 

Antagonists and Incompatibles*. 

Narcotics generally antagonize the emetic action, so also do Bismuth, Car- 
bolic and Hydrocyanic Acids. The salts of Lead and Mercury, Vegetable 
Acids and astringent infusions are incompatible with Ipecac. 



IRIS. 237 

Therapeutics. 

Ipecac is much used as an emetic, being safe, efficient and non- 
depressant, though slow of action. It is the best agent of the 
kind to relieve the stomach in acute indigestion and bilious sick- 
headache, and an ipecac-vomit is frequently very serviceable at 
the commencement of eruptive, continued and periodical fevers. 
The syrup is a favorite domestic emetic to cut short an attack of 
laryngismus stridulus, and it may be used beneficially in mem- 
branous croup and capillary bronchitis. 

Dysentery is a disease in which large doses of Ipecac (gr. xx 
every 4 hours) are used with great success, especially in the epi- 
demic form, and in the summer dysentery of teething children. 
Tolerance must be established to produce its curative action. In 
small doses (tt^j of the wine) frequently repeated, it will relieve 
many kinds of vomiting, especially those of nervous origin, per- 
haps through a sedative action on the pneumogastric. As an 
antihemorrhagic it has been efficiently employed in post-partum 
hemorrhage, menorrhagia, epistaxis, hemoptysis, etc., and it is 
considered very useful in night coughs, acute catarrh and bron- 
chitis, spasmodic asthma and hay fever. In most of these affec- 
tions slightly nauseating doses must be used. 



IRIS, Blue Flag, — is the rhizome and rootlets of Iris versi- 
color, an indigenous plant of the nat. ord. Iridaceae, growing in 
moist meadows and on the borders of swamps, having large blue 
flowers and a horizontal rhizome, 2 to 4 inches long, with long 
rootlets, slight odor but an acrid, nauseous taste. It contains 
tannin, sugar, starch, gum, an acrid resin, fixed oil and traces of 
an alkaloid. Dose of the powdered root, gr. v-xx. 

Preparations. 

Extractum Iridis, — Dose, gr. j-v. 

Extractum Iridis Fluidum, — Dose, ttiv-^j. 

Iridin or Irisin (Unofficial), — is a so-called resinoid found in the shops, 
of undetermined composition, but probably an oleoresin precipitated by water 
from an alcoholic preparation. Dose, gr. j-v. 

Physiological Action. 

Iris when fresh is actively purgative, emetic and diuretic, pro- 
ducing severe nausea and prostration. Iridin has been the subject 
of experimentation upon dogs, and is shown to be a powerful 
hepatic stimulant with considerable influence on the intestinal 
glands, being more purgative than Euonymin and less irritant 



238 JALAPA. 

than Podophyllin. In very small doses it causes obstinate con- 
stipation by producing rectal inactivity. 

Therapeutics, 

Iris is very serviceable in duodenal catarrh with obstruction of 
the bile-ducts and consequent jaundice, also in malarial poison- 
ing, bilious remittents, and jaundice of malarial origin. It is 
used in many hepatic and intestinal disorders as a cholagogue and 
purgative of mild but efficient action, also as a diuretic in drop- 
sies. In small doses (n^j of a tincture) it is strongly recom- 
mended in a peculiar blinding headache in the right supra-orbital 
region with nausea or vomiting, supposed to be of hepatic origin. 



JALAPA, Jalap, — is the tuberous root of Exogonium purga, 
a Mexican plant of the nat. ord. Convolvulaceae. It is large, 
turnip-shaped, externally dark-brown and wrinkled, internally 
grayish-brown with numerous concentric circles composed of 
small resin-cells, odor slight, taste sweetish and acrid. It con- 
tains 15 to 20 per cent, of the officinal Resin, which is composed 
of two resins, Jalapin, soft, soluble in ether, and Convolvulin, 
C 31 H 50 O 16 , which is hard, insoluble in ether, and the most active 
of the two. 

Preparations. 

Abstractum Jalaps, — is an ingredient of Pil. Catharticae Composite, gr. 
j in each. (See aizte, page 157.) Dose, gr. j-v. 

Resina Jalap^e, — prepared by precipitation by water from a tincture. In- 
soluble in water, soluble in alcohol. Dose, gr. ij-v. 

Pulvis Jalap^e Compositus, — Jalap 35, Potassium Bitartrate 65 parts, 
triturated together. Dose, gr. x-£j. 

Physiological Action, 

Jalap is an active cathartic, producing copious and watery 
stools, with considerable tormina and tenesmus, also sometimes 
nausea. It does not produce hemorrhoids, but does increase the 
secretions of the intestinal canal and the flow of bile. Its action 
is not due to any one of the contained principles, but all the 
active constituents are found in the resin. Compared with other 
agents of the same class its action most resembles that of Scam- 
mony. It is more drastic than Senna and less irritant than Gam- 
boge, but in overdoses may produce dangerous hypercatharsis. 

Convolvulin in sufficient dose is an active irritant poison, 
producing gastro-enteritis and narcotism. Its action as a purga- 
tive seems to be wholly local, as from its intravenous injection no 



JUGLANS. 239 

catharsis results, yet it exerts little if any irritant action on the 
conjunctiva, nasal mucous membrane or skin. It is not eliminated 
in the urine or the faeces, and is therefore probably destroyed in 
the system by oxidation. 

Therapeutics, 

In olden bowel-moving times Jalap and Calomel were used 
together in doses of gr. x each (" ten and ten"), as a routine 
purgative prescription. Less ponderous doses are now considered 
equally efficient, and one grain of each agent with the same 
quantity of Extract of Hyoscyamus as a corrective may be used 
with advantage at the onset of fevers and inflammations. As the 
compound powder it is much employed to produce free watery 
evacuations in ascites and anasarca. Being nearly tasteless it is 
a useful cathartic for children, and may be administered in Syrup 
of Rhubarb (gr. ij-v in §ss). As a vermifuge it is efficient as an 
adjunct to more powerful agents, and is employed with Calomel 
after Santonin for the expulsion of lumbrici. Jalap is contra- 
indicated in all inflammatory conditions of the intestinal mucous 
membrane, but in proper doses it is one of the most manageable 
and efficient cathartics. 



JUGLANS, Butternut, — is the inner bark of the root col- 
lected in autumn of Juglans cinerea, the Butternut or White Wal- 
nut, an indigenous forest tree of the nat. ord. Juglandaceae. It 
occurs in flat or curved pieces, the outer surface smooth, dark- 
brown, mottled, and nearly free from corky remnants of the 
outer bark, odor feeble, taste bitter and acrid. It contains an 
orange-yellow, crystalline and acrid substance named Juglandic 
Acid ox Nucin, resembling Chrysophanic Acid, also some resin, 
volatile acid, etc., but neither tannin nor any alkaloid. 

Preparation. 
Extractum Juglandis, — Dose, gr. v-xx or more. 

Physiological Action and Therapeutics, 

Juglans is a mild cathartic operating without the production of 
pain or irritant symptoms. It is never used in substance, but 
the extract is a good laxative in doses of gr. v-x, and a purgative 
in larger doses. It has considerable reputation in dysentery and 
chronic constipation. 



24O JUNIPERUS. 

JUNIPERUS, Juniper, — is the fruit oi Juniper us commu- 
nis, an evergreen shrub of the nat. ord. Coniferae, growing in 
Europe and N. America. The fruit or berry is dark-purple with 
a bluish-gray bloom, having a three-rayed furrow at the apex, 
internally pulpy, containing 3 triangular, bony seeds. It con- 
tains a Volatile Oil which is official and consists of terpenes and 
camphors in complex combination, also a non-crystallizable 
principle named Ju niperin, and grape sugar, resin, formic, acetic 
and malic acids, etc. 

Preparations. 

Oleu^i Juniperi,— the volatile oil, a colorless or faintly greenish-yellow 
liquid, of sp. gr. about 0.870, of terebinthinate and sweetish taste, and the 
odor of juniper, soluble in 12 of alcohol. Dose, ttjv-xx. 

Spiritus Juniperi, — has of the oil 3 parts in 97 of alcohol. Dose, &j-§j. 

Spiritus Juniperi Compositus, — approximates closely to the best grade'of 
" Gin" (see atite, page 51). It contains Oil of Juniper 10, Oil of Caraway 1, 
Oil of Fennel 1, Alcohol 3000, and Water sufficient to make 5000 parts. 
Dose, 3 ss ~j- 

Infusum Juniperi (Unofficial), — Juniper Berries §j in Oj of boiling water. 
Dose, ^ss-ij. 

Oleum Cadini, Oil of Cade (Unofficial), — is a tar obtained by the destruc- 
tive distillation of Juniper wood, but is of uncertain purity. The official 
Oleum Picis Liquids (Oil of Tar) is just as efficient for all purposes to which 
the Oil of Cade has been applied. 

Physiological Action. 

Juniper is a stomachic tonic, diaphoretic, diuretic and aphro- 
disiac. The oil is the active principle, and is readily diffused, 
exciting increased cardiac action, stimulating the renal functions 
and the action of the skin, and causing a subjective sense of heat 
throughout the system. It is eliminated chiefly by the kidneys, 
and may set up renal irritation, in large doses producing stran- 
gury, priapism, hematuria, suppression of the urine, and uraemic 
convulsions. It imparts a violet odor to the urine, and will pro- 
duce diuresis when inhaled. 

Therapeutics. 

The Oil of Juniper is used to flavor gin and to impart the diu- 
retic power popularly ascribed to that liquor. The medicinal use 
of the juniper preparations (spirit and compound spirit) is restricted 
to their employment as vehicles for less irritant diuretics. The 
oil acts therapeutically like the Oil of Turpentine, and may be 
used in chronic pyelitis and cystitis, prostatorrhoea, gleet, etc., 
but it is contraindicated in all cases where acute inflammation of 
the kidneys exists. 

Oil of Cade is used locally in chronic skin diseases as a stim- 



KAMALA — KAVA-KAVA. 24 1 

ulant application. It is too active for acute eruptions, but has 
been used with benefit in chronic eczema and psoriasis. The 
official Oil of Tar (see Pix) is equally efficient. 



KAMALA, Rottlera, — the glands and hairs from the cap- 
sules of Mallotus Philippine nsis, or Rottlera linctoria, a small tree 
of the nat. ord. Euphorbiaceae, growing in Abyssinia, Arabia, 
India, China, etc. It occurs as a granular, mobile, brick-red 
powder, inodorous and nearly tasteless, partly soluble in alcohol 
and ether. It contains several resins, one of which is named 
Pottlerin, C u H 10 O 3 , also tannin, starch, gum, red coloring mat- 
ter, etc. There are no official preparations. Dose, 5ss-iij. 

Physiological Action and Therapeutics. 

Kamala is anthelmintic and purgative, sometimes causing nau- 
sea and colic, seldom vomiting. It is used as a tgeniafuge and to 
expel lumbrici and ascarides vermiculares. One or two drachms 
are given suspended in water, mucilage or syrup, and repeated 
in 4 hours if necessary. A tincture (§vj in xvj of alcohol) may 
be used in doses of 3J~o ss - I n India it is used locally in scabies 
and other skin affections, and has been found of especial service 
in herpetic ringworm. As a remedy against tapeworm it is per- 
haps next after Male-fern in efficiency, and requires no prepara- 
tory treatment. 



KAVA-KAVA, Ava-Kava (Unofficial),— the root of Piper 
methysticum, a shrub of the nat. ord. Piperaceae growing in South 
America and the South Sea Islands. The root is large, weighing 
from 2 to 20 pounds, fibrous, light and spongy, and contains a 
crystalline principle, Kavahin or Methysticin, which is analogous 
to Piperin, an acrid, greenish-yellow resin Kawin, which is prob- 
ably the active principle, also a Volatile Oil. Dose, Jss-j, mace- 
rated in water, or the same quantity of a fluid extract. 

Physiological Action and Therapeutics* 

Kava is intoxicant, diuretic and motor-depressant. A beverage 
is prepared in the Sandwich Islands by chewing the root and then 
infusing it in water or cocoanut milk, which produces a drowsy 
intoxication with pleasant dreams often of erotic character, and 
followed by severe headache. A moderate dose is tonic and 
stimulant, lessening the sense of fatigue and sharpening .the 



242 KINO — KRAMERIA. 

mental faculties. It is highly recommended in gonorrhoea and 
gout, also in chronic gleet and obstinate cystitis. 



KINO, — is the inspissated juice of Pterocarpus Marsupium, 
a tall tree of the nat. ord. Leguminosae, growing in India. It 
occurs in angular, brown-red pieces, shining and brittle, inodor- 
ous, taste astringent and sweetish, soluble in alcohol. It con- 
tains 75 per cent, of a variety of tannin named Kino-tannic Acid, 
C 18 H 18 8 , which gives a greenish precipitate with persalts of iron, 
also a crystalline, neutral substance, Kinoin, C u H 12 6 , and Kino- 
red, formed from Kino-tannic Acid by oxidation, besides gum, 
pectin, etc. There are several other varieties of Kino in the 
market, brought from S. America, Africa, Australia, etc., which 
are products of other trees than the official one. 

Preparations. 

Tinctura Kino, — strength 10 per cent. Dose, TTtx-^ij. 
Pulvis Kino Compositus (Unofficial), — Kino 15, Opium 1, Cinnamon 4, 
(has of Opium 1 in 20). Dose, gr. v-xx. 

Physiological Actio?i and Therapeutics. 

The action of Kino is the same as that of Tannic Acid, though 
less powerful (see ante, page 38), and may be used for the same 
purposes, both internally and locally. It is chiefly employed as 
an astringent gargle and as a constituent of diarrhoea-mixtures. 



KRAMERIA, Rhatany, is the root of Kra?neria triandra 
and Krameria tomentosa, shrubs of the nat. ord. Polygalaceae, 
growing in S. America, the first-named in Peru and the latter in 
New Granada. It is about an inch thick, branched below, more 
or less knotty, covered with a brownish bark which is very astrin- 
gent ; and contains 20 to 45 per cent, of Rhatania-tannic Acid, 
C^H^O^, and Rhatanine, C 10 H 13 NO 3 , an alkaloid, — also wax, 
gum, etc. 

Preparations. 

Extractum Krameri^e, — aqueous. Dose, gr. v-x. 
Extractum Krameria Fluidum, — Dose, niv-gss. 
Tinctura Krameri^e, — 20 per cent. Dose, tttv-^j. 
Syrupus Krameri^e, — Fluid Extract 35, Syrup 65. Dose, gss-gss. 
.Trochisci Krameria, — each troche contains gr. j of the extract, with 
Tragacanth, Sugar and Orange- Flower Water. 



KUMYSS. 243 

Physiological Action and Therapeutics. 

Krameria possesses the same astringent qualities as Tannic Acid 
(see ante, page 38), and maybe employed for the same purposes 
except as an antidote to Antimony. It has long had a high repu- 
tation as an injection for fissure of the anus, as a local application 
to spongy gums, and as a tonic for debilitated subjects. 



KUMYSS, Koomiss (Unofficial), — is an effervescing fer- 
mented liquor originally prepared by the Tartars from mares* 
milk, but now imitated with cow's milk by adding sugar of milk, 
fermenting in open tanks, skimming off the casein and butter, 
then bottling during active fermentation. Wolff's formula for 
its preparation in small quantity is as follows, — 

Dissolve gss of grape sugar in giv of water. Dissolve gr. xx of Fleisch- 
mann's compressed yeast or well-washed and pressed out brewer's yeast in ^ ij 
of cow's milk. Mix the two solutions in a quart champagne bottle, and nil 
to within 2 inches of the top with good cow's milk. Cork well, secure the 
cork with wire, keep it in a cellar or ice chest, maintaining a temperature of 
50 F. or less, and agitate thrice daily. In three or four days it is ready for 
use, but should not be kept longer than four or five days. Draw it with a 
champagne tap. 

Kumyss contains Alcohol, 1.23 to 3.23 per cent., Carbonic 
Acid, 0.75 to 1.99, Lactic Acid, 0.25 to 2.92, Casein, 1.12 to 
3.08, Sugar of Milk, 1.77 to 2.37, Fat, 1.05 to 2.05, Salts, 0.28 
to 0.57 per cent., besides volatile, fragrant compounds. The 
further the fermentation is carried the more Alcohol and Car- 
bonic Acid will result and the less Sugar and Casein, while if 
carried on to a considerable degree Butyric, Succinic and Acetic 
Acids are produced. 

Physiological Action and Tlierapeutics. 

The taste of Kumyss is acidulous and peculiar. In large quan- 
tity it takes the place of food, each quart equalling four ounces 
of solids. It is said to be a powerful diuretic especially in cold 
weather, and in warm weather to produce free diaphoresis. It is 
stimulating and tonic_, increases the body nutrition and produces 
considerable somnolence. The stomach is very tolerant of it, 
and retains it when any other food will be rejected. It is easily 
assimilated and very nutritious. 

Kumyss is an invaluable article of diet in many wasting dis- 
eases, especially phthisis. It is also of great benefit in dyspepsia, 
the diarrhoea of children, convalescence from acute maladies, 



244 LACTUCARIUM — LAPPA. 

chronic affections of the kidneys, chronic bronchitis, and other 
cachexiae. In cases of feeble digestive power gj every hour is 
sufficient, but as its digestion and assimilation increase it may be 
given almost ad libitum, and when used with other food a half- 
pint may be taken after each meal. 

Kefir is the name of a fermented .drink prepared from the 
milk of a cow or mare by the addition of a secret ferment. It is 
used by the natives of the Asiatic plains as a remedy for struma, 
lung and stomach diseases. 



LACTUCARIUM, Lettuce,— is the concrete milk-juice 
of Lactuca virosa, or Acrid Lettuce, a biennial European plant, 
of the nat. ord. Compositae. It occurs in sections of cakes or 
irregular pieces showing the form of the vessel in which it hard- 
ened, externally reddish-brown, internally white or yellowish and 
of waxy lustre, odor heavy and narcotic, taste bitter, partly sol- 
uble in alcohol and in ether, and yielding a turbid mixture when 
triturated with water. Lactucarium is a mixture of several sub- 
stances, the most important being Lactucerin, 42 per cent., a 
crystalline, tasteless body, resembling caoutchouc, insoluble in 
water and probably inert ; Lactucin, 0.3 per cent., a neutral prin- 
ciple, crystallizing in pearly scales, insoluble in cold water, per- 
sistently bitter ; Lactucic Acid, bitter, amorphous, but crystallizes 
after long standing. 

Preparations. 

Extractum Lactucarii Fluidum,— Dose, for a child Tnj-iij, for an adult 
Tn_x-^j, according to the activity of the drug. 

Syrupus Lactucarii, — 5 per cent. Dose, £j-§j. 

Physiological Action and Therapeutics. 

Lactucarium is feebly hypnotic, somewhat sedative and diuretic. 
It is supposed to act similarly to Opium, but very feebly and 
without depressing after-symptoms. Its preparations are very 
uncertain in activity, and are chiefly used as placebos, to allay 
cough and quiet nervous irritability. The syrup is a good 
vehicle for expectorants and antispasmodics. 



LAPPA, Burdock, — is the root of Lappa officinalis, the 
common Burdock, a coarse-looking biennial weed of the nat. ord. 
Compositae, found in waste places and along roadsides in Europe, 
Asia and N. America. Three varieties are recognized, — Lappa 
major, L. tomentosa and L. minor, of which the first-named is 



LAVANDULA. 245 

most frequently met with in this country. The root is about a 
foot long, an inch thick, has a feeble odor and a mucilaginous, 
bitterish taste, and contains a bitter principle, traces of a volatile 
oil, also inulin, resin,, tannin, mucilage, sugar, etc. There are 
no official preparations. Dose, 3J _1 Jj m infusion, decoction or 
tincture. Dr. Squibb recommends a tincture of the seed, R)j of 
ground seed to gall, j of whiskey, allowed to stand for 2 weeks 
before decanting, and used in doses of 3ij—iij before meals. 

Physiological Action and Therapeutics. 

Lappa promotes all the secretions and is considered aperient, 
diuretic and diaphoretic, without irritating qualities. In decoc- 
tion it has been a popular domestic remedy for many morbid 
conditions, especially rheumatism, gout, pulmonary catarrhs and 
chronic cutaneous affections. By several practitioners it is 
praised as an alterative in constitutional diseases, as syphilis and 
scrofula, also as an external application to swellings, hemorrhoids 
and chronic sores. A tincture of the seed has proved remarkably 
efficient as a stomachic tonic and has cured several cases of pso- 
riasis inveterata. (See Squibb's Ephemeris, vol. i., page 116.) 



LAVANDULA, Lavender, — the flowers of Lavandula vera, 
a small European shrub of the nat. ord. Labiatse, largely culti- 
vated in England. They have a bluish-gray tubular calyx, a 
violet-blue corolla, a. fragrant odor, and an aromatic, camphora- 
ceous taste, and contain resin and tannin, also a Volatile Oil which 
is official. Lavender is a constituent of Vinum Aromaticum. 

Preparations. 

Oleum Lavandulae, — is a volatile oil distilled from the flowering tops or 
the whole herb. It is much coarser than the oil of lavender flowers and more 
stimulant. Dose, Tlj-v. 

Oleum Lavandulae Florum, — is a volatile oil distilled from fresh Lav- 
ender, and having the fragrant odor of the flowers. Sp. gr. 0.890, soluble 
in alcohol and in acetic acid of 90 per cent. It is a constituent of Spiritus 
Odoratus. (See ante, page 50.) Dose, TTlj-v. 

Spiritus Lavandulae,— has of the Oil of Lavender Flowers 3 parts in 97 
of Alcohol. A perfume and flavoring. Dose, Jss-j. 

Tinctura Lavandulae Composita, — an aromatic stimulant composed of 
Oil of Lavender 8, Oil of Rosemary 2, Cinnamon 18, Cloves 4, Nutmeg 10, 
Red Saunders S, Alcohol 680, Water 270, Diluted Alcohol q. s. ad 1 000 parts. 
Dose, gss-ij. Is a constituent of Liquor Potassii Arsenitis. 

Physiological Action and Therapeutics. 

Lavender is aromatic, stimulant and carminative, but is rarely 
used alone as a medicine. It is an agreeable flavoring and per- 



246 LEPTANDRA LICOPERDON GIGANTEUM — LIMON. 

fume, in the form of the official spirit, which is sold under the 
name of " Lavender-water/' after the addition of Oil of Berga- 
mot and Essence of Ambergris. The compound tincture, formerly- 
called the compound spirit of Lavender, is a very agreeable com- 
pound of spices, and is much used as a remedy for gastralgia, 
nausea, flatulence, etc*, and as an adjuvant or corrigent of other 
medicines. 



LEPTANDRA, Culver's Root,— is the rhizome and 
rootlets of Leptandra virginica, an indigenous perennial plant of 
the nat. ord. Scrofulariaceae. The rhizome is horizontal, about 
5 inches long and % inch thick, bent and branched, with thin, 
wrinkled rootlets, inodorous, taste bitter and feebly acrid. It 
contains a glucoside named Leptandrin, which is probably the 
active principle, also Saponin, resin, tannin, etc. The Leptan- 
drin of the shops is an impure alcoholic extract. 

Preparations. 

Extractum Leptandr,*:, — Dose, gr. j-iij. 
Extractum Leptandr^e Fluidum, — Dose, "nixx-^j. 

Physiological Action and Therapeutics. 

Leptandra is tonic, laxative, and like other resin-bearing pur- 
gatives is decidedly cholagogue. The recent root is a violent 
cathartic, but in the dried state it is less active. It is indicated 
in duodenal indigestion and chronic constipation with insuffi- 
ciency of the biliary and intestinal secretions. 



LICOPERDON GIGANTEUM, Puff-Ball,— is a com- 
mon fungus of the nat. ord. Trichogastres, found in hilly and 
wooded districts. The dust, which consists of the capillitium 
and spores, is a valuable hemostatic, and dusted over bleeding 
surfaces acts promptly in arresting hemorrhage. It has been pro- 
posed as a surgical dressing, but while useful in emergencies where 
other agents are unattainable, the fetor which results from its 
application to wounds will prevent its use becoming general for 
this purpose. It may prove of value as an internal hemostatic in 
hematemesis and the hemorrhage of typhoid fever. 



LIMON, Lemon, — is the fruit of Citrus Limonum, a tree 
of the nat. ord. Aurantiaceae, native in Asia but cultivated in 



LIMON. 



247 



southern Europe and many other countries. It is official in the 
two forms described below. The Orange {Citrus vulgaris and 
C. Aurantium), the Citron {Citrus medica), and the Lime {Citrus 
acrisj, all belong to the same genus as the Lemon (Citrus Limo- 
num). 

Limonis Cortex, Lemon Peel,— is the rind of the recent fruit, 
and contains a Volatile Oil, C 10 H 16 , which is official, and a bitter 
crystalline glucoside, Hesperidin, C 22 H 26 12 , chiefly contained in 
the white portion of the rind. 

Limonis Succus, Lemon Juice, — is the freshly expressed juice 
of the ripe fruit, each lemon yielding from 2 /z to 1 fluid ounce. 
It contains about 7 per cent, of free Citric Acid, besides Phos- 
phoric and Malic Acids, Citrates of Potassium and of other 
bases, etc. Dose, §ss-iv. 

Acidum Citricum, Citric Acid. H 3 C 6 H 5 7 .H 2 0, — is obtained 
from the juice of the Lemon or the Lime by adding chalk to form 
the Citrate of Calcium, which is then decomposed by dilute Sul- 
phuric Acid. It occurs in colorless, rhombic crystals which are 
very soluble in water. A solution of gr. xvij in §ss of water cor- 
responds to 355 of fresh lemon-juice, and this quantity of either 
will neutralize of Potassium Bicarbonate gr. xxv, of Sodium 
Bicarbonate gr. xx, and of Ammonium Carbonate gr. xivss. 
Dose, gr. x-xxx. 

Citrates of Bismuth, Bismuth and Ammonium, Iron, Iron and 
Ammonium, Iron and Quinine, Iron and Strychnine, Lithium, 
Potassium, eight in all, are official. They are described under 
their respective bases, to which rather than to the acid their me- 
dicinal qualities are due. 

Preparations, 

Oleum Limonis, Oil of Lemon, C 10 H 16 , — is the volatile oil, isomeric with 
oil of turpentine, and extracted from fresh lemon peel by mechanical means. 
It is used for flavoring and is an ingredient of Spiritus Limonis, Spiritus 
Odoratus, and Spiritus Ammoniae Aromaticus. Dose, ttij-v. 

Spiritus Limonis, Essence of Lemon, — prepared by macerating 6 parts of 
the oil and 4 of the peel in 90 of alcohol. Used for flavoring. Dose, accord- 
ing to the alcohol required to be given. 

Syrufus Limonis. — Lemon-juice 40, Lemon-peel 2, Sugar 60, Water q. s. 
ad 100 parts. Dose, indefinite. 

Syrupus Acidi Citrici, — Citric Acid 8, Water 8, Spirit of Lemon 4, 
Syrup 9S0 parts. Dose, indefinite. 

Pin 'siologica I A ction . 

Lemon-peel is bitter and probably tonic to the stomach, but is 
only used for flavoring purposes. Lemon-juice, on the other hand, 
is refrigerant and antiscorbutic, entering the blood as alkaline 



248 LINUM. 

citrates, potassium salts and phosphoric acid, the citrates being 
therein partly oxidized into C0 2 and H 2 0, while the potassium 
salts and phosphoric acid probably act upon the red corpuscles. 

Citric Acid has the same general action as Acetic and the 
other vegetable acids (see Acidum Aceticum, ante, page 19). It 
is wholly decomposed in the blood, and appears to be non-toxic 
in man, but used internally it may precipitate uric acid and thus 
promote the formation of calculi. 

Therapeutics. 

Lemon-juice is employed largely in the treatment and preven- 
tion of scurvy, in which disease it possesses powers of specific 
rank, but whether its action therein is due to the citric acid, the 
phosphoric acid or the salts of potassium is not known. Lime- 
juice is equally efficient but Citric Acid itself is not so. 

As refrigerants and diuretic mixtures in fevers, Lemon-juice 
and Citric Acid are much used, entering into the composition of 
lemonades, effervescing draughts, etc., to allay thirst and subdue 
restlessness, and to promote the action of the skin and the kid- 
neys. For acidity of the stomach they are efficient if given in 
small doses before meals, but the mineral acids are usually pre- 
ferred for this purpose. Long-continued they will impair diges- 
tion and impoverish the blood. Atheromatous degeneration of 
the vessels is said to be retarded by the daily use of lemon-juice, 
which is supposed to dissolve the excess of organic matter and to 
aid its excretion. Obesity may be reduced by using the juice of 
limes or lemons in large quantity, but it will be done at the ex- 
pense of the digestion. Lemon-juice has been found of service 
in acute rheumatism, probably through the alkalies which it con- 
veys into the blood. As a local application it has been found 
efficient in pruritus scroti, sunburn, and post-partum hemorrhage, 
and as a gargle in diphtheritic sore throat. 



LINUM, Flaxseed, Linseed, — is the seed of Linum usi- 
tatissimum (flax), a cultivated annual plant of the nat. ord. Lina- 
ceae. The seeds are small, flattened, oblong-ovate bodies, brown 
and glossy, inodorous, taste mucilaginous and bitter; and con- 
tain 15 per cent, of Mucilage in the epithelium, also 30 to 40 per 
cent, of Fixed Oil in the embryo. Ground Flaxseed should yield 
not less than 25 per cent, of the fixed oil. 

Preparations. 

Oleum Lini, Linseed Oil, — the fixed oil expressed from flaxseed without 
the use of heat. . A yellow, oily liquid, of slight odor, bland taste, and neu- 



LITHIUM. 249 

tral reaction, soluble in 5 of absolute alcohol and in 1^ of ether. Consists 
chiefly of the Glyceride of Li7ioleic Acid, C 16 H 28 4 , which having a powerful 
affinity for oxygen becomes resinoid on exposure to the air, making it a " dry- 
ing oil." Dose, §ss-ij. 

INFUSUM Lini, Linseed Tea (Unofficial), — Flaxseed giij, Liquorice-root 
3J, Boiling Water gx, infused for 4 hours and strained. Dose, indefinite. 

Carron Oil (Unofficial), — is made by emulsifying equal parts of Linseed 
Oil and Limewater. The official Linimentum Calcis is intended for the same 
purposes. 

Physiological Action and Therapeutics. 

Flaxseed is demulcent, emollient, expectorant and diuretic. 
The oil is laxative in a dose of %), and in smaller doses is oxi- 
dized in the system and excreted as a resinoid body by the 
kidneys, which it stimulates slightly. The infusion contains the 
mucilaginous principle and a small portion of the oil, and is ad- 
vantageously used in inflammations of the mucous membrane of 
the throat, the gastro-intestinal tract and the urinary passages. It 
is an excellent demulcent in coughs of various kinds, and will be 
found very serviceable in cystitis, irritable bladder, renal colic, 
strangury, etc. The oil may be administered internally as a lax- 
ative but is usually given as an enema, and has considerable rep- 
utation as a remedy for hemorrhoids in doses of §ij twice daily. 
Externally it is a favorite application to burns when made into 
an emulsion with lime-water. The ground seed (flaxseed meal) 
is one of the best agents for use in poultices, and is universally 
employed for that purpose. 



LITHIUM, Li, — is represented in the Pharmacopoeia by 
five of its salts, of which the Carbonate is but slightly soluble 
while the others are readily so. The low atomic weight of this 
metal (7) makes its saturating power greater than that of the 
other alkaline metals, hence the value of its salts in medicine. 

Salts of Lithium. 

Lithii Benzoas, Benzoate of Lithium, LiC 7 H 5 2 , — is classed with the 
Benzoates and described under Benzoic Acid. (See ante, page 99.) 

Lithii Bromidum, Bromide of Lithium, LiBr, — is classed with the Bro- 
mides and described under Bromine. (See ante, page 103.) 

Lithii Carbonas, Carbonate of Lithium, Li 2 C0 3 , — a light, white powder, 
permanent in the air, odorless, of alkaline taste and reaction, soluble in 130 
of water, insoluble in alcohol. Dose, gr. ij-xv. 

Lithii Citras, Citrate of Lithium, Li 3 C 6 H 5 7 , — a white, deliquescent 
powder, odorless, of faintly alkaline taste and neutral reaction, soluble in 5^ 
of water, slightly in alcohol. Dose, gr. v-xxx. 

Lithii Salicylas, Salicylate of Lithium, 2LiC 7 H 5 3 .H 2 0, — is classed with 
the Salicylates and described under Salix. 

21 



2 SO LOBELIA. 

Physiological Action, 

The Lithium salts have strong alkaline qualities and act on the 
system in the same manner as other alkalies (see under Potas- 
sium). The high saturating power of this metal makes its salts 
more alkaline than those of Potassium, Sodium or Calcium, hence 
more efficient in alkalinizing the urine. The Urate of Lithium 
is the most soluble of the urates, hence the value of lithium salts 
in the uric acid diathesis. The Carbonate and Citrate are the 
salts referred to in this connection, the others partaking more of 
the qualities of their acid factors. Both these salts are antacid 
and strongly diuretic, the Carbonate being but slightly soluble 
is given in wafer or in carbonic acid water, and the Citrate in 
solution. The latter may be extemporaneously prepared by add- 
ing Citric Acid to an aqueous solution of the Carbonate, and in 
the organism is decomposed, the citric acid being oxidized and 
the carbonate formed. Many mineral waters contain small quan- 
tities of the carbonate, varying from a mere trace to o.oi grain to 
the pint, an amount so minute as to be practically inert in com- 
parison with the much greater quantities of potassium and sodium 
salts in the same waters. 

Therapeutics. 

The Carbonate and Citrate of Lithium are extensively used in 
gout and the lithaemic diathesis, for the purpose of holding the 
uric acid in solution as urate of lithium, and preventing its deposit 
in the tissues as urate of sodium which *is less soluble. Their 
prolonged administration is so efficient in this affection that they 
have been credited with the power of dissolving uric acid calculi 
and called lithontriptics. They«are also highly useful in .the 
indigestion and rheumatism of obese subjects, and in irritable 
bladder from excess of acid in the urine. 



LOBELIA, Indian Tobacco, — the leaves and tops of 
Lobelia inflata (nat. ord. Lobeliaceae), collected after a portion of 
the capsules have become inflated. The plant is a common 
annual weed growing on roadsides throughout the United States, 
having pale-green, alternate leaves, a single, erect and very hairy 
stem, with hairy branches and small, pale-blue flowers, odor 
slight but irritating, taste at first mild, afterwards burning and 
acrid. It contains gum, resin, fixed oil, wax, lignin, salts of 
lime, potassium and iron, a liquid alkaloid Lobeline, which is the 
narcotic principle of the plant, also Lobelic Acid y and an acrid 
substance named Lobelacrin. 



LOBELIA. 251 

Preparations. 

Extractum Lobelia Fluidum, — Dose, "ntj-x. 

Tinctura Lobelia, — 20 per cent. Dose, -rn_v-xxx. 

Acetum Lobelia, — 10 per cent. Dose, rnv-^j. 

Infusum Lobelia (Unofficial), — f ^j to the pint. Dose, £j-gj. 

Lobelin (Unofficial), — an impure resinoid. Dose, gr. ss-j. 

Physiological Action. 

Lobelia has an acrid, nauseous taste, and a heavy, unpleas- 
ant odor. It is expectorant, diaphoretic, emetic, purgative, anti- 
spasmodic, motor-depressant and narcotic. It excites an abundant 
flow of saliva, much gastric mucus, profuse urination and sweat- 
ing, with nausea, vomiting and great depression. The heart's 
action is enfeebled, and the blood-pressure, at first increased, 
soon falls ; muscular debility, reduced temperature and coma 
follow, and death occurs by paralysis of the respiratory apparatus. 
The drug produces paralysis of the motor nerve-trunks, the peri- 
pheral vagi, and probably the respiratory and vaso-motor centres 
also. It strongly resembles tobacco in its action, and is highly 
dangerous in full medicinal doses, having caused many deaths 
when administered therapeutically, the most important instance 
of its fatal results being the case of Ezra Lovett, Jr., who in 1809 
was poisoned by Lobelia administered by the founder of the 
Thomsonian sect of medical practitioners. The responsible party 
escaped conviction on the plea that he gave the drug in ignorance 
of its qualities. 

Antidotes and Incofnpatibles. 

Tannic Acid to form the insoluble tannate. Strychnine, Picrotoxine and 
Thebaine antagonize its action on the nervous system ; — the vaso-motor ex- 
citants, as Alcohol, Digitalis, Belladonna, Ergot, etc., antagonize its effects 
on the circulation. Caustic alkalies are incompatible, decomposing the 
alkaloid. 

Therapeutics. 

Lobelia was a favorite remedy with the Indians at the time 
of the first settlement of the United States, and was introduced 
into regular practice as an anti-asthmatic, after having served as 
the main stock-in-trade of the irregular practitioners for many 
years. Its principal therapeutic action is that of an antispas- 
modic, and in cautious hands it is extremely useful in paroxysmal 
spasmodfc asthma, as well as in dry cough with constant tickling 
in the throat. As an enema in cases of strangulated hernia the 
infusion is much safer than Tobacco and fully as efficient, and 
may overcome the obstruction in intussusception, while the tinc- 
ture in 2-drop doses every hour will often relieve a case of im- 



252 LYCOPODII JM — MAGNESIUM. 

pacted csecum. In constipation from atony and deficient secre- 
tion a io-minim dose of the tincture at bed-time acts excellently, 
and in the poison-oak eczema the infusion is a good local applica- 
tion. As an emetic it is entirely too depressant for children's use. 

LYCOPODIUM, — is a very mobile, pale-yellow, fine pow- 
der, consisting of the sporules or seeds of the Club-moss, Zyco- 
podium clavatum, and of other species of Lycopodium (nat. ord. 
Lycopodiaceae). The plant is a native of Europe and the U. S., 
has a trailing stem several feet long, with smooth, deep-green, 
pointed leaves, flowers in terminal spikes, and yellow capsules 
which contain the seeds. Lycopodium is odorless, tasteless, 
floats on water which does not wet it, and burns quickly when 
thrown on a flame. It should be free from pine-pollen, starch, 
sand and other impurities, which are detected by means of the 
microscope, the seeds being about -g-^th of an inch in diameter, 
four-sided and reticulated, with short projections on the edges. 
They contain about 47 per cent, of a bland, fixed oil. 

Physiological Actions and Therapeutics. 

The plant was formerly considered to be diuretic and anti- 
spasmodic, and was used in rheumatism, epilepsy and pulmonary 
and renal disorders. The powder is now employed quite exten- 
sively in pharmacy to facilitate the rolling of a pill-mass and to 
prevent adhesion of pills to each other. It makes an excellent 
absorbent and protective powder when dusted over an excoriated 
surface, as seen between the thighs of infants. 

By the homoeopathic practitioners Lycopodium is elevated to 
the rank of an active drug when triturated with sugar of milk 
sufficiently long to break up the seeds and liberate their oily con- 
tents. In their first centesimal trituration ( T fo) it is said to 
have produced symptoms of high excitement of the circulation 
and irritation of the urinary organs, and they profess to use it 
with benefit in many affections of the mucous tracts, dyspepsia, 
pyrosis, flatulence, constipation, ileo-colitis of infants, hepatic 
congestion, aneurism, chronic affections of the lungs and bronchi, 
diphtheria, lithiasis, intertrigo, porrigo capitis, plica polonica 
and pruritus ani, in all of which as an internal remedy and in 
high attenuation. 

MAGNESIUM, Mg.— This metal is represented by its 
Oxide, Carbonate, Citrate, Sulphate and Sulphite, of which the 
Sulphate occurs native in sea-water, caves, etc., the others being 



MAGNESIUM. 253 

prepared from it. The first two are almost insoluble in water or 
alcohol. Its salts are either white or colorless, and those which 
are official are as follows, — 

Official Salts of Magnesium. 

Magnesia, Light Magnesia, Oxide of Magnesium, MgO, — made by heat- 
ing the light carbonate in a crucible to expel nearly all the carbonic acid. A 
white, light and very fine powder, almost insoluble in water, insoluble in 
alcohol, and gelatinizes with 15 of water after standing y z hour, having be- 
come hydrated. Is a constituent of Pulvis Rhei Compositus, Massa Copaibae 
and Ferri Oxidum Hydratum cum Magnesia. Dose, gr. x-^j. 

Magnesia Ponderosa, Heavy Magnesia, Oxide of Magnesium, MgO, — is 
a white, dense and very fine powder, corresponding in other properties and 
reactions with Magnesia, except that it does not gelatinize with water. It is 
made by calcining the heavier variety of the carbonate, and is much slower in 
action than the light magnesia. Dose, gr. x-gj. 

MAGNESII Carbonas, Carbonate of Magnesium, (MgC0 3 ^Mg(HO\.5H 2 0, 
— light, friable masses, or powder, odorless and tasteless, insoluble in alcohol, 
almost insoluble in water. Dose, gr. x-^j. 

MAGNESII Sulphas, Sulphate of Magnesium, Epsom Salt, MgS0 4 .7H 2 0, 
— colorless prisms or acicular needles, slowly efflorescent, odorless, of cool- 
ing, saline taste, and neutral reaction, very soluble in water, insoluble in alco- 
hol. Is a constituent of Infusum Sennae Compositum. Dose, 3J-^j. 

MAGNESII SULPHIS, Sulphite of Magnesium, MgS0 3 .6H 2 0, — a white, crys- 
talline powder, becoming oxidized on exposure to air, of sulphurous and 
slightly bitter taste, and neutral or slightly alkaline reaction, soluble in 20 of 
water, insoluble in alcohol. Dose, gr. x-xxx. 

Preparations. 

Magnesii Citras GrANULATUS, Granulated Citrate of Magnesium, — pre- 
pared from the Carbonate with Citric Acid, Sugar, Bicarbonate of Sodium, 
Alcohol and Distilled Water. A coarsely granular, white salt, deliquescent, 
of acidulous taste and acid reaction, soluble with copious effervescence in 2 
of water, insoluble in alcohol. Dose, gij- gj. 

Liquor Magnesii Citratis, — prepared from the Carbonate gr. 200, Citric 
Acid gr. 400, Syrup of Citric Acid gr. 1200, Potassium Bicarbonate gr. 30, 
Water q. s. ad gxij. Dose, giv-vj, repeated for catharsis. 

Trochisci Magnesii,— each troche contains of Magnesia gr. 3, Nutmeg 
gr. 0.15, with Sugar and Mucilage of Tragacanth. Dose, indefinite. 

Mistura Magnesia et Asafcetid.e, Dewees' Carminative, — contains of 
the Carbonate 5 per cent., Tincture of Asafcetida 7, Tincture of Opium I, 
Sugar 10, and Distilled Water 77. Dose, gss-iv. Used for flatulent colic 
and diarrhoea in infants. 

Physiological Action. 

Magnesia and the Carbonate of Magnesium are mildly laxa- 
tive and antacid, neutralizing free acids in the stomach and form- 
ing therewith laxative salts. If used in large quantity for any 
length of time it may become hydrated and produce intestinal 
concretions. The freshly-precipitated hydrate (see above, Mag- 



254 MAGNOLIA. 

nesia) is an antidote to Arsenic in solution, but less effective 
than the Hydrated Sesquioxide of Iron, with which it is combined 
in the official Ferri Ox. Hydratum cum Magnesia. (See ante, page 
191.) Magnesia may also be used in acid or phosphorus-poi- 
soning. 

The Citrate and Sulphate are saline cathartics, the latter 
being the most powerful, producing prompt and free watery dis- 
charges, with but little griping or irritation, but frequently a 
sense of coldness and depression. The purgative action is chiefly 
due to increase of the intestinal fluids by an outward osmosis 
from the vessels, and not from increase of the secretions of the 
glandular appendages. If the purgative action should not take 
place a diuretic one will result, but to secure the desired catharsis 
the drug should be administered in a considerable quantity of 
water. Sulphate of Magnesium is the principal aperient con- 
stituent of many of the popular laxative mineral waters, as Fried- 
richshall, Piillna, Hunyadi, etc. 

The Sulphite shares the actions and uses of the other sulphites, 
and is more properly considered with them. (See ante, page 36.) 

Therapeutics. 

Magnesia and the Carbonate are used as antacids and laxatives, 
in acidity, sick headache, flatulent colic, etc., and as antidotes in 
poisoning by acids, arsenic, phosphorus, mercuric and cupric 
salts. The Citrate is an agreeable laxative, cooling and accept- 
able to the stomach. The Sulphate is the most efficient of the 
saline cathartics and has a wide field of application. In acute 
inflammatory conditions, renal and cardiac dropsy, ascites from 
obstruction of the portal circulation, increased blood-pressure 
within the cranium, intestinal obstruction without acute inflam- 
mation, the constipation of lead poisoning, and habitual consti- 
pation from deficiency of the intestinal secretions, this agent will 
be found to be exceedingly serviceable. Acute dysentery is well 
treated by Magnesium Sulphate combined with diluted Sulphuric 
Acid, and followed by Opium and starch enemata. Bleeding 
from hemorrhoids and uterine hemorrhage are often relieved by 
the same combination when other agents fail. The ferro-saline 
mixture (see ante, page 194) is a very useful laxative in the con- 
stipation of anaemic women. The bitter taste of Epsom Salt is 
best covered by coffee. 

MAGNOLIA, — is the bark of Magnolia glauc a (Sweet Bay, 
Swamp Sassafras), M. acuminata (Cucumber-tree), and M. tripe- 



MALTUM — MAN AC A. 255 

tala (Umbrella-tree), all of which belong to the nat. ord. Mag- 
noliaceae, and are indigenous to the eastern and southern States. 
It occurs in quilled or curved pieces, of orange-brown color exter- 
nally, whitish or a pale-brown internally, taste astringent, pun- 
gent and bitter. It contains a crystalline principle named Mag- 
nolin, which is insoluble in water, but soluble in alcohol, ether, 
etc. Dose of the powdered bark, 3 ss ~j- There are no official 
preparations. 

Physiological Action and Therapeutics. 

Magnolia is an aromatic bitter tonic and diaphoretic, usefully 
employed in chronic rheumatism, remittent and intermittent 
fevers. In the latter affection it will arrest the paroxysms if used 
freely. 

MALTUM, Malt, — is the seed of Hordeum distichum, Bar- 
ley (nat. ord. Graminaceae), caused to enter the incipient stage of 
germination by artificial means and dried. The germination is 
allowed to go far enough to develop the maximum amount of 
Diastase, the peculiar ferment by which the starch of the grain 
is converted into Glucose. Malt is the source of beer, ale and 
whiskey, and is composed of the germinated, dead grains with 
their acrospires and radicles. It should be fresh, not darker in 
color than a pale amber, and of agreeable odor and sweet taste. 

Preparations. 

Extractum Malti, — a liquid of the consistence of thick honey, contain- 
ing all the soluble principles of malt in permanent form. It consists chiefly 
of diastase and glucose. Dose, £j-iv. 

Horlick's Food (Unofficial), — is, like Mellin's and many other foods for 
children, a granulated Extract of Malt. Hoff J s Malt Extract is another such 
preparation, containing alcohol, and corresponding to a concentrated beer. 

Physiological Action and Therapeutics. 

Malt Extract is directly nutritive, containing good food ele- 
ments, and indirectly so from the presence of the ferment Dias- 
tase, which converts the starch of bread or other farinas into 
sugar. It is usefully employed in wasting diseases, and mixed 
with milk or oleaginous foods it aids their digestion and assimila- 
tion. It may be used to form a syrupy mixture with preparations 
of Iron or Cinchona. 



MAN AC A (Unofficial), — is the root of Franciscea uniflora, 
a shrub of the nat. ord. Scrophulariaceae, indigenous to Brazil, 



256 MANGANUM. 

where it is known as Mercurio-vegetal, or Vegetable Mercury, a 
name applied by charlatans to a number of widely differing plants. 
Very little is known about Manaca, but it is extensively adver- 
tised as an unfailing remedy for subacute and chronic rheumatism. 
It is also considered purgative, diuretic, emmenagogue and anti- 
syphilitic, being official in the Brazilian Dispensatories, and no- 
ticed as follows in the Diet, de Botan. Brazileira. 

" This whole plant, but especially the root, excites powerfully the lymphatic 
system, eliminating morbid matter by the skin and kidneys. It is antisyphilitic ; 
the interior bark is nauseating and stimulates the throat. In small doses it is 
resolvent ; in larger purgative, diuretic and emmenagogue. In large doses it 
is an acrid poison." 

A fluid extract is on the market, the average dose of which is 
mx three or four times daily. 



MANGANUM, Manganese, Mn.— This metal is repre- 
sented in the Pharmacopoeia by two of its salts, viz. — the native 
Black Oxide and the Sulphate, as follows, — 

Mangani Oxidum Nigrum, Black Oxide of Manganese, Dioxide of Man- 
ganese, — is native, crude Binoxide of Manganese, containing at least 66 per 
cent, of the pure Oxide, Mn0 2 . A heavy, grayish-black powder, odorless 
and tasteless, insoluble in water or alcohol, giving off oxygen gas at a red heat, 
and if heated with hydrochloric acid it causes the evolution of chlorine gas. 
Is used in preparing Chlorine Water. Dose, gr. ij-x. 

Mangani Sulphas, Sulphate of Manganese, MnS0 4 .4.H 2 0, — colorless 
prisms, of slightly bitter and astringent taste, faintly acid reaction, very soluble 
in water, insoluble in alcohol. Dose, gr. ij-v. 

Preparations. 

Potassii Permanganas, Permanganate of Potassium, K 2 Mn 2 8 , — deep, 
purple-violet prisms, of sweet and astringent taste, neutral reaction, soluble 
in 20 of water with a scanty, brown residue, decomposed by alcohol. It 
should be kept in well-stoppered bottles, and should not be triturated nor 
combined in solution with organic or readily oxidizable substances. Dose, 
gr. ss-ij, in distilled water. 

Syrupus Mangani Iodidi, Syrup of the Iodide of Manganese (Unofficial), 
— contains about gj of the iodide in each g. Dose, rri x-xxx. For formula 
see U. S. D., page 1691. 

Syrupus Ferri et Mangani Iodidi, Syrup of the Iodide of Iron and 
Manganese (Unofficial), — each g contains gr. 50 of the mixed iodides in the 
proportion of 3 of the Iodide of Iron to 1 of that of Manganese. Dose, 
TTLx-xxx. For formula see U. S. D., page 1692. 

Ferri et Mangani Carbonas Saccharatus, Saccharated Carbonate of 
Iron and Manganese (Unofficial), — is a tasteless, reddish -brown powder. Dose, 
gr. v-xx. For formula see U. S. D., page 1693. 



MANGANUM. 257 

Physiological Action. 

The salts of Manganese in small doses improve the appetite 
and the digestion and stimulate the action of the heart. Used, 
in larger doses and for considerable length of time they lower 
the heart's action, paralyze the muscular system especially the 
muscular coat of the arteries, causing progressive wasting, para- 
plegia, and acute fatty degeneration of the liver. They are 
gastro-intestinal irritants, and the Sulphate is emeto-cathartic 
and decidedly cholagogue. Manganese is closely associated with 
Iron in the blood, bile, etc., in the proportion of about 1 
to 20. 

Permanganate of Potassium is an active oxidizer, containing 
as it does a large proportion of oxygen which it yields very 
readily in the form of ozone, and then becomes the binoxide of 
manganese. This property gives it the qualities of an antiseptic, 
a disinfectant and a deodorant. It is considered by some au- 
thorities to be an efficient emmenagogue. Used internally it 
must be instantly decomposed in the stomach, and probably is 
not absorbed in its own state. 

Therapeutics. 

The salts of Manganese are used by those practitioners who 
affect to see a manganese-anaemia in cachectic subjects, and they 
are always combined with ferric preparations. In gastrodynia 
and pyrosis the purified oxide is a good remedy in doses of 10 to 
15 grains, and the same preparation is used as an ointment in 
many skin diseases. In jaundice of malarial origin or catarrh of 
the biliary passages the sulphate gives good results. 

Permanganate of Potassium is used as an antiseptic and 
oxidizing agent in diphtheria, scarlatina, septicaemia, erysipelas, 
etc., given internally and used locally at the same time. It is 
given with apparent benefit in dyspepsia, flatulence, lithaemia 
and obesity, and has often seemed to be of service in acute rheu- 
matism. In amenorrhcea it is reported to be very efficient, and 
has lately been used with success as a remedy for the bites of 
venomous serpents and for other animal poisons. Locally it is 
frequently employed (3j to the pint) to correct fetor in cancer, 
ulcers, caries, abscesses, ozaena, and 'in the -proportion of gr. iv 
to the 3 it will destroy the odor of a foul breath or that of the 
fetid perspirations of the feet. It is used both as a test and as a 
corrigent for organic impurities in drinking-water. 

22 



258 MANGO MANNA MARRUBIUM. 

MANGO (Unofficial), — is the bark of Mangifera indica, an 
Indian tree of the nat. ord. Guttiferae. It is supposed to be an 
astringent with special tonic action upon mucous membranes. 
It is highly recommended by its vendors for nasal catarrh, hemor- 
rhages, and muco-purulent discharges from the intestines, uterus, 
vagina and bronchi. A fluid extract is sold, which may be used 
in doses of wix-5j- 

Mango-Fruit, or Mangosteen, is the fruit of Garcinia mangostana, nat. 
ord. Guttiferae, also from India. It is a powerful astringent, and is used for 
nasal catarrh, diarrhoeas, dysentery, leucorrhcea, etc. 



MANNA, — is the concrete, saccharine exudation of Fraxinus 
Ornus, or Flowering Ash, a tree of the nat. ord. Oleacese, grow- 
ing in Southern Europe. Manna is produced also by several 
other trees, and substances resembling it are exuded by many 
plants. The official Manna occurs in three-edged, flattish pieces, 
brownish-white and glutinous externally, white and crystalline 
internally, odor honey-like, taste sweet, slightly bitter and faintly 
acrid. It contains from 40 to 90 per cent, of Mannit, C 6 H u 6 , or 
Manna-sugar, which does not undergo vinous fermentation, and is 
chemically allied to the alcohols and to glycerin. Manna also 
contains glucose, mucilage, some acrid resin, and a small quantity 
of the fluorescent glucoside Fraxin, C 16 H 18 O 10 . There are no official 
preparations, but Manna itself may be given in doses of Jj-ij. 

Physiological Actio?i and Therapeutics. 

Manna is a mild laxative, with some tendency to produce flatu- 
lence and colic. It is usually combined with other purgatives, as 
Senna, Rhubarb, Magnesia, etc., to disguise the taste and increase 
the effect. It is a constituent of the official Infusum Sennae Com- 
positum. Manna may be eaten by children if of good quality, or 
may be readily dissolved in milk and so administered. 



MARRUBIUM, Horehound, — the leaves and tops of 
Marrubium vulgare, a plant of the nat. ord. Labiatae, native in 
Europe, but naturalized in America. It contains a bitter prin- 
ciple named Marrubiin, also a volatile oil, resin, tannin, lignin, 
etc. There are no official preparations. Dose, 5 ss ~j- 

Physiological Action a?id Therapeutics. 

Horehound in large doses is laxative, diuretic and diaphoretic, 
and in ordinary dosage it is a gentle tonic and stomachic. It is 



MASTICHE — MATICO. 259 

generally used in catarrhal states of the air-passages, over which 
it seems to have a soothing effect, and is much employed in con- 
fectionery as an ingredient in " cough-drops/ ' 



MASTICHE, Mastic, — is a concrete, resinous exudation 
from Pistacia Zentiscus, a tree of the nat. ord. Terebinthaceas, 
growing in the island of Scio. It occurs in globular tears, cov- 
ered with a whitish dust, of weakly resinous odor and slightly 
terebinthinate taste. Alcohol dissolves about 90 per cent, includ- 
ing the resin Mastichic Acid, C 20 H 32 O 3 , the remainder consisting 
of another resin Mastichin, which is soluble in ether and resem- 
bles copal. There are no official preparations, but Mastic is an 
ingredient of the official Pil. Aloes et Mastiches (see ante, page 

56). 

Physiological Action and Therapeutics. 

Mastic was formerly used for supposed properties analogous to 
those of other oleo-resins, but now its application is confined to 
dentistry, being employed as a temporary filling for carious 
teeth, a solution in ether being applied on cotton with moderate 
pressure, and remaining as a firm plug after evaporation of the 
solvent. 

MATICO, — the leaves of Artanthe etongata (Piper angusti* 
folium), a Peruvian shrub of the nat. ord. Piperaceae. They are 
4 to 6 inches long, and prominently venated on the under sur- 
face, the veins forming deep, angular meshes, Matico contains 
a crystallizable acid named Artanthic Acid y also resin, tannin, 
and a volatile oil. Its odor is aromatic, and its taste astringent, 
spicy and somewhat bitter. 

Preparations* 

Extractum Matico Fluidum, — Dose, ^ss-ij. 
Tinctura Matico, — 10 per cent. Dose, gss-ij. 

Physiological Action and Therapeutics. 

Matico is an aromatic tonic and stimulant, also aphrodisiac, 
vulnerary and hemostatic. It acts, like cubebs, on the urinary 
passages, and is an excellent alterative stimulant to mucous mem- 
branes. It has been used with considerable success in mucous 
catarrhs, as gonorrhoea, leucorrhoea, chronic cystitis, etc., also in 
epistaxis, hemorrhoids, menorrhagia, hemoptysis, hematemesis 
and other hemorrhages. The under surface of the leaf is so 
formed as to promote coagulation of blood if applied to a bleed- 



26o MATRICARIA MEL. 

ing surface, and therefore it is a good local hemostatic for trivial 
cuts or wounds. 



MATRICARIA, German Chamomile, — the flower-heads 
of Matricaria Chamomilla, a European annual plant of the nat. 
ord. Compositae. They are small, yellow flowers, with white 
ray-florets, the receptacle being hollow, naked and conical, 
of strongly aromatic odor and bitter taste; and contain ^th 
per cent, of a blue Volatile Oil (the color of which is due to 
Azuleri), also a bitter extractive, tannin, etc. There are no official 
preparations, but the flowers may be eaten or a decoction or in- 
fusion used almost ad libitum. 

Physiological Actio?? and Therapeutics. 

Matricaria is a mild tonic, in large doses emetic, anthelmintic 
and antispasmodic. It is much used in Germany, and in this 
country is a popular domestic remedy among German people, 
who use it in infusion as a diaphoretic, etc. This plant is the 
" Chamomilla " of the homoeopaths, who find in it remarkable 
power over morbid impressionability of the sensory and excito- 
motor nerves, and administer it in various pains, aggravated at 
night and by warmth, clonic spasms of pregnancy, irritability of 
teething-children, flatulent colic, etc. 



MEL, Honey, — is a saccharine secretion deposited in the 
honey-comb by Apis ??iellifica, the honey-bee ; occurring as a 
pale-yellowish, syrupy liquid, gradually becoming crystalline and 
opaque, of peculiar and heavy odor, and a very sweet, faintly 
acrid taste. It is a strong aqueous solution of several sugars 
(cane and grape sugar, levulose), with wax-pollen, coloring and 
odorous matters, etc. The sugars, which may be resolved into 
Levulose and Dextrose, amount to 70 or 80 per cent. Honey is 
frequently adulterated with starch and artificial glucose, which 
may be detected by the official tests (see U. S. Phar.). Dose, in- 
definite. 

Preparations. 

Mel Despumatum, Clarified Honey, — is honey heated, skimmed and 
strained. It is an ingredient of Confectio Rosse, Mel Rosse, and Massa Ferri 
Carbonatis. Dose, indefinite. 

Mel Ros^e, Honey of Rose, — Red Rose 8, Clarified Honey 92, Diluted 
Alcohol q. s. Dose, indefinite ; generally used as a local application to the 
throat for its astringency and flavor, in combination with more active agents. 



MELISSA — MENISPERMUM. 26 1 

Physiological Action and Therapeutics. 

Honey is emollient, nutritive and laxative, in some persons 
giving rise to pyrosis, flatulence and colic, and in others to an 
eruption of urticaria, but generally constituting an agreeable 
article of diet. It is sometimes actually poisonous from the pres- 
ence of toxic agents extracted by the bee from certain plants, in 
this country generally the Mountain Laurel {Kalmia Latifolid). 
Honey is chiefly used as an emollient in diseases of the throat, 
to relieve dryness, pain, cough and dysphagia. A mixture of 
Honey 8 parts to 1 each of Acetic Acid and Water is official in 
the Br. Phar. under the title Oxymel, and forms a pleasant addi- 
tion to gargles or a vehicle for expectorant medicines. Honey 
of Rose is somewhat astringent, and is used in gargles for the 
throat and in mouth-washes. 



MELISSA, Balm, — the leaves and tops oi Melissa officina- 
lis, a European plant of the nat. ord. Labiatse, growing also in 
America. It has a perennial root, which annually gives forth 
several stems from 1 to 2 feet high, with leaves about two inches 
long, deeply serrate, hairy and glandular, and white or yellowish 
flowers in axillary whorls of four or five around half the stem. It 
contains gum, tannin, bitter extractive, and a fragrant essential 
oil in very small quantity {yi to ^ per cent.). There are no 
official preparations. 

Physiological Action and Therapeutics. 

Balm has little or no action, except to flavor hot water for use 
as a beverage or a mild diaphoretic. 



MENISPERMUM,— is the rhizome and rootlets of Menu 
spermum canadense, or Canadian Moonseed, a woody, climbing 
plant of the nat. ord. Menispermaceae, native of the eastern U. 
S., having peltate three- to seven-lobed leaves, greenish-yellow 
flowers in small clusters, and a kidney-shaped fruit. The rhi- 
zome is several feet long, % inch thick, finely wrinkled, rootlets 
numerous, taste bitter. It contains starch, Berberine, and a 
white alkaloid which is soluble in alcohol and in ether. There 
are no official preparations. Dose, gr. v-xx, in infusion. 

Physiological Action and Therapeittics. 

Menispermum is reputed to have tonic properties, and is used 
in some of the Southern States in domestic practice as a substi- 



262 MENTHA PIPERITA. 



tute for Sarsaparilla in scrofulous conditions. Little is known 
about it of a definite character. 



MENTHA PIPERITA, Peppermint,— the leaves and 
tops of Mentha piperita, a perennial herbaceous plant, of the nat. 
ord. Labiatae, native of Britain, but largely cultivated elsewhere. 
The leaves are about 2 inches long, ovate-lanceolate, sharply ser- 
rate, of aromatic odor, and pungent, cooling taste. They con- 
tain 1 to 1% per cent, of a Volatile Oil which is official, and a 
little tannin. 

Preparations. 

Oleum Mentha Piperita, Oil of Peppermint, — is the volatile oil dis- 
tilled from the fresh herb ; a colorless or pale yellow fluid of sp. gr. about 
0.900, having the odor of peppermint, a strongly aromatic taste followed by a 
cold sensation when air is drawn into the mouth. It consists of a liquid ter- 
pene, and a stearoptene named Menthot or Peppermint Camphor, C 1Q H 20 O. 
Dose, iflj-v. 

Aqua Mentha Piperita, Peppermint Water, — has of the oil 2 parts in 
1000 of Distilled Water. Dose, indefinite. 

Spiritus Mentha Piperita, Essence of Peppermint, — is an alcoholic 
solution containing 10 per cent, of the Oil and 1 per cent, of the powdered 
herb. Is an ingredient of Mistura Rhei et Sodae. Dose, ti\x-xxx. 

Trochisci Mentha Piperita, Peppermint Troches, — each troche con- 
tains gr. j 1 ^ of the Oil, with Sugar and Mucilage of Tragacanth. Dose, in- 
definite. 

Menthol, Peppermint Camphor, C 10 H 20 O (Unofficial), — is a stearoptene 
deposited by Oil of Peppermint on exposure to cold. Used externally. 

Physiological Action. 

Peppermint is an aromatic stimulant, carminative and anti- 
spasmodic. The oil possesses these qualities in greater degree 
and is also a local anodyne and anaesthetic when applied locally, 
especially if its evaporation be prevented. The Chinese oil is 
particularly anodyne and contains a large quantity of Menthol. 
The oil is best administered internally in its alcoholic solution, 
the spirit. Menthol is antiseptic and locally anaesthetic, but 
not corrosive, and acts also as a vascular stimulant when applied 
to the surface. 

Therapeutics. 

Peppermint is used internally for the relief of nausea and 
colic, and to expel flatus by its local stimulant and after sedative 
action on the bowel. It is an agreeable corrigent for combina- 
tion with purgatives to prevent griping, and efficiently covers the 
taste of many nauseous substances. The spirit is the best form 
for internal use. The oil is used locally to relieve the pain of 



MENTHA VIRIDIS MEZEREUM. 263 

superficial neuralgia, a cloth being wet with it, laid along the 
course of the affected nerve, and covered with oiled silk to re- 
strain evaporation. It is also efficient in rheumatism as an ano- 
dyne counterirritant. Menthol is highly vaunted as an external 
application in various neuralgias, sciatica, pleurodynia, toothache, 
etc. For neuralgia it is used in saturated alcoholic solution 
painted over the affected nerve. For toothache a crystal intro- 
duced into the carious cavity is promptly anodyne. As an anti- 
septic it promises well as an application in parasitic skin-diseases. 
As the Chinese have used their Oil of Peppermint for ages as an 
application in neuralgias, and as this oil contains a large quantity 
of Menthol, the latter preparation will probably prove a very 
efficient agent in these affections if the cupidity of the manu- 
facturers will allow of its being obtained pure. 



MENTHA VIRIDIS, Spearmint,— the leaves and tops 
of Mentha viridis, the " mint " of the kitchen garden, a plant of 
the nat. ord. Labiatae, indigenous to England, but naturalized in 
many countries. Its constituents and properties are identical 
with those of Peppermint, but its odor and taste differ therefrom. 

Pi-eparations. 

Oleum Mentha Viridis, Oil of Spearmint, — is the Volatile Oil distilled 
from the plant. Dose, tit. ij-v. 

Aqua Mentha Viridis, Spearmint Water, — has 2 parts of the Oil in 1000 
of Distilled Water. Dose, indefinite. 

Spiritus Mentha Viridis, Essence of Spearmint, — is an alcoholic solu- 
tion containing 10 per cent, of the Oil and 1 per cent, of the powdered herb. 
Dose, ""Ix-xl. 

Physiological Action and Therapeutics, 

Spearmint corresponds in action to Peppermint, but is gener- 
ally less powerful. It is usefully employed to correct flatulence 
and to relieve colic, and makes an agreeable flavoring for many 
mixtures. 



MEZEREUM, Mezereon, — is the bark of Daphne Meze- 
reum and of other species of Daphne, plants of the nat. ord. 
Thymelaceae, growing in mountainous districts of Europe and 
Asia, and cultivated as a garden shrub in Britain. The bark 
occurs in long, thin bands, rolled into disks, brownish-yellow on 
the surface, whitish and silky within, inodorous, very acrid. It 
contains an inert, fixed oil, an inactive glucoside Daphnin, and 



264 MORRHUiE OLEUM. 

an acrid Resin, which is the anhydride of a resinous acid named 
Mczerei7iic Acid. Mezereum is an ingredient of the compound 
decoction and the compound fluid extract of Sarsaparilla. Dose, 
gr. j-x. 

Preparations. 

Extractum Mezerei, — is only used to prepare the Linimentum Sinapis 
Compositum. 

Extractum Mezerei Fluidum, — is too acrid for internal use, but from it 
is prepared the following. 

Unguentum Mezerei, — has of the preceding 25 parts, Lard 80, Yellow 
Wax 12. An irritant ointment. 

Physiological Action, 

Mezereon is a sialagogue, and an intensely acrid, irritant 
poison, producing violent vomiting, purging, nephritis and gastro- 
enteritis. In small doses it is laxative and diuretic, and has had 
considerable reputation as an alterative. Externally the recent 
bark is a powerful local irritant, speedily producing vesication. 

Therapeutics. 

Mezereon is rarely used internally by itself, but is employed in 
mixtures with Sarsaparilla, etc., as an alterative in syphilis, rheu- 
matism and some skin diseases of chronic type, but with doubtful 
efficacy. It has been used with good effect in toothache and as 
a masticatory in paralysis of the tongue. Its principal use is as 
a local irritant to keep up the discharge from issues or blisters, 
and to stimulate indolent ulcers. 



MORRHUiE OLEUM, Cod-liver Oil— is a fixed oil 
obtained from the fresh livers of Gadus Morrhua (Cod-fish) or 
of other species of Gadus. It is a colorless or pale yellow, thin, 
oily liquid, of slightly fishy odor and taste, and faintly acid 
reaction, soluble in ether; sp. gr. 0.920 to 0.925. . It consists 
chiefly of Olein and Margarin, with a peculiar principle named 
Gaduin, also Trimethylamine, free fatty Acids (oleic, palmitic, 
stearic), traces of Iodine, Bromine, Sulphuric and Phosphoric 
Acids, the ordinary inorganic salts of animal tissues and products, 
and perhaps bile constituents. When saponified it does not yield 
Glycerin but Oxide of Propyl. Three kinds or varieties are 
found in the market, the pale, the light brown and the dark. 
The pale is the official oil and the purest. Dose, 3J~iJ> on a m ^ 
stomach, increased as assimilated. 



MORRHILE OLEUM. 265 

Unofficial Preparation. 

Glyconin Emulsion of Cod-liver Oil, — Ol. Morrhuse gtv, Glyceritum 
Vitelli ^ix, Aromatic Spirit of Ammonia gj, Sherry Wine !|ij, Diluted Phos- 
phoric Acid ^iv, Essence of Bitter Almond (^j of the Volatile Oil in Oss 
Alcohol) gij. The Cod-liver Oil is to be added to the Glyconin very slowly 
with brisk stirring, and the other ingredients added in the order named. 

Physiological Action, 

The action of Cod-liver Oil is that of any other fat, except 
that it is more easily assimilated than any member of the class. 
Fats in small quantity are necessary for the digestion of nitro- 
genous food, and form the molecular basis of the chyle, being 
prepared for absorption by the pancreatic juice and the bile, 
especially by the latter. Fat is an essential constituent of the 
products of tissue formation, whether physiological or pathologi- 
cal, and is the principal material concerned in the production of 
force. After oxidation it is excreted as carbonic acid and water. 
Locally applied fats reduce the body temperature. 

Cod-liver Oil is the most easily digestible of fats, penetrating 
animal membranes with comparative ease after being emulsified 
by the pancreatic and biliary secretions, hence entering the lacteal 
vessels readily and appearing to bring with it the oily and nitro- 
genous elements of the food. The result is facilitation of the 
digestive process, increase of the red blood-corpuscles and of the 
body-weight, and stimulation of healthy cell-formation through- 
out the tissues. The properties of this oil have been ascribed to 
its contained biliary constituents, Iodine, free Oleic Acid, etc., 
but no satisfactory explanation has yet been offered for the differ- 
ence between its action and that of other animal or vegetable oils. 

Therapeutics, 

The use of Cod-liver Oil is that of a nutrient wholly, this ac- 
tion being most marked in wasting diseases. In high febrile 
states or catarrhal conditions of the gastro-intestinal tract its use 
is contraindicated, but in phthisis a slight degree of fever will 
not interfere with its beneficial employment. It is found to be 
of most value in chronic forms of phthisis, chronic bronchitis and 
emphysema, chronic rheumatic disorders, atheroma of the arteries, 
strumous skin diseases and diarrhoea, syphilodermata, neuralgia, 
chorea and epilepsy. In many disorders referable to exhaustion 
or debility of the nervous centres it is of great value as a nerve 
tonic, and in convalescence from acute diseases it is of marked 
benefit. It should always be considered as a supplementary food, 



266 MOSCHUS. 

and if its use endangers the appetite for other food it should be 
abandoned. 

The administration of this valuable agent is a serious matter, as 
many patients cannot overcome their repugnance to its taste and 
smell. Various emulsions are on the market, but they are objec- 
tionable because in no case do they conceal the taste, and the 
efficacy of the oil is seriously impaired by the processes used in 
their preparation. Moreover, the temptation is very great to 
employ an inferior grade of the oil or to adulterate it with other 
fish-oils in the manufacture of these preparations, and when the 
commercial spirit of gain is remembered one can never be sure 
of the quality of the oil so prepared. The oil itself is the best 
form for use, in small doses, say a teaspoon ful thrice daily for an 
adult, after meals, in black coffee, beer or lemon-juice. The 
essential Oil of Eucalyptus in the proportion of i part to ioo of 
cod-liver oil will effectually extinguish the odor and taste to 
many persons. Alkaline stomachics given before meals, the oil 
after, and a teaspoonful of the "Liquor Pancreaticus ' ' given 
half an hour afterwards, would be a good routine in most cases, 
the latter agent preventing the fishy eructations which often give 
so much trouble. Extemporaneous emulsions may be prepared 
with Glycerite of Yolk of Egg (see ante, page 265), White of Egg, 
Mucilage of Tragacanth, Extract of Malt, or any syrup, and 
flavored with Lemon, Cinnamon or Bitter Almond. The addi- 
tion of miv of Ether to each 3 of the oil promotes its digestion 
by stimulating the pancreatic secretion, and enables a patient to 
take it with whom it had previously disagreed. 

Inunction by Cod-liver Oil is a method of value in the wasting 
diseases of children. A tablespoonful may be rubbed into the 
skin of the abdomen twice a day, and covered with a flannel 
binder with oiled silk or mackintosh-cloth outside. It readily 
passes through the skin and is absorbed, producing valuable and 
lasting results. 



MOSCHUS, Musk, — is the dried secretion from the pre- 
putial follicles of Moschus moschiferus (the Musk Deer), an ani- 
mal inhabiting the mountainous regions of Central Asia. It 
occurs in irregular, unctuous grains, of a reddish-brown color, 
peculiar and penetrating odor and bitterish taste, contained in 
oval sacs about 2 inches in diameter, membranous on one side, 
hairy on the other. About 10 per cent, is soluble in alcohol, 50 
per cent, in water. Chinese Musk in the pods or sacs is the 
most valuable, but all varieties are much adulterated, the price of 



MYRCLE OLEUM. 267 

the drug being very high. The odor is destroyed by drying, but 
returns again on the addition of moisture. Trituration with 
Camphor or Hydrocyanic Acid also destroys it. The odorous 
principle has not been isolated, it is probably a product of de- 
composition which is constantly being formed. The constituents 
of Musk are a bitter resinous substance, ammonia, fat, choles- 
terin, etc. Dose, gr. ij-x. 

Preparation. 
Tinctura Moschi, — io per cent. Dose, ^ss-^jss. 

Physiological Action and TJierapeutics. 

Musk is a very diffusible stimulant, acting directly on the 
nervous and circulatory systems, but without much energy. It is 
also an antispasmodic, and is used with benefit in general prostra- 
tion of the system with nervous agitation or irregular muscular 
action. It has been used with advantage in laryngismus stridulus, 
insomnia, the collapse of typhoid and typhus fevers, spasmodic 
affections of the stomach, obstinate hiccough and convulsions of 
children due to intestinal spasms. The pure Musk is very diffi- 
cult to obtain, and its high price makes it an extremely expensive 
medicine, so that it is seldom used except as a perfume. 



MYRCIA OLEUM, Oil of Myrcia, Oil of Bay,— 

is a volatile oil distilled from the leaves of Myrcia acris, or Bay- 
berry, a tree of the nat. ord. Myrtaceae, native of the West Indian 
Islands. It is a dark-brown liquid, of aromatic odor, pungent 
taste, slightly acid reaction, and soluble in an equal weight of 
alcohol. Sp. gr. about 1.040. It contains a hydrocarbon and 
Eugenic Acid. Used as a perfume. 

Preparation. 

Spiritus Myrci.£. Spirit of Myrciae, Bay Rum, — contains in 1800 parts 
Oil of Myrcia 16, Oil of Orange-peel I, Oil of Pimento 1, Alcohol 1000, 
Water 782 parts, filtered through Carbonate of Magnesium. Used as a wash 
or perfume. 

Physiological Action and Therapeutics, 

The Oil of Bay is an agreeable perfume used to prepare bay- 
rum and in other cosmetic preparations. The spirit, known as 
"Bay-rum," is used principally as a refreshing perfume, and is 
thought to relieve headache, faintness, etc., by application to the 
forehead or to the nostrils. 



268 MYRISTICA. 

MYRISTICA, Nutmeg,— is the kernel of the seed of 
Myristica fragrans deprived of its testa. The nutmeg tree is 
cultivated extensively in the East and West India Islands, belongs 
to the nat. ord. Myristicaceae, and is a native of the Banda 
Islands in the Malayan Archipelago, The Nutmeg is about an 
inch long, oval or roundish-ovate, recticulately furrowed, inter- 
nally pale-brown or grayish-red with dark-brown veins, having a 
strongly aromatic odor and a somewhat bitter taste. It contains 
4 to 9 per cent, of the official Volatile Oil, and 30 per cent, of a 
concrete oil, commonly called "Oil of Mace," which is a com- 
pound of fluid glycerides of Oleic and Butyric Acids, and the 
solid glyceride of Myristic Acid, some resin and volatile oil. 
Dose, gr. v-xx. 

Macis, Mace, — is the arillus or fleshy covering of the fruit of 
Myristica fragrans ', the Nutmeg-tree. It occurs in narrow bands 
about an inch long, branched and lobed, of brownish-orange 
color, fragrant odor, warm and aromatic taste. It yields a fixed 
oil by pressure and a volatile oil by distillation, the latter being 
probably identical with Oil of Nutmeg. 

Prepai-ations. 

Oleum Myristica, Oil of Nutmeg, — is the volatile oil, and consists 
chiefly of a terpene and an oxygenated oil Myristicol. It is colorless or pale- 
yellow, of hot, spicy taste and neutral reaction, and is soluble in alcohol. 
Dose, ttij-v. 

Spiritus Myristica, Spirit or Essence of Nutmeg, — is a 3 per cent, solu- 
tion of the oil in alcohol. Dose, jjj-ij. 

Nutmeg is an ingredient of Acetum Opii, Pulvis Aromaticus, Tr. Lavan- 
dulae Co., Syr. Rhei Aromat., Trochisci Cretae, Trochisci Magnesias and 
Trochisci Sodii Bicarbonatis. 

Physiological Action and Therapeutics. 

Nutmeg is an aromatic stomachic of agreeable flavor. In small 
doses it stimulates the production of gastric juice," and thus pro- 
motes digestion and increases appetite. It also relieves intestinal 
spasm and flatulence. In large doses it is powerfully narcotic, 
acting directly on the cerebrum, and producing stupor and de- 
lirium. It is used chiefly for flavoring purposes, and generally in 
substance, grated as required, but has been employed as a car- 
minative, anodyne and astringent in diarrhoeas and dysentery, as 
well as to relieve nausea and vomiting. The Volatile Oil is 
decidedly rubefacient when used externally, and has narcotic 
powers if used internally in sufficient quantity. It is occasionally 
employed as an external stimulant in paralysis and chronic rheu- 
matism. 



MYRRHA — NAPHTHALIN. 269 

Mace is stimulant, carminative and aromatic. It is used 
solely as a spice or condiment. Dose, gr. v-xx. 



MYRRHA, Myrrh, — is a gum resin obtained from Bal- 
samodendron Myrrha, an Arabian tree of the nat. ord. Bursera- 
ceae, collecting spontaneously upon the bark, and occurring in 
roundish tears, having a waxy fracture, a balsamic odor, and an 
acrid and bitter taste. Triturated with water it yields a brownish- 
yellow emulsion ; with alcohol it yields a brownish-yellow tincture 
which turns purple on the addition of nitric acid. It contains 
60 per cent, of gum, 35 per cent, of Myrrhin a resin, and about 
2 per cent, of an oxygenated ethereal oil Myrrhol, C 10 H n O. 
Dose, gr. x-xxx. 

Preparations, 

Tinctura Myrrhs, — 20 per cent. Dose, nt x-xxx. 

Myrrh is also contained in Mist. Ferri Co., Pil. Aloes et Myrrhse, Pil. Ferri 
Co., Pil. Galbani Co., Pil. Rhei Co., and Tr. Aloes et Myrrhse. 

Physiological Action and Therapeutics. 

Myrrh in small doses stimulates the gastro-intestinal mucous 
membrane ; in large doses it is an irritant thereunto, producing 
vomiting and purging. It quickens the action of the heart and 
diminishes the bronchial secretion. It is a uterine stimulant 
and emmenagogue, a stimulant expectorant, and is thought to 
increase the number of leucocytes in the blood. Locally it is 
stimulant and disinfectant to mucous membranes and ulcerated 
surfaces. 

Myrrh is used internally in the various combinations noted 
above for anaemia and amenorrhcea, bronchial catarrh, etc. It has 
been supposed to diminish excessive secretion from the mucous 
surfaces of the uterus, vagina, bladder, and bronchi, and to have 
an especially beneficial influence on chronic pharyngitis. Lo- 
cally, the tincture has a good tonic action on diseased mucous 
surfaces, and is applied to spongy gums, relaxed throat, aphthous 
patches and unhealthy ulcers. The tincture diluted with water 
makes an excellent disinfectant and stimulant gargle in ulcerated 
sore-throat. Myrrh has long been used as an ingredient of den- 
tifrices. 



NAPHTHALIN, C 10 H 8 (Unofficial),— is one of the many 
products of the distillation of coal-tar, occurring in white crystals, 



2/0 NUX VOMICA. 

fusible at 176 F., and boiling at 423 F., insoluble in water, but 
soluble in alcohol, ether, naphtha, and the oils. Dose, gr. v-5^s, 
in emulsion or syrup, and frequently repeated. 

Physiological Action and Therapeutics. 

Naphthalin is destructive to all low forms of life and hence is 
antiseptic in a high degree. Internally it is a stimulant expecto- 
rant of decided power. As an antiseptic it has been extensively 
used in the form of a fine powder applied to indolent ulcers, 
sloughing wounds, chancres, open cancers, also to fresh wounds 
and for disinfectant purposes in pus cavities. Internally it has 
been administered with decided benefit in impending suffocation 
accompanying the chronic pulmonary catarrh of the aged, in 
humoral asthma, verminous affections, and as an ointment in pso- 
riasis, lepra vulgaris, and other forms of scaly skin diseases. 
Applied as a paint to organic remains it effectually prevents the 
ravages of insects. 



NUX VOMICA, — is the seed of Strychnos Nux-vomica, an 
East India tree of the nat. ord. Loganiacese, having white, fun- 
nel-shaped flowers, and a fruit about the size of an orange, with 
many seeds in a juicy pulp. The seeds are flattened and nearly 
circular, about one inch in diameter, ashy-gray in color, covered 
with short, satiny hairs, internally translucent, tough and horny, 
with a large cavity, inodorous, taste intensely bitter. It contains 
two alkaloids, Strychnine, 0.2 to 0.5 per cent., and Brucine, 0.1 
to 1.0 per cent., with a crystalline acid Igasuric or Strychnic Acid, 
and a yellow coloring matter, a concrete oil, gum, starch, wax, 
earthy phosphates, etc. A third alkaloid, Igasurine, is claimed 
to exist by some authorities and is denied by others. 

Preparations. 

Abstr actum Nucis Vomicae, — Dose, gr. %, gradually increased. 

Extractum Nucis Vomica, — Dose, gr. y%-y 

Extractum Nucis Vomica Fluidum, — Dose, Tnj-v. 

Tinctura Nucis Vomica, — 20 per cent. Dose, ntv-xx. 

Strychnina, Strychnine, C 21 H 22 N 2 2 , — is an alkaloid prepared from Nux 
Vomica, Ignatia, and other plants of the order Loganiacese ; crystalline, in- 
tensely bitter even in 1 to 700,000 solution, of alkaline reaction, soluble in 6 
of chloroform, no of alcohol, 6700 of water, almost insoluble in ether. It is 
a constituent of Ferri et Strychninae Citras, and of Syrupus Ferri, Quininse et 
Strychninae Phosphatum. Dose, gr. -fa— fa. 

Strychnine Sulphas, Sulphate of Strychnine (C 21 H 22 N 2 2 ) 2 H 2 S04.7H 2 0, 
— crystalline, efflorescent, odorless, of intensely bitter taste even in I to 



NUX VOMICA. 271 

700,000 solution, neutral reaction, soluble in 10 of water and 60 of alcohol at 
59 F. Dose, gr. J^V 

Brucina, Brucine, C. 23 H o6 X 2 4 | Inofficial), — colorless prisms, pearly 
flakes, or masses, soluble in water, less so in alcohol ; as compared with 
Strychnine it is less bitter, 1 2 times weaker and 3 times slower physiologically. 
Is thought to be a compound of strychnine and resin, corresponding with the 
other alkaloid both physiologically and therapeutically. Is seldom used. 
Dose, gr. i y-J. 

Phy 'si logical A ction . 

The actions of Xux Vomica are those of its alkaloid Strychnine. 
In small doses, it acts as a bitter tonic, stimulates respiration, 
secretion, appetite and digestion, and sharpens the vision. It 
increases peristalsis, stimulates both the motor and the inhibitory- 
apparatus of the heart, and raises the arterial tension by stimu- 
lating the vaso-motor centres, thus contracting the arterioles, 
though by full doses the arterioles are relaxed. By a full dose 
(Strychnine, gr. y 1 ^, the pupils are dilated, the limbs jerk, respi- 
ration becomes spasmodic and the lower jaw stiff, a sensation of 
cerebral tension, sudden shuddering and anxiety follow, the face 
wearing an unmeaning smile. A toxic dose (Strychnine gr. y 2 
for an adult) on an empty stomach quickly produces heightened 
reflexes ; tonic spasms, especially of the extensor muscles, on the 
least irritation quickly succeed each other with intervals of re- 
pose, resulting after two or three hours at most in death by as- 
phyxia, from tetanic fixation of the muscles of respiration, con- 
sciousness being preserved until carbonic acid narcosis sets in. 

Strychnine exalts all the functions of the spinal cord, — reflex, 
motor, vaso-motor and sensory. — the latter being the least af- 
fected. It has a selective action on the large multipolar ganglia 
in the anterior columns, which it first stimulates and then para- 
lyzes by over-stimulation. A large dose destroys the spinal func- 
tions as by one blow. It does not affect the brain directly. The- 
baine, one of the alkaloids of Opium, is a powerful spinal exaltant 
and acts very similarly to Strychnine. 

From the spasms of tetanus those of Strychnine may be differ- 
entiated by their intermittency, the former being constant. More- 
over, the meaningless smile, the less marked trismus, the absence 
of a wound, and the rapid course of the symptoms, all point to 
the action of Xux vomica. 

The excretion of Strychnine takes place very slowly, and by 
the urinary, salivary and cutaneous channels. Rapidly absorbed 
but very slowly excreted, it accumulates in the system if even a 
small dose be frequently repeated. 

On the eye Strychnine has marked effects, augmenting the ex- 



272 NUX VOMICA. 

citability of the retinal elements, increasing the sharpness of 
vision and enlarging the visual field. 

Antagonists cmd Incompatibles. 

The antidote is Tannic Acid, to form the very insoluble tannate, or a sol- 
uble salt of Iodine. Then emetics or the stomach-pump, followed by perfect 
quiet which is very important. Antagonists are Chloral, Tobacco, Chloro- 
form inhalations or Ether, and Potassium Bromide, the latter being almost too 
slow of action to be of much use in practice. Chamomile oil should antago- 
nize the reflex excitability. The bladder must be frequently evacuated to 
prevent re-absorption of the poison, and artificial respiration maintained as 
necessary. 

Incompatibles are Bromides, Chlorides and Iodides in the same solution, 
the Strychnine being precipitated as hydrobromate, hydriodate, etc. 

Therapeutics. 

Nux Vomica and its chief alkaloid are used as a stomachic 
tonic and as a respiratory, cardiac, muscular and nervous stimu- 
lant. As the quantity of Strychnine in Nux Vomica varies greatly, 
it is best to use the alkaloid when its physiological action is de- 
sired, as more definite dosage may thus be obtained. The tinct- 
ure in 5-drop doses is excellent in atonic dyspepsia and gastric 
catarrh, especially in drunkards, and in constipation from atony 
of the bowels it may be given in 10-drop doses with good re- 
sults, not as a purgative but to increase peristalsis. The extract 
is much used in laxative pills for habitual constipation. In the 
vomiting of pregnancy the tincture is frequently an efficient 
remedy, and in the vomiting of phthisis Strychnine is the very 
best agent. Epidemic diarrhoeas and dysentery are well treated 
by Strychnine, and in anaemia and chlorosis it is invaluable, com- 
bined with Iron and Quinine. In neuralgiae, especially the vis- 
ceral, tetanus of the idiopathic type, cardiac failure from any 
cause, and in intermittents as an adjunct to Quinine, it is always 
a useful drug. Local paralyses of various forms are well treated 
by injecting Strychnine hypodermically into the affected muscles, 
and diphtheritic paralyses are almost invariably cured by it. 
Strychnine is an excellent remedy in hemiplegia when degenera- 
tion has not yet set in, and when the paralyzed muscles are com- 
pletely relaxed ; but is of no avail in recent cases, nor when the 
muscles have lost electrical contractility. In amaurosis from 
lead, tobacco or alcohol, it has proved remarkably useful, and in 
the dyspnoea of pulmonary affections it may be employed with 
benefit as a respiratory stimulant. Strychnine is a physiological 
antagonist to Chloral, Physostigmine and Morphine, and may be 



NYMPH^A ODORATA OLIV^ OLEUM. 273 

carefully administered in poisoning by these substances while the 
ordinary methods are also employed. 

In many eye diseases Strychnine is injected into the tissues 
about the temple with great benefit, especially in amblyopia due 
to functional disorder of the retina without lesions, and in atro- 
phy of the optic nerve. Used in the same manner it is highly 
recommended in infra-orbital neuralgia, and in other neuralgise 
characterized by debility and anaemia. 



NYMPH^A ODORATA, Sweet-scented Water- 
lily (Unofficial), — is a well-known American plant of the nat. ord. 
Nymphaeaceae, the root of which is very bitter and highly astrin- 
gent, containing much Gallic and Tannic Acids, to which its 
actions and uses are due. A decoction of 3j to the pint may be 
used in doses of o ss ~j> or a fluid extract in doses of 3ss-j. For 
the physiological actions and therapeutics of this vegetable astrin- 
gent see Tannic Acid, ante, page 38. 



OLIVJE OLEUM, Olive Oil, Sweet Oil, Salad Oil,— 

is a fixed oil expressed from the ripe fruit of Olea ewopcea, the 
Olive tree (nat. ord. Oleaceae), which is cultivated in southern 
Europe, California and Australia. It is a pale-yellow or greenish- 
yellow, oily liquid, of nutty, oleaginous taste, and neutral re- 
action, sparingly soluble in alcohol but readily soluble in ether. 
Sp. gr. about 0.916. 

Olive Oil consists of 72 per cent, of Olein (a fluid oil) and 28 per cent, of 
Palmitin (a solid oil or stearoptene), which are compounds of the base 
Glyceryl, C 3 H 5 , with Oleic Acid, C 19 H 34 2 , and Palmitic Acid, C 17 H 31 2 , re- 
spectively. It is frequently adulterated with cheaper fixed oils, especially 
poppy oil, lard oil, and cotton-seed oil, quantities of the latter being exported 
every year to Italy, whence it is returned to us as Olive Oil under a French 
label. (See Gossypium, ante, page 206.) It is an ingredient of Ceratum 
Camphorse, Ceratum Cetacei, Emplastrum Plumbi and Unguentum Diachylon, 
and is the source of the official Soap. Dose, ^ss-j. 

Physiological Action and Therapeutics, 

Externally used Olive Oil is a good protective from the air, 
and renders the skin soft and flexible. If rubbed into the integu- 
ment it is absorbed by the lymphatics and is directly nutritive in 
effect. Internally it is also nutritious and mildly laxative, and in 
quantity acts as a protective of the mucous membrane against acrid 
or poisonous substances. Like other oils it is partly emulsified, 

23 



274 OPIUM. 

partly saponified in the intestines, its glycerin being set free and 
its fatty acids combining with free alkalies to form soap, which 
with the emulsion forms the molecular basis of the chyle, enter- 
ing the blood through the lacteals and being finally oxidized into 
carbonic acid and water, though an excess will appear unchanged 
in the urine. Oils are therefore a food within certain limits, in- 
crease the fat of the tissues, furnish force, and save the waste of 
nitrogenous tissue, but are unable of themselves to support life. 

Therapeutics. 

Olive Oil possesses no very marked therapeutic power above 
any other bland oil or fat. It is a good laxative for infants ad- 
ministered internally, and may be used as an enema followed by 
warm water. Its chief employment is as a local application. 
Applied to burns and acute inflammations of the skin it is an ex- 
cellent protective, coating the surface and excluding the air ; and 
as an ingredient of liniments it acts as a diluent for more active 
agents. It is used to facilitate friction over enlarged or stiff 
joints, and in the desquamative stage of scarlet fever is a very 
useful and grateful application. As an antidote in corrosive poi- 
soning it acts mechanically by protecting the mucous membrane 
of the stomach and preventing absorption. In pharmacy its 
bland, unirritating qualities have procured its common employ- 
ment as an ingredient of liniments, plasters, ointments and 
cerates, but the foreign article is so frequently adulterated with 
inferior oils that Cotton-seed Oil is now directed in its place in 
many official preparations. 



OPIUM, — is the concrete, milky exudation, obtained in Asia 
Minor by incising the unripe capsules of the White Poppy, Pa- 
paver somniferum, an annual herb of the nat. ord. Papaveraceae, 
indigenous to Western Asia but cultivated extensively elsewhere. 
Its capsules are globular, two or three inches in diameter, and are 
crowned by a sessile, stellate stigma, which distinguishes them 
from Colocynth and Bael fruits. Opium occurs in irregular 
lumps or cakes, of dark- brown color, sharp, narcotic odor, and 
bitter taste ; and in its normal, moist condition should yield not 
less than 9 per cent, of Morphine when assayed by the process 
official in the Pharmacopoeia. 

Composition of Opium. 

Opium contains 17 alkaloids, 2 neutral substances and 2 organic 
acids, together with sugar, gum, resin, pectin, extractives, odor- 



OPIUM. 2/5 

ous principles, water and other constituents of plants. Its most 
important alkaloids are the following : 

Morphine, C 17 H 19 N0 3 , 5 to 20 per cent , — the principal alkaloid, occurs 
ring in the drug in the form of the tribasic meconate. Its properties are ano- 
dyne, hypnotic and narcotic. From it by a process of dehydration by heat 
and hydrochloric acid is prepared the artificial alkaloid Apomorphine, a 
powerful emetic. (See ante, page 74.) 

Codeine, C 18 H 21 N0 3 , 0.3 to 0.5 per cent., — is calmative and when pure a 
not very active alkaloid, but is frequently contaminated with other alkaloids. 
Apomorphine may be prepared also from it. 

Narcotine, C 22 H 23 N0 7 , 2 to 10 per cent., — is antiperiodic and a tetanizer, 
but wholly devoid of narcotic properties. 

Thebaine or Paramorphine, C 19 H 21 N0 3 , 0.15 to 0.20 per cent., — is a power- 
ful spinal exaltant and tetanizer, resembling Strychnine in its action. 

Narceine, C 23 H 29 N0 9 , 0.02 per cent., — closely resembles Morphine in 
action, but is probably more hypnotic, and is not followed by many of the 
disagreeable after-effects of Morphine. It is extremely difficult to obtain this 
alkaloid pure. 

Papaverine, C 21 H 21 NO^, i per cent., — is reported inert on man by some 
observers, a narcotic and convulsant by others. 

Other Alkaloids at present acknowledged are — Cryptopine, Pseudomor- 
phine, Protopine, Hydrocotarnine, Laudanine, Codamine, Rhceadine, Meconi- 
dine, Laudanosine, Lanthopine and Gnoscopine. Many of them are probably 
to be regarded as derivatives from Morphine. 

Besides the above-named alkaloids the most important of the 
constituents of Opium are the following acids and neutral princi- 
ples, viz. : 

ACIDS are — Meconic Acid, C 7 H 4 7 , 4 per cent., and Lactic Acid, C 3 H 6 3 , I J 
per cent., which exist in combination with the alkaloids as meconates, bime- 
conates, etc. The second acid is generally called Thebolactic, but has been 
recently shown to be identical with lactic acid. 

Neutral Principles are — Meconin, C 10 H 10 O 4 , 0.01 per cent., white, crys- 
talline, neutral, but very acrid ; Meconoiosin, C 8 H 10 O 2 , also crystalline, and 
Porphyroxin, which is now said not to be a proximate principle but a very 
complex combination of several alkaloids. 

Smyrna, Turkey or Levant Opium is the best grade. Con- 
stantinople Opium is of uncertain quality, while of the other 
varieties in the market Egyptian, Persian and Indian samples are 
those most frequently met with. All varieties are more or less 
adulterated with fruits and leaves of other plants, starch, pitch, 
clay, wax, gum, liquorice, etc. 

Preparations of Opium. 

Pulvis Opii, Powdered Opium, — is Opium dried at a temperature not ex- 
ceeding 185 F., and reduced to a moderately rine powder. It should contain 
not less than 12 nor more than 16 per cent, of Morphine when assayed by the 
official process. Dose,gr. ss-iij,an average adult dose being about one grain. 



276 OPIUM. 

Opium Denarcotisatum, Denarcotized Opium, — is powdered Opium freed 
from the constituents which are soluble in ether, namely — the odorous matters 
and Narcotine, which are supposed to cause the unpleasant after-effects of 
Opium. It should yield 14 per cent, of Morphine, and therefore is by no 
means " denarcotized," but is a good preparation, being a purified Opium 
having a fixed Morphine standard. Dose, gr. ss-iij, an average adult dose 
being about one grain. The proprietary article named Svapnia is a similar 
preparation. 

Extractum Opii, — an aqueous extract containing Glycerin to keep it soft, 
and freed from some disturbing principles which are insoluble in water. Dose, 

Pilule Opii, — each pill contains gr. j of powdered Opium with gr. y A of 
Soap. Dose, j-iij. 

Tinctura Opii, Laudanum, — Opium-strength 10 per cent., average Mor- 
phine-strength gr. vj, equalling gr. vijss of the Sulphate to the fl^. Titxj (gtt. 
xxij ) '= gr. j of Opium or gr. J/£ of Morphine Sulphate. Sixty minims yield on 
the average 120 drops. Dose, TUv-xx as per effect required. 

Tinctura Opii Deodorata, Deodorized Tincture of Opium, — an aqueous 
extract shaken with ether, which being separated the residue is dissolved in 
water, and enough alcohol is added to preserve it. An excellent liquid prepa- 
ration, being freed from all the noxious and useless ingredients soluble in 
alcohol and ether. McMunn's Elixir is a similar preparation, so also is a 
recent nostrum named Papine. Opium-strength 10 per cent., average Mor- 
phine-strength gr. vj to the fl^. Dose, as Tinct. Opii. Drops of this prepa- 
ration nearly equal minims. 

Vinum Opii, Wine of Opium, Sydenham's Laudanum, — Opium-strength 10 
per cent., with the aromatics Cinnamon and Cloves of each 1 per cent., in 
Stronger White Wine. A vinous tincture decreased somewhat in strength 
from the wine of 1870. Dose, as Tinct. Opii. Drops of this preparation are 
larger than those of the tincture. 

Acetum Opii, Vinegar of Opium, Black Drop, — Opium-strength 10 per 
cent., with Nutmeg and Sugar in Dilute Acetic Acid. Is now y^ weaker 
than formerly, having the same strength and dose as Tinct. Opii. 

Tinctura Opii Camphorata, Camphorated Tincture, Paregoric, — has of 
Powdered Opium 4, Benzoic Acid 4, Camphor 4, Oil of Anise 4, Glycerin 40, 
Diluted Alcohol q. s. ad 1000 parts, gss contains nearly one grain of pow- 
dered Opium, Dose, for an infant gtt. v-xx, for an adult gj-iv. 

[Note. — According to the U. S. Pharmacopoeia of 1880 the official dried 
Opium should contain 12 to 16 per cent, of Morphine instead of 10 per cent, 
as required by the Pharmacopoeia of 1870. The liquid preparations, except 
Paregoric, are now directed to be of the uniform Opium-strength of 10 per 
cent, by weight, making the Wine less strong by 2 per cent., the Acetum fully 
y^ less in strength, and the other liquid preparations stronger by % m Mor- 
phine than formerly. So that if the full anodyne dose of Tincture or Deo- 
dorized Tincture be taken at 24 minims, equalling gr. % of Morphine Sulphate, 
the corresponding dose under the new system will be 16 minims.] 

Liquor Opii Compositus, Compound Solution of Opium (Squibb), Unoffi- 
cial, — has the same strength as the official tinctures, namely gr. vj of Morphine, 
equalling gr. vijss of the Sulphate to each fluidounce. tttxvj = gr. j£ of Mor- 
phine Sulphate. 

Tinctura Opii Composita, Squibb's Diarrhoea Mixture (Unofficial),— has 
of Tinct. Opii, Spt. Camphorae and Tinct. Capsici 5J of each, Purified Chlo- 
roform ^iij, Stronger Alcohol q. s. ad gv. Each fl^ or teaspoonful contains 



OPIUM. 277 

about 100 drops or nixij of each of the first three ingredients and lUivss or 
18 drops of Chloroform. Dose, for infants gtt. j-x, for children gtt. x-xxx, for 
adults 3J. 

Emplastrum Opii, — Extract of Opium 6, Burgundy Pitch 18, Lead Plaster 
76 parts. 

Pulvis Ipecacuanha et Opii, Dover's Powder, — Ipecac 10, Powdered 
Opium 10, Sugar of Milk 80, triturated to a fine powder. Dose, gr. v-xv, ten 
grains equalling one grain each of Ipecac and Opium. 

Tinctura Ipecacuanha et Opii,— Deodorized Tincture of Opium 100 
parts evaporated to 85, Fluid Extract of Ipecac 10, Diluted Alcohol q. s. ad 
100. Intended to represent Dover's Powder in a liquid form. Dose, v\ v-xv. 

Trochisci Glycyrrhiza et Opii, — each troche contains Extract of Opium 
gr. ^y, with Extract of Liquorice, Acacia, Sugar and Oil of Anise. Dose, j-iv. 

Alkaloids and their Preparations. 

Morphina, Morphine, C 1? H 19 N0 3 .H ? 0, — white, prismatic crystals or a 
crystalline powder, odorless, of bitter taste and alkaline reaction, almost in- 
soluble in water, soluble in 100 of alcohol. Its comparative insolubility 
makes the salts preferable for use, and as a very small proportion of acid neu- 
tralizes it, the dosage is about the same for the alkaloid .and its salts, viz., 
gr. 2V~S r - J- Gr. %- l /6 is about equal to one grain of Opium of medium 
Morphine-strength. [Compare Morphina Sulphas, below.] 

Morphina Acetas, Acetate of Morphine, — a white, crystalline or amor- 
phous powder, of faintly acetous odor, bitter taste, neutral or faintly alkaline 
reaction, soluble when fresh in 12 of water and in 68 of alcohol at 59 F. 
Dose, gr. ^j. 

Morphina Hydrochloras, Hydrochlorate of Morphine, — white, feathery 
crystals of silky lustre, of bitter taste and neutral reaction, soluble in 24 of 
water and in 63 of alcohol at 59 F. Dose, gr. ■}■$-]. 

Morphina Sulphas, Sulphate of Morphine, — white, feathery, acicular 
crystals of silky lustre, of bitter taste and neutral reaction, soluble in 24 of 
water and in 702 of alcohol at 59 F., and in 0.75 of boiling water. Con- 
tains about 80 per cent, of Morphine. Dose, gr. -^jj-gv. j ; -gV"/^ being a 
small dose for an adult, %-]£ a moderate one, %-% a full dose, and ^-j a 
large one. 

Pulvis Morphina Compositus, Tully's Powder, — has of Morphine Sul- 
phate 1 part to 20 each of Camphor, Liquorice and Calcium Carbonate. A 
similar preparation to Dover's Powder minus the Ipecac. Dose, gr. v-xv, 
ten grains containing gr. y$ of Morphine Sulphate. 

Trochisci Morphina et Ipecacuanha, — each troche contains gr. ^ of 
Morphine Sulphate with about gr. -j\ of Ipecac, also Sugar, Oil of Gaultheria 
and Mucilage of Tragacanth. Dose, one every hour or so, cautiouslywith 
children. 

Liquor Morphina Sulphatis, Magendie's Solution (Unofficial), — has 
gr. xvj of Morphine Sulphate in each fig, or gr. j in ttixxx, or gr. %. in 
TUvijss. 

Oleatum Morphina, Oleate of Morphine (Unofficial), — Morphine- 
strength 10 per cent, with Oleic Acid 90. For local use. 

Codeina, Codeine, C 18 H 21 N0 3 .H 2 0,— white or yellowish-white, rhombic 
prisms, efflorescent in warm air, of bitter taste and alkaline reaction, soluble 
in 80 of water at 59 F. and in 17 of boiling water, very soluble in alcohol, 
chloroform and ether. This alkaloid is official. Dose, gr. ss-ij, but gr. yi has 
caused alarming symptoms in children. 



278 OPIUM. 

Narcotine Hydrochloras, Hydrochlorate of Narcotine (Unofficial), 

Dose, gr. ij-x, as an antiperiodic. 

The Tincture of Opium is an ingredient of Mistura Magnesise et Asafcetidse, 
and the Camphorated Tincture is an ingredient of Mistura Glycyrrhizse Com- 
posita. (See ante, pages 253, 205.) 

Children bear Opium badly, and for them its proportionate 
dosage should be much below that for other agents. Morphine 
should not be given to children below 10 years of age, and never 
hypodermically to those beneath the age of 15. Opium given 
to a nursing mother will affect the child, being partly excreted 
in the milk. 

Reactions and Incompatibles. 

An aqueous or alcoholic preparation of Opium reddens litmus paper (free 
meconic acid); — gives a deep red color with Perchloride of Iron (meconic 
acid); — forms precipitates with Acetate and Subacetate of Lead, Nitrate of 
Silver, Zinc, Copper, and Arsenic (meconates, sulphates and coloring matter) ; 
— forms a precipitate with tincture of Galls or astringent preparations (tan- 
nates of morphine and codeine); — and becomes turbid with the fixed Alka- 
lies, Carbonates, Alkaline Earths, and Ammonia (precipitated morphine and 
narcotine). 

Tests for Morphine, 

Nitric Acid produces a blood-red, turning orange, then yellow, then disap- 
pearing. Test-solution of Ferric Chloride gives a blue color changing to 
green with excess of the reagent, and destroyed by free acids or alcohol, but 
not by alkalies. Iodic Acid liberates Iodine which may be tested by starch. 

Physiological Action. 

Opium is analgesic, hypnotic, antispasmodic, diaphoretic and 
narcotic. It first stimulates then depresses the cerebrum, heart 
and respiratory apparatus, and is classed among the cerebral 
depressants. 

In medium dose (gr. j) it arrests all the secretions except the 
milk and sweat, the latter being increased ; producing dryness of 
the mouth and throat, retarded digestion from stoppage of the 
gastric juice, and decided loss of appetite. The action of the 
heart is increased, arterial tension raised and the pupils slightly 
contracted. The cerebral faculties are stimulated by increased 
blood-supply to a pleasant activity, ideas follow each other rapidly 
through the mind, and an exhilaration bordering on mild intoxi- 
cation is experienced, succeeded by a calm of variable length. 
Sleep generally follows, disturbed, however, by dreams, and after 
waking headache, malaise, constipation, digestive disturbance 
and some depression result. The conductivity of the nerves is 
not affected. Frequently the stage of mental activity is absent, 
but in persons habituated to the use of Opium it is usually well 



OPIUM. 279 

marked. In some subjects a lengthened period of calm repose 
takes the place of sleep, in others neither calm nor sleep occurs, 
but the stimulant action of the drug prevails, the spinal func- 
tions as well as the cerebral are exalted, and great restlessness is 
the result. 

In full dose (gr. iij-v) the same symptoms are produced but in 
greater intensity; the stage of stimulation is much shorter, 
digestion is arrested, nausea and vomiting produced, also profuse 
diaphoresis. The conductivity of the nerves is more or less 
impaired, the heart and circulation depressed, oxidation being 
interfered with and the body-temperature lowered. The pupils 
are contracted by stimulation of the motor oculi through the 
basal ganglia, intense pruritus is produced especially at the nose, 
and often spasmodic retention of the urine. Profound sopor 
soon comes on, with irregular and slow respiration, but in some 
subjects this is replaced by coma-vigil and delirium. After- 
effects are nausea, depression, constipation, racking headache, 
vertigo, anorexia, nasal pruritus and fetid pathological secretions. 

A toxic dose produces cold and clammy sweat, very slow pulse, 
slow and stertorous respiration gradually becoming feeble and 
irregular, cyanosed face, abolished reflexes, coma gradually deep- 
ening, the pupils minutely contracted but dilating as the end 
approaches, and finally death by paralysis of the respiratory 
centre due to direct action on the medulla. Post-mortem shows 
only a wet brain, congested lungs, and engorgement of the venous 
trunks and of the right heart. 

The principal action of Opium is exerted upon the nervous 
system, first affecting the cerebral convolutions which are briefly 
stimulated and soon depressed, — next the perceptive and sensory 
centres in the higher brain are more or less blunted and the con- 
ductivity of the afferent nerves impaired, — soon the ganglia at 
the base of the brain are involved, evinced by the contraction of 
the pupils, vomiting, and slowing of respiration, — the cardiac, 
vascular and other centres are depressed but to a less degree than 
the respiratory and perceptive, — the gray matter of the cord, at 
first stimulated, as shown by the increase of reflex excitability, 
is also depressed, and locomotion becomes difficult, the motor 
nerves becoming paralyzed from the centre outwards, but muscular 
irritability is never lost. Death generally occurs by paralysis of 
the respiratory centre, rarely by sudden cardiac failure. 

Metabolism is greatly reduced in activity by Opium, the quan- 
tity of urea excreted being markedly lessened, and the biliary 
and glycogenic functions of the liver being affected, resulting in 



28o OPIUM. 

whitish stools, perhaps jaundice, and certainly decided decrease 
of the sugar excreted by diabetics. 

The hypnotic action of Opium is now believed to be produced 
by a double influence, (i) on the vascular system causing anaemia 
of the brain, (2) on the cerebral cells, diminishing their activity 
and consequently lessening their demand for blood. 

Its constipating action is shown experimentally to be produced 
by stimulation of the inhibitory nerves of the intestines through 
the splanchnics. 

Morphine acts similarly to Opium in general, being the prin- 
cipal alkaloid therein, but when used alone its influence is not 
complicated with that of the convulsant alkaloids (Thebaine, 
Codeine, Narcotine), which must affect to a considerable degree 
the action of Opium. Consequently, as compared with the latter, 
Morphine acts more quickly, and for a snorter time, has less 
influence on the intestines and skin, is less constipating, less 
stimulant, less convulsant and less diaphoretic, but more sedative, 
more anodyne and hypnotic and produces more intense pruritus. 
Its excretion commences quickly but may not be completed for 
as much as 48 hours, and is effected by most of the secretions, 
especially by the urine. It is probably retained in the system 
when the action of the kidneys is defective, and hence when 
given in renal disease may accumulate with fatal results. 

Codeine exalts the spinal cord more than Morphine and affects 
the cerebrum less, producing muscular tremor in excess of the 
sedative action. It is anodyne and hypnotic with less general 
disturbance than produced by Morphine. It markedly reduces 
the amount of sugar excreted by diabetics, and has a special 
sedative influence on the pneumogastric nerve. 

Narcotine should be named Anarcotine, as it has little or no 
narcotic power. It is a convulsant in animals and an antiperiodic 
in man. 

Narceine is said by some observers to be remarkably hypnotic, 
and free from convulsant action, —by others equally deserving of 
credit it is considered almost inert. This alkaloid is difficult to 
obtain pure ; hence the samples heretofore used have probably 
been contaminated with other alkaloids. 

Thebaine is a powerful convulsant, exalting the spinal cord 
almost like Strychnine and Brucine. It is not used medicinally. 

Fatal Doses. 

In a child one day old mj of Laudanum caused death. A me- 
dicinal dose given to a nursing mother proved fatal to the infant. 
A few drops of Paregoric have killed a child of nine months. 



OPIUM. 28l 

In the adult gr. y$ of Morphine in one case, and gr. iv of crude 
Opium in another, have proved fatal. 

A?it agonists and Treatment of Poisoning. 

Atropine antagonizes the cerebral action of Morphine, also its action on 
the pupils, respiration, heart and arterial tension, but if given too freely will 
endanger the case by substituting Belladonna-narcosis for Opium-narcosis. 
Gr. t Jq hypodermically every 15 minutes for three doses, is generally suffi- 
cient. Caffeine is also physiologically antagonistic, and is generally used 
in the form of strong black coffee frequently administered. The chief indica- 
tions in Opium-poisoning are — to evacuate the stomach, maintain respiration 
and keep up the circulation. Faradization of the chest muscles, cold affusion, 
and artificial respiration are of great value, and evacuation of the bladder is 
important. Flagellation is a very dangerous procedure from the exhaustion 
which may be produced ; strong faradic currents are much more efficient. 

Some of the cerebral effects of Opium, as vertigo and mental confusion, are 
removed by a full dose of Potassium Bromide, others are antagonized by Qui- 
nine, and the general intra-cranial effects of the drug are to some extent 
opposed by Digitalis and Tartar Emetic. 

Atropine may be advantageously combined with Morphine in solution for 
hypodermic injection, in the proportions of gr. T \-§ to T fa of the former to 
gr. % °f the latter, preventing the sickness and depression and many other 
unpleasant after-effects of Morphine, while increasing its anodyne, hypnotic 
and antispasmodic powers. 

Therapeutics. 

The chief indications for the use of Opium are — (1) to relieve 
pain from any cause except acute inflammation of the brain, — (2) 
to produce sleep, particularly in the insomnia of low 7 fevers with 
delirium, in which the combination of Morphine and Chloral is 
very efficient, — (3) to allay irritation in the various forms of 
acute nervous erethism, — (4) to check excessive secretion, as in 
diarrhoeas, dysentery, diabetes, ptyalism, etc., — (5) to support 
the system in low fevers and other adynamic conditions, w r hen 
sufficient food cannot be retained, — (6) as a sudorific, to produce 
sweating in coryza, etc. It is considered of especial value in any 
irritation of the stomach, bladder or bronchi, in severe vomiting, 
both forms of diabetes, gastralgia, colic and muscular spasm. In 
peritonitis and inflammations of other serous membranes, used 
freely even to narcotism it has often saved life. In cerebro-spinal 
meningitis it is the one remedy if given early, before exudation 
has set in. Cholera morbus and dysentery are efficiently treated 
by Morphine and Atropine hypodermically (gr. T V with gr. T | T ) 
after the ingesta have been removed by purging. In acute urae- 
mia its use in large doses is recommended by Loom is to control 
convulsions and promote diuresis, but here it is a dangerous 
agent. In muscular rheumatism and acute colds Dover's powder 
as a diaphoretic, conjoined with hot drinks and foot-baths, is old 

24 



282 OPIUM. 

but excellent treatment. In delirium tremens, acute and chronic 
mania and melancholia, nervous prostration and the delirium of 
fevers Opium is probably the best hypnotic. Severe pain from 
any cause (except cerebritis) is relieved by Opium with an effi- 
ciency possessed by no other drug, as the pain of sciatica, 
neuralgia, lumbago, cancer, renal and hepatic colic from calculi, 
etc. Cough of harassing and frequent character with but little 
secretion is best treated by Opium, but when there is profuse 
expectoration it should not be used, as the lowering of excita- 
bility of the respiratory centre which it produces would in such 
a case be dangerous. In nearly all acute inflammations it is valu- 
able, especially where it becomes advisable to lock up the bowels. 
Its tranquillizing power over the circulation makes it invaluable 
in various forms of hemorrhage. 

Applications of the Various Preparations. 

Intense pain, as from the passage of calculi, is best met by 
hypodermic injection of Morphine Sulphate in full doses (gr. i^- 
}4) with Atropine Sulphate (gr. T fo). Either the Solution of 
Morphine or the liquid preparations of Opium may be given by the 
mouth in corresponding doses for the same purpose. Severe pain 
enables the system to resist the action of Opium, which in such 
cases should be repeated at short intervals for effect regardless of 
dosage. 

Superficial pain is often alleviated by the Plaster or by extem- 
poraneous liniments containing Laudanum or some other fluid 
preparation. It is, however, very doubtful whether such applica- 
tions are of direct value, as Morphine is not absorbed by the 
unbroken integument ; but the Oleate of Morphine is said to be 
very penetrating. 

To produce sleep the most efficient preparations are the De- 
odorized Tincture, the Solution of Morphine, Pil. Opii and 
Dover's Powder, in dose corresponding to the degree of insomnia 
and restlessness present. 

Cough is relieved by the two Trochisci, the Deodorized and 
Camphorated Tinctures, and by the Solution of Morphine in 
small doses with Syrup of Wild Cherry or Syrup of Tolu. 

Diaphoresis is best obtained by the use of Dover's Powder in 
either of its three forms. 

Sedative action is obtained by different preparations for dif- 
ferent organs. 77ie stomach is best affected by the Solution of 
Morphine in effervescing mixtures, the Extract in a small pill, or 
Morphine hypodermically over the epigastrium. The intestines 
may be influenced by Laudanum in a starch enema, or internally 



ORIGANUM. 283 

by Dover's Powder, Pulvis Opii,or Pil. Opii, especially the latter, 
with or without Calomel as an astringent when the bowel must 
be paralyzed, as in peritonitis, hernia, intussusception, etc. The 
rectum and other pelvic organs are promptly affected by a supposi- 
tory of the Extract of Opium, gr. ^ with gr. y 1 ^ of the Extract 
of Belladonna. 

Administration. 

Probably no drug in the Materia Medica is so useful as Opium, 
or has so wide a range of application. At the same time no 
drug requires such careful handling, by reason of the many in- 
fluences which modify its action and uses. As before pointed out, 
children are extremely susceptible to its narcotic action, and 
women are more easily affected by it than men. Many persons 
are found with idiosyncrasies in respect to Opium, some being 
easily narcotized, others being remarkably insusceptible to its 
action, and many suffer from a decided shock after its hypodermic 
administration, which may even produce alarming symptoms of 
collapse. In subjects of kidney disease it may accumulate and act 
more powerfully than expected, and generally it may be said to 
be contraindicated or to be used with great care in alcoholism, 
congestion of the brain, and disease of the respiratory organs, 
heart and kidneys. 

Morphine and Atropine are sufficiently antagonistic to each other to 
make their combination extremely valuable as a therapeutic measure, and 
their use as mutual antidotes in poisoning by either a most efficient procedure 
if employed with due precautions. When Morphine is given as a hypnotic 
or an anodyne, Atropine should always be administered at the same time in 
the proportion of gr. t ^ _ tJo °f tne tatter to gr. % of the former. By this 
means the anodyne and hypnotic qualities of Morphine are increased, while 
the nausea and depression with the subsequent dyspepsia and constipation due 
to it are avoided. Moreover, as in the doses above-mentioned Atropine is a 
cardiac and respiratory stimulant, it will counteract the depressing tendency of 
Morphine on the heart and respiration in subjects who have undue suscepti- 
bility to its action. 



ORIGANUM, Wild Marjoram, — is the plant Origanum 
vulgare, a perennial herb of the nat. ord. Labiatae, native of 
Europe and America, having a stem branched above, petiolate 
leaves about an inch long and hairy beneath, pale purple flowers, 
aromatic, pungent and bitterish. It contains a Volatile Oil, 
some tannin, resin, and a bitter principle. The oil was formerly 
much used and was official, but it is now entirely superseded by 
the Oil of Thyme. Origanum is an ingredient of Vinum Aro- 



284 PANCREATIN PAPAIN. 

maticum. There are no official preparations. Dose, 3J-ib * n 
infusion. 

Physiological Action and Therapeutics, 

Origanum is gently tonic, also carminative, stimulant and 
emmenagogue. It was formerly much employed as a diaphoretic, 
etc., but is now rarely administered. 



PANCREATIN (Unofficial),— is the juice of the pancreas, 
and consists of four ferments: (1) Pancreatic Diastase, the anx- 
iolytic ferment, (2) Trypsin, the proteolytic ferment, (3) a fat- 
emulsifying and (4) a milk-curdling ferment. It is marketed in 
various forms, named Pancreatine, Pancreatic Emulsion, and 
Liquor Pancreaticus, of which the last-named is the most effi- 
cient preparation. 

LiQt/OR Pancreaticus, Pancreatic Solution (Unofficial), — prepared by di- 
gesting a finely-chopped pig's pancreas with 4 times its weight of dilute alco- 
hol. Is a nearly clear alcoholic solution, with little taste or smell. Dose, 

3J-3 SS - 

Physiological Action and Therapeutics. 

Pancreatic preparations are active digestives of proteid and 
amyloid foods, converting proteids into peptones, and emulsify- 
ing fats, in the presence of an alkaline solution (Pepsin requiring 
an acid one). Pancreatin is digested by Pepsin, and hence 
probably never passes into the duodenum in its own character. 
Trypsin affects albuminoids even in a slightly acid solution. 
Liquor Pancreaticus is used to partially digest (peptonize) milk, 
gruel, soups and other foods, before their administration in cases 
of great digestive debility. These peptonized foods may be ad- 
ministered per orem vel rectum, and are valuable in intestinal 
dyspepsia, wasting diseases, and convalescence from acute affec- 
tions. A teaspoonful taken after the administration of Cod-liver 
Oil will prevent the disagreeable eructations which are so offen- 
sive to some patients, and will aid in the digestion of the oil. 

Trypsin, unlike Pepsin, will dissolve mucin, and like Pepsin 
it is inert towards nuclein, horny tissues and amyloid matter. 
Used as a spray on diphtheritic membrane it has proved a very 
efficient solvent. 



PAPAIN, Papaiva (Unofficial), — is a ferment obtained 
from the milky juice of Carica Papaya, a S. American fruit-tree 
of the nat. ord. Papayaceae. It is soluble in water but net in 



PARALDEHYDE PAREIRA. 285 

alcohol, and has active digestive powers. It softens and dissolves 
fibrin in liquids which may be either acid, or neutral, or slightly- 
alkaline, in this respect differing greatly from Pepsin.. It also 
acts at higher temperatures and more rapidly than Pepsin. It is 
a rapid solvent of false membranes and intestinal worms. It has 
been injected into tumors, dissolving the tissues in its vicinity, 
but with much pain and considerable febrile reaction. It is not 
used internally, as it is feared that it may digest the gastrointes- 
tinal mucous membrane as well as its contents. 

Papaw Milk is the milky juice of the fruit, coagulating into two parts, a 
pulpy mass and a liquid serum. When mixed with alcohol an amorphous 
powder is precipitated, which when dried forms Papain. 



PARALDEHYDE, C 6 H 12 3 (Unofficial),— is a polymeric 
modification of Aldehyde, fluid above 51 F., solidifying below 
that temperature, soluble in 8 of water. Dose, "nixx-^ijss. It is 
powerfully hypnotic and diuretic, but has no diaphoretic action. 
It possesses many of the qualities of Chloral with none of its 
dangers, strengthening and slowing the heart, instead of weaken- 
ing it. A toxic dose paralyzes the medulla and the respiratory 
centre. As compared with Chloral its action is not so persistent 
and it requires more frequent repetition, but it is unquestionably 
safer. As a hypnotic it has been used with great benefit in fevers, 
rheumatism, acute mania, hysteria, and insomnia from various 
causes. The above-mentioned maximum dose has frequently 
been given without any ill-effect, and with no digestive or cere- 
bral disturbances afterwards. 



PAREIRA, Pareira Brava, — is the root of Chondodendron 
tomentosum, a climbing, woody vine of the nat. ord. Menisperma- 
ceae, with very large leaves and grape-like fruit, inhabiting Peru 
and Brazil. Occurs in sub-cylindrical, tortuous pieces, 4 to 6 
inches long, dark brownish-gray externally, with transverse ridges, 
fissures and furrows ; internally pale-brown, interior woody, po- 
rous, in concentric circles with medullary rays. It contains 
Pelosine or Cis s amp e line, an alkaloid identical with the Berberine 
of Nectandra and the Buxine of Buxus sempervirens (Boxwood). 

Several other Pareiras are on the market, that from the West 
Indies (Cissampelos Pareira) being the plant formerly official in 
the Br. Pharmacopoeia. 



286 PEPO — PEPSINUM. 

Preparations. 

EXTRACTUM PAREIRyE FLUIDUM, — Dose, ^SS-^j. 
Infusum Pareira (Unofficial), — I in 17. Dose, gj— ij. 

Physiological Action and Therapeutics. 

Pareira is diuretic and laxative, stimulating peristalsis and the 
action of the kidneys. It is eliminated by the renal secretion, 
and passing over the mucous membrane of the genito-urinary 
tract, it acts thereon in a tonic and soothing manner, especially 
on the bladder. 

It is particularly useful in chronic cystitis, suppurative kidney 
diseases, gonorrhoea and gleet, but must be used internally, as 
when injected locally for gonorrhoea and cystitis it has not proved 
successful. Formerly Pareira was considered an efficient lithon- 
triptic, and in Brazil it is used as a cure for bites of poisonous 
serpents, being employed both internally and locally to the wound. 



PEPO, Pumpkin-seed,— is the seed of Cucurbita Pepo, or 
common Pumpkin (nat. ord. Cucurbitaceae), about fy inch long, 
white, flat, oval, inodorous, bland and oily. The active prin- 
ciple is a resin contained in the endopleuron or envelope imme- 
diately surrounding the embryo. It also contains an alkaloid 
Cucurbitine, a fixed oil, starch, sugar, etc. There are no official 
preparations. Dose, of the resin, gr. xv ; of the seeds, 3j-ij> 
beaten up in emulsion with sugar and water. 

Physiological Action and Therapeutics \ 

Pumpkin -seed is an efficient agent for the removal of tape- 
worm (taeniafuge), and its use is not followed by unpleasant 
symptoms. The outer coat of the seed should be removed, and 
an emulsion then made by trituration with sugar and water. This, 
if taken on an empty stomach and followed by a brisk cathartic, 
will generally prove effective. Dr. Squibb maintains that the 
seeds should not be decorticated, but that husks and all should 
be swallowed. According to some observers the expressed oil is 
equally efficient in doses of §ss repeated twice or three times, 
and followed by a cathartic. 



PEPSINUM, Pepsin, — is a hypothetical name for the di- 
gestive principle of the gastric juice, and as a definite body is 
unknown, the various preparations, official and unofficial, being 



PEPSINUM. 287 

mere approximations, and vary much from each other. They are 
usually obtained from a solution prepared by digesting the mu- 
cous membrane scraped from the rennet-bags of sheep or the 
stomach of the pig in acidulated water for several days. The so- 
called "Pepsin" is then precipitated by Chloride of Sodium 
(JScheffer), Acetate of Lead (Boudaulf), or by drying the pep- 
tones on glass plates (Beale). It may also be precipitated by 
alcohol. By Scheffer's process it occurs as a tough, gray, leathery 
substance, partially soluble in water, one grain dissolving 3000 
grains of albumen in a few days. Jensen's " Crystal Pepsin," 
probably prepared after Beale's method, is in yellowish, translu- 
cent scales, soluble in water, and reputed to be many times 
stronger than any other preparation yet obtained. 

Preparations. 

Pepsinum Saccharatum, Saccharated Pepsin, — is Pepsin obtained from 
the mucous membrane of the hog, and mixed with powdered Sugar of Milk. 
One part dissolved in 500 of water acidulated with 7^ of Hydrochloric Acid, 
should digest at least 50 parts of hard-boiled egg-albumen in 5 or 6 hours at 
a temperature of ioo° to 104 F. Dose, gr. v— gj, soon after meals. 

Liquor Pepsini, Liquid Pepsin, — contains of Saccharated Pepsin 40 parts, 
Hydrochloric Acid 12, Glycerin 400, Water q. s. ad 1000 parts. Dose, £ij- 
iv, after meals. 

Lactopeptine (Unofficial), — claimed to contain Pepsin, Diastase or Ptya- 
lin, Pancreatin, Lactic and Hydrochloric Acids, and that £j will digest gviij-x 
of albumen, fibrin, casein or gelatin, will emulsionize jxvj of cod-liver oil, 
and convert giv of starch into glucose. A proprietary preparation. Dose, 
gr. v-xv. 

Ingluvin (Unofficial), — is a preparation obtained from the gizzard of the 
domestic fowl, which owes its activity to no ferment corresponding to Pepsin, 
but to a peculiar bitter principle. Dose, gr. x-xxx. 

[Every manufacturer has his own preparation of Pepsin, and his peculiar 
name therefor, such as " Liquid Pancreopepsine," " Lacto-peptine," " GlucO- 
pepsine," "Golden Scale Pepsin," " Peptogenic Milk Powder," etc. They 
vary considerably in their properties, but all have the power in some degree 
of digesting albumen or fibrin.] 

Physiological Action. 

Pepsin is not a solvent but a ferment, and is a normal con- 
stituent of the gastric juice, converting albuminoids (casein, albu- 
men, fibrin, etc.) into peptones for assimilation, with the aid of 
the Lactic and Hydrochloric Acids associated with it. This it 
will do out of the body or in cavities as the rectum, if warmth, 
acidity and moisture be present. Pancreatin, on the other hand, 
is destroyed by acids and requires an alkaline medium in which 
to exercise its powers. As the food passes out of the stomach in 
2 or 3 hours, Pepsin should be administered within, and Pancre- 
atin after that period to be effective. 



288 PETROLATUM. 

Incompatibles. 

Alcohol destroys the activity of Pepsin. Alkalies and many mineral salts 
precipitate it. 

Therapeutics. 

Dyspepsia in its various forms is the malady for which Pepsin 
is chiefly employed, but it is also extremely useful in the apepsia 
of infants, gastralgia, anaemia, chlorosis, gastric ulcer and cancer, 
the diarrhoea of infants and the vomiting of pregnancy. It is 
added to nutritive enemata, the rectum not being a digestive or- 
gan, and is injected into the substance of morbid growths which 
are homologous to the tissues, particularly fatty tumors, for the 
purpose of arresting their growth and promoting their absorption. 
It has been injected into the bladder to break down a blood-clot, 
and has been suggested as an atomized inhalation in diphtheria 
and croup to digest the membrane without injuring the living 
tissues. 

Ingluvin is particularly useful against vomiting and has been 
found exceptionally efficient in the vomiting of pregnancy, given 
in 20-grain doses before meals. [Compare Pancreatin, ante, 
page 284.] 



PETROLATUM, Petroleum Ointment,— is a semi- 
solid substance, consisting of hydrocarbons, obtained from Petro- 
leum by distilling off the lighter portions and purifying the resi- 
due. It is a yellowish, fat-like mass, somewhat fluorescent, 
amorphous, odorless and tasteless, of neutral reaction, insoluble 
in water or alcohol, soluble in ether, chloroform, fixed and vola- 
tile oils, benzin, etc. Its melting point is from 104 F. to 125 
F., the first being the softer, and the second the firmer variety. 
Commercially, it is known as Cosmoline, Vaseline, etc., and is 
largely prepared from residuums or sediments deposited in tanks 
containing crude petroleum. 

Physiological Action and Therapeutics. 

Petrolatum is a valuable protective dressing, and an excellent 
basis for ointments, having no acridity and no liability to become 
rancid. It is readily miscible with many active agents, as the 
alkaloids, phenol compounds, etc., but it does not penetrate the 
skin as readily as animal fats and fixed oils. Uncombined, it 
forms an excellent bland application in all irritated conditions 
and injuries of the skin. 



PHOSPHORUS, PHOSPHITES AND PHOSPHATES. 289 

PHOSPHORUS, Phosphites and Phosphates,— are 

best studied together, as the supplying of the element Phosphorus 
to the body is the aim of the administration of these agents. 

Phosphorus, P, — is a non-metallic element obtained from 
bones, and occurs as a translucent, nearly colorless solid, of waxy 
lustre, and usually the consistence of beeswax, insoluble in water, 
soluble in 50 parts of any fatty oil, in 80 of absolute ether, 350 
of absolute alcohol, and freely in carbon bisulphide. It has a 
disagreeable odor and taste, melts at in° F., is luminous in the 
dark, ignites in the air, and should be kept under water in a 
cool place, protected from light. It usually contains Arsenic 
and sometimes Sulphur, the limits of which are fixed by the 
pharmacopceial tests. Dose, gr. xi^-jV thrice daily. 

Preparations of Phosphorus. 

Pilule Phosphori, Pills of Phosphorus, — each contains gr. yi^ of Phos- 
phorus, dissolved in Chloroform, mixed with Althaea and Acacia in Glycerin 
and Water, and coated by shaking with a solution of Balsam of Tolu in 
Ether. Dose,j-v. 

Oleum Phosphoratum, Phosphorated Oil, — has of Phosphorus 1 part, 
^Ether Fortior 9, Expressed Oil of Almond q. s. ad 100 parts. Dose, ^j-v, 
thrice daily. 

Acidum Phosphoricum and Acidum Pkosphoricum Dilutum, — are 
described on page 34, ante. 

Tinctura Phosphori (Thompson's), Unofficial, — Phosphorus gr. j, Abso- 
lute Alcohol £v, Glycerin £)%, Alcohol ^ij, Spt. Menthae Piperitse, ttixL Of 
this %} contains gr. -^ of Phosphorus. 

Tinctura Phosphori ( Belle vue Hospital), Unofficial, — Phosphorus gr, 
xxxij, Absolute Alcohol ^xlvj, Essence of Vanilla ^j, Oil of Orange giij, 
Alcohol q. s. ad ^xlviij. Of this gj contains gr. T L of Phosphorus. 

Zinci Phosphidum, Phosphide of Zinc, Zn 3 P 2 , — crystalline fragments or a 
gray-black powder, insoluble in water or alcohol, but completely soluble in 
hydrochloric or sulphuric acids with evolution of phosphoretted hydrogen. 
Is very irritant to the stomach. Dose, gr. ^o~ A* 

Preparations of Phosphites. 

Calcii Hypophosphis, Hypophosphite of Calcium, Ca 4 (P0 2 ) 3 , — colorless 
prisms, or thin, pearly scales, of nauseous taste, soluble in 6.8 of water, insol- 
uble in alcohol. Is an ingredient of the Syrupus Hypophosphitum. Dose, 
gr. x-xxx. 

Ferri Hypophosphis, Ferric Hypophosphite, Fe 2 (H 2 P0 2 g), — a white or 
grayish-white powder, odorless and tasteless, slightly soluble in water, freely 
so in hydrochloric acid or a solution of sodium citrate. Dose, gr. v-x. A 
ferruginous tonic. 

Potassii Hypophosphis, KH 2 P0 2 , — white masses, or a white, granular 
powder, deliquescent, odorless, of saline taste and neutral reaction. Soluble 
in 0.6 of water and in 7.3 of alcohol at 59 F. Dose, gr. v-x. 

Sodii Hypophosphis, NaH 2 P0 2 H 2 0, — small plates, or a white, granular 
powder, deliquescent, odorless, of sweetish, saline taste and neutral reaction. 
Soluble in 1 of water and 30 of alcohol at 59 F. Dose, gr. v-x. 



29O PHOSPHORUS, PHOSPHITES AND PHOSPHATES. 

Syrupus Hypophosphitum, Syrup of Hypophosphites, — has of the Cal- 
cium salt 35, of the Sodium and Potassium salts each 12, Citric Acid I, Spirit 
of Lemon 2, Sugar 500, Water q. s. ad 1000 parts. Dose, ^j-^j. 

Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with 
Iron, — has of the preceding 99 parts with I of the Lactate of Iron, dissolved 
by trituration. Dose, 3J-§j. 

Preparations of Phosphates. 

Calcii Phosphas Pr^cipitatus, Precipitated Phosphate of Calcium, 
Ca 3 (P0 4 ) 2 , — a light, white, amorphous powder, odorless and tasteless, insol- 
uble in water or in alcohol. Dose, gr. ij-x. 

Syrupus Calcii Lactophosphatis, — has of the preceding 22 parts, Lactic 
Acid 33, Orange-flower Water 80, Sugar 600, Hydrochloric Acid, Water of 
Ammonia, Water, aa q. s. ad 1000. The Phosphate of Calcium is dissolved 
by the acid, but does not enter into the chemical combination suggested by 
the title. Dose, %) — §j. 

Sodii Phosphas, Na 2 HP0 4 . i2H 2 0, — large, monoclinic prisms, efflorescent, 
of saline taste and alkaline reaction. Soluble'in 6 of water at 59 F., insol- 
uble in alcohol. Dose, 3J-^j. 

Sodii Pyrophosphas, Na 4 P 2 7 .ioH 2 0, — colorless, monoclinic prisms, of 
saline taste and alkaline reaction. Soluble in 12 of water at 59 F., insoluble 
in alcohol. Dose, gss-^ss. 

Syrupus Ferri, Quinine et Strychnine Phosphatum, — has of the 
Phosphate of Iron 133, Quinine 133, Strychnine 4, Phosphoric Acid 800, 
Sugar 6000, Distilled Water q. s. ad 10,000 parts. A powerful tonic. Dose, 

Syrupus Phosphatum Compositus, Compound Syrup of Phosphates, 
Parrish's Chemical Food (Unofficial), — has in each 3 Phosphate of Iron gr. 
2^, Phosphate of Calcium gr. j. Dose, £}-ij. 

Ammonii Phosphas, Ferri Phosphas and Ferri Pyrophosphas are 
respectively described on pages 60 and 191. 

Physiological Action. 

Phosphorus in small doses stimulates the brain and circulation, 
the functions of the stomach and the genital organs, and the 
growth of bones. It aids digestion by irritating the end-organs of 
the gastric nerves, and produces eructations of Hydrogen Phos- 
phide. Its fumes cause necrosis of the upper or lower maxillae, 
especially in those whose teeth are decayed, but this may be 
prevented by the inhalation of fumes from old acid turpentine. 
In poisonous doses it is a powerful irritant of the gastro-intestinal 
tract, causing vomiting and purging with great depression of the 
vital forces. Reaching the blood as Phosphorus, it is partly 
oxidized at the expense of the oxygen of the red corpuscles, 
causes acute hemorrhages from fatty degeneration of the arterial 
walls, rapid steatosis of the stomach, liver and heart, with deep 
jaundice, — then delirium, convulsions, coma and death usually 
from gradual failure of the respiration and circulation. Acute yel- 



PHOSPHORUS, PHOSPHITES AND PHOSPHATES. 29 1 

low atrophy of the liver resembles acute phosphorus-poisoning 
so much that it is generally impossible to distinguish between 
them. 

Its effect on metabolism is to increase the nitrogenous products, 
to diminish the excretion of carbonic acid, reduce the glycogen 
of the liver to almost nothing, and to raise the temperature. 
While generally increasing metabolism it so influences that pro- 
cess as to arrest it at the stage of conversion of proteids into 
urea and oil, instead of allowing it to proceed to the final oxida- 
tion of oil into carbonic acid and water, hence leading to fatty 
degeneration of epithelial, glandular and muscular protoplasm 
throughout the body. 

Phosphate of Calcium is an essential ingredient of all the tis- 
sues and fluids of the body, and forms more than 50 per cent, of 
the bones. Lactic and Hydrochloric acids dissolve it in small 
quantities. It increases the alkalinity of the blood as well as its 
power of holding Carbonic Acid, and diminishes the excretion of 
urea. 

Phosphate of Sodium acts on the blood and on the excretion 
of urea similarly to the calcium salt. It increases secretion gen- 
erally, especially of the bile, being an excellent cholagogue and 
thereby aiding in the digestion of fats. In ounce doses it is 
laxative. It is a normal constituent of the blood, and possesses 
the property of increasing the capacity of any fluid to hold Car- 
bonic Acid in solution. 

The Hypophosphites are generally tonic, and are supposed to 
constitute a safer form in which to administer Phosphorus than 
in the unoxidized state. They are probably converted into phos- 
phates in the stomach. 

Antidotes and Antagonists. 

Antidotes are hydrated magnesia, lime-water, powdered charcoal, sulphate 
of copper and old acid turpentine. Sulphate of Copper is the best emetic, 
forming a comparatively insoluble phosphide of copper ; 3-grain doses should 
be given every 5 minutes in dilute solution until emesis occurs. Hydrated 
Magnesia as a quickly-acting purgative. Limewater or Charcoal to pre- 
vent the action on the tissues. Crude French Acid Turpentine is the best 
antidote, which may be given rapidly in an emulsion of gum. Opium to 
counteract the depression of the heart and system. Transfusion has proved 
efficient where the blood is affected. No oils or fats should be used, as they 
dissolve Phosphorus and promote its absorption. 

Therapeutics. 

Phosphorus is chiefly used to promote the nutrition of osseous 
and nervous tissue. It is useful in chronic nervous exhaustion 



292 PHYSOSTIGMA. 

when the nerve centres are implicated, in osteomalacia, rachitis 
and progressive locomotor ataxia. In threatened cerebral soft- 
ening it affects the nerve centres as no other drug does, and in 
paraplegia of myelitic origin from excessive venery it is often very 
efficient. Progressive pernicious anaemia has sometimes been 
arrested by Phosphorus in very small doses, while in impotence 
of functional character there is no remedy so effective. In wake- 
fulness of the aged and that due to cerebral anaemia small doses 
of the pill or tincture are sometimes remarkably beneficial. In 
certain skin diseases (acne, psoriasis, lupus), it is an excellent 
substitute for Arsenic. Neuralgia is often cured by Phosphorus, 
but large doses are necessary, at least gr. -J^ every 4 hours. 

Phosphate of Calcium and the Hypophosphites are used 
with benefit in all diseases of mal-nutrition, and where the repair 
or development of the bones is required. They are particularly 
useful in protracted suppuration, osteomalacia, rachitis, caries, 
scrofulosis, chronic phthisis, and in the anaemia and bone-soften- 
ing of lactation. The Hypophosphites are much employed in 
nervous and general debility and in chronic lung diseases, and 
are supposed to act in the same manner as free Phosphorus, but 
without irritation. They are probably converted into Phos- 
phates in the stomach, and hence may be expected to promote 
the growth and healing of bones, to stimulate the hepatic and 
intestinal secretions, and to affect the lymphatic glands and ade- 
noid tissue. The Compound Syrup of the Hypophosphites is an 
excellent remedy in acne indurata. 

Phosphate of Sodium in drachm-doses thrice daily for adults, 
gr. x-xx for children, is extremely useful as a laxative in condi- 
tions depending on catarrh of the bile-ducts and duodenum, as 
headache, jaundice, chalky stools, etc. Gall-stones may be pre- 
vented from forming by scruple or drachm doses before meals for 
months at a time. It is also an efficient agent in obesity, hepatic 
diabetes, incipient hepatic sclerosis, chronic infantile diarrhoea, 
cerebral debility, bilious sick headache, and the pasty, white 
stools of ill-conditioned children. Vichy-water contains this 
salt in the proportion of gr. ^ to the pint, and is considered a 
valuable water in hepatic colic and kindred conditions. Finally 
for the condition of the system producing a crop of boils, Phos- 
phate of Sodium is probably the best remedy. 



PHYSOSTIGMA, Calabar Bean,— is the seed of P/iy- 
sostigma venenosum (nat. ord. Leguminosae), a woody creeper of 
Calabar, West Africa, where it is used by the natives as an ordeal 



PHYSOSTIGMA. 293 

for witches, etc., vomiting after its ingestion being held to estab- 
lish the innocence of the accused. It is about an inch long, irreg- 
ularly kidney-shaped, with two flat sides and a furrow along its 
convex margin ending in an aperture near one end. It contains 
an alkaloid, variously named Pserine, Physostigmine, and Cala- 
barine, C 15 H 21 N 3 2 , which is obtained as a crystalline, an amor- 
phous or a syrupy body. Some authorities apply the above names 
to different bodies, but acknowledge that they agree in physio- 
logical action, though not in physical qualities. 

Preparations. 

Extractum Physostigmatis, — an alcoholic extract, of which the dose is 
from gr. ]/ 6 to gr.j. 

Tinctura Physostigmatis,— strength 10 per cent. Dose, rriv-xx. 

PHYSOSTIGMINE Salicylas, Salicylate of Physostigmine, — colorless, col- 
umnar crystals, of bitter taste and neutral reaction, soluble in 130 of water and 
in 12 of alcohol at 59 F. Dose, gr. i^q—^-q. 

Eserina, Eserine (Unofficial), — perhaps the same as Physostigmine, but is 
considered as representing the powers of the plant. Dose, gr. ^-^V 

Physiological Action. 

Physostigma is a direct spinal paralyzer, producing complete 
general paralysis, and abolished reflexes, but not affecting mus- 
cular irritability or the cerebral functions. It stimulates secre- 
tion, excites nausea and vomiting, salivation and diaphoresis, and 
is laxative by stimulating the muscular coat of the intestines to 
increased peristalsis as well as by increasing the intestinal secre- 
tions. It first lowers then raises arterial tension, increases the 
frequency of the heart-beat, but depresses the power of the cardiac 
muscle though not destroying it. It produces dyspnoea by a 
tetanic action on the respiratory muscles, causing carbonic acid 
narcosis and death by paralysis of respiration. It contracts the 
pupil (how, is disputed), and the ciliary muscle, producing marked 
myosis. It is eliminated chiefly by the kidneys, the urine of the 
animal affected poisoning another. 

Antagonists and Incompatibles. 

ATROPINE is antagonistic as to the effects on the respiration, heart and 
pupil. Chloral is also antagonistic and over a greater field of action, but to 
be effective must be administered before the ingestion of the Physostigma. 

The vegetable astringents, tannic acid and the caustic alkalies are chemically 
incompatible. 

Therapeutics. 

The applications of Physostigma are not many. It is efficient 
in constipation due to torpor of the bowels, in which condition it 



294 PHYTOLACCA. 

is usually combined with Belladonna and Nux-vomica. In 
tetanus it has been used with advantage to diminish reflex excita- 
bility in grain-doses of the extract repeated every 2 hours and the 
dose modified according to the effect produced. Progressive 
paralysis of the insane is apparently retarded by it, and while 
antagonistic theoretically in atropine and strychnine poisoning, 
practically it is not of much value. 

Eserine is now used locally by ophthalmologists for many 
purposes in affections of the eye. In a solution of gr. ij to the 
% of water dropped into the eye, it is efficient in breaking up or 
preventing adhesions of the iris, diminishes intraocular tension, 
prevents suppuration after operations, contracts the pupil, dimin- 
ishing the entrance of light in photophobia, etc., and empties 
the vessels of the eye. It is very useful in keratitis, glaucoma, 
strumous ophthalmia, and neuralgia of the eye-ball. The salts 
of Eserine or Physostigmine in neutral solution may be used for 
these purposes, as well as to counteract the effects of Atropine on 
the pupil. Gelatin disks medicated with Eserine may be ob- 
tained in the shops, and are a convenient form in which to use 
the drug for ophthalmic purposes. 



PHYTOLACCA, Poke,— is official under two forms, the 
berry and the root of Phytolacca decandra, a plant of the nat. 
ord. Phytolaccaceae, found in all parts of the United States. It 
contains a neutral principle Phytolaccin, and an acid Phytolaccic 
Acid, also tannin, starch, fixed oil, etc. There are no official 
preparations. 

Phytolaccae Bacca, Poke Berry, — dark-purple, depressed 
globular, about yi inch in diameter, composed of 10 carpels, each 
containing one black seed ; juice purplish-red, sweet and slightly 
acrid. 

Phytolaccae Radix, Poke Root, — large, conical, branched, 
fracture fibrous, wood-bundles in concentric circles, inodorous, 
sweetish and acrid. Dose, as emetic, gr. x-xxx, — as an alterative, 
gr. j-v. 

Preparations. 

Extractum Phytolacca Fluidum (Unofficial), — Dose, Trvv-^j. 
Tinctura Phytolacca (Unofficial), — Dose, ttlx-^j. 

Physiological Action. 

Phytolacca is an emeto-cathartic, acting slowly but persistently, 
with great nausea and considerable depression. It lowers the 
rate of respiration and of cardiac action, and is a motor depres- 



PICROTOXINUM. 295 

sant, paralyzing the spinal cord and the medulla, death occur- 
ring from paralysis of respiration, preceded by tetanic convulsions. 
Several cases of poisoning by this plant have occurred. Its 
action is antagonized by Alcohol, Ether, Opium, Digitalis, etc. 

Therapeutics. 

Alterative powers have been ascribed to Phytolacca, and com- 
petent observers have reported curative results from its use in 
malignant tumors, varicose and other ulcers, obstinate eczema, 
sycosis, favus and other skin affections, employing it both inter- 
nally and externally. It is a very serviceable remedy in chronic 
rheumatism, and given internally has undoubtedly cured cases of 
granular conjunctivitis. Mastitis is sometimes aborted and sup- 
puration of the breasts prevented by the use of the fluid extract 
internally while a solid extract is locally applied to the seat of 
the impending inflammation. In tonsillitis and diphtheritic sore 
throat, also in chronic follicular pharyngitis, it has been much 
used with good results, especially when there is high fever and 
pains in the head, back and limbs. In true adynamic diphtheria 
it will do little good. 



PICROTOXINUM, Picrotoxin, Picrotoxic Acid, 
C 9 H 10 O 4 , — is a poisonous, neutral principle obtained from the 
seeds contained in the berries {Co c cuius Indicus, Fish-berries), 
of Anamirta paniculata (Anamirta Cocculus, Menispermum Coc- 
culus), a climbing shrub of the nat. ord Menispermacese, a native 
of the East Indies. The berries are somewhat kidney-shaped, of 
blackish -brown color, wrinkled, brittle, inodorous and nearly 
tasteless, except the shrivelled embryo which is bitter. They 
contain, besides Picrotoxin, a large quantity of fixed oil and 
other substances of less interest. In the shell are found Menis- 
permin an alkaline principle, Paramenispermin which is neutral 
and crystalline, and Hypopicrotoxic Acid. 

Picrotoxin occurs in colorless, flexible crystals, of prismatic 
form, bitter taste and neutral reaction, soluble in 150 of water 
and in 10 of alcohol at 59 F., also in acids and in alkaline solu- 
tions. Dose by the stomach, gr. g V~2V> cautiously. For hypo- 
dermic use a solution in water of gr. ij in §j may be used, in 
doses of gr. ^V~Tft of the principle, miv equalling gr. ^L. 

Unofficial Preparations of Cocculus. 

Tinctura Cocculi, — I in 8. Dose, mij-xv. 
Extr actum Cocculi Fluidum, — Dose, rnj-iij. 
Planat's Tincture of Cocculus, — 1 in 4. Dose, nij-v. 



296 PICROTOXINUM. 

Physiological Action. 

Picrotoxin is a cerebro-spinal exaltant, affecting especially the 
centres in the medulla oblongata, and in its action representing 
the combined actions of Belladonna and Nux-vomica. It stimu- 
lates all the secretions, especially the cutaneous, the salivary and 
intestinal ; produces nausea and vomiting, and slows the heart 
and the respiration after transiently accelerating both. It causes 
muscular twitching, incoordination, stupor, delirium, epilepti- 
form convulsions, tonic spasms of the flexor muscles alternating 
with clonic ones, exalted reflexes and trembling, — then coma, in- 
sensibility and death by paralysis of the heart, which is arrested 
in diastole. The action of the drug is on the spasm and vagus 
centres in the medulla, and on Setchenow's inhibitory centre, as 
well as on the cerebellum and spinal cord, paralyzing the first- 
named centres and stimulating the reflex centres in the cord. 
It is eliminated by all the excretory channels, chiefly by the 
kidneys. 

The spasms caused by Picrotoxin are choreic and chiefly affect 
the flexor muscles, — those from Strychnine are tetanic, affecting 
principally the extensors. The order, succession and character 
of the phenomena produced by Picrotoxin resemble in marked 
degree those of the epileptic paroxysm. 

Cocculus berries are used to stupefy fish, being thrown into 
ponds containing them. They are also employed to adulterate 
beer and porter in order to make these drinks more intoxicating. 

Antagonists. 

Chloral is antagonistic to its cerebral and spinal actions, but synergistic to 
its depressant power over the heart and the respiration. Acetic Acid gives 
relief in overdosing, and may have some antidotal power. Anaesthetics 
antagonize its spasm-producing action. 

Therapeutics. 

Picrotoxin is used chiefly in nervous diseases. Epilepsy is 
amenable to it, especially when the attacks are nocturnal, and in 
anaemic cases and those attributable to onanism. Paralyses of 
several forms have been greatly benefited by it, especially par- 
alysis of the sphincters, hemiplegia from cold, glosso-labio-laryn- 
geal paralysis, and paralysis agitans. Chorea is well treated by 
it but requires full doses. It is remarkably efficient in control- 
ling the nightsweats of phthisis, and in flatulent colic, also in 
dyspepsia with flatulence and severe epigastric pain, and in vom- 
iting with giddiness, headache and intolerance of light and 
sound. Dysmenorrhcea is often benefited by Cocculus adminis- 



PILOCARPUS. 297 

tered for two days before the period ; and leucorrhoea, when the 
discharge is sero-purulent with lumbar pains, is frequently con- 
trolled by it. Parasitic skin diseases are well treated by an oint- 
ment of Picrotoxin (gr. x to the 3), which will also kill pediculi, 
but it must be used cautiously and with special care to avoid an 
abraded surface. 



PILOCARPUS, Jaborandi,— the leaflets of Pilocarpus 
pennatifolius, a Brazilian plant of the nat. ord. Rutaceae. They 
are about 4 inches long, ovate-oblong, coriaceous, pellucid-punc- 
tate, mostly smooth, somewhat pungent and bitter. It contains 
two alkaloids, — Pilocarpine, C n H 16 N 2 2 , soft and viscous, slightly 
soluble in water but soluble in alcohol, ether and chloroform ; 
Jaborine, isomeric with Pilocarpine, to which it is antagonistic 
in action; also a Volatile Oil and probably a peculiar acid. 

Preparations. 

Extractum Pilocarpi Fluidum, — Dose, rriv-^j. 

Pilocarpine Hydrochloras, — minute, white, deliquescent crystals, very 
soluble in water and in alcohol, almost insoluble in ether or chloroform. Dose, 

Physiological Action. 

Jaborandi is a paralyzer of the vaso-motor system. It pro- 
duces prompt and profuse diaphoresis, the perspiration from a 
full dose amounting to ten or fifteen fluid ounces ; also profuse 
salivation (gx to xxx), and much increase of the nasal, bronchial 
and lachrymal secretions, with sometimes a watery diarrhoea. 
Nausea is generally experienced and sometimes vomiting. The 
face is flushed, the action of the heart is first increased and after- 
wards lowered, the arterial tension is reduced and the tempera- 
ture falls from i° to 4 . Drowsiness, pallor, chilliness and de- 
bility succeed and last several hours, the pupils are contracted 
and accommodation is impaired. The respiratory power is 
lowered, and apncea may occur from increase of the bronchial 
mucus. The elimination of urea is increased greatly, but not the 
quantity of urine. The effects pass off usually in from 3 to 6 
hours. The drug is rapidly diffused and is eliminated by the 
skin and the salivary glands. Children are less affected than 
adults by proportionate doses. Uterine contractions are reported 
by several observers as having been initiated by Jaborandi, but 
according to others it frequently fails to produce this effect. 

Pilocarpine is the principle to which the foregoing actions 
are due, but Jaborine, though chemically identical, is perfectly 

25 



298 PILOCARPUS. 

antagonistic thereto in its effects on the heart, pupils, lungs and 
salivary glands, acting precisely like Atropine on these organs. 
The difference is probably due to a different molecular arrange- 
ment. 

Antagonists and Incompatible^ . 

Atropine is the antagonist to Pilocarpine in dose of gr. T ^ for gr. \ of the 
latter. The antagonism between these two alkaloids extends over the whole 
range of their action, and is the most complete known to physiological exper- 
imentation. Caustic alkalies, the persalts of Iron and salts of the metals 
generally, are chemically incompatible. 

Therapeutics. 

Jaborandi is used with great benefit in dropsies, especially the 
renal form, also in eclampsia of renal origin, in uraemia, pleuritis, 
meningitis and other inflammations of serous membranes, but it 
is contraindicated when from any cause there is weak heart. In 
diabetes insipidus it reduces the quantity of urine remarkably, 
relieving the kidneys by throwing the work on the skin. In the 
acute and chronic forms of Bright's disease it has been used with 
great advantage, but being so depressant it must be employed 
with great caution in this disorder. For alopecia it is the most 
efficient remedy known, stimulating the skin and improving the 
color and condition of the hair. In agalactia it stimulates the 
secretion of the milk, and it often gives prompt relief in parotitis. 
Ptyalism is frequently relieved by minute doses of Pilocarpine 
(gr. -g^), which acting on the same gland antagonizes the morbid 
action ; and similar doses used thrice daily will check profuse 
perspiration. The hypodermic use of Pilocarpine will arrest a 
paroxysm of spasmodic asthma, and is equally efficient in hic- 
cough. Atropine-poisoning is best combated by the use of Pilo- 
carpine hypodermically. 

Ophthalmologists employ Pilocarpine with most excellent re- 
sults in the amblyopia of alcoholism and that from the abuse of 
tobacco, in detachment of the retina, chronic iritis, keratitis, 
glaucoma, hemorrhage into the vitreous, atrophic choroiditis, 
white atrophy, to promote resolution and absorption in inflam- 
matory conditions with exudation, and instead of Eserine as a 
myositic. 

Erysipelas and diphtheria are diseases in which Pilocarpine has 
recently proved very efficient, but its depressant action on the 
heart and respiration must not be lost sight of. In the writer's 
experience the fluid extract is one of the best agents for break- 
ing up a common cold. It may be given in doses of ntx-3j, 



PIMENTA — PIPER. 299 

according to age, at bedtime. Children bear the drug well in 
respect to all its physiological actions. 



PIMENTA, Allspice, — is the nearly ripe fruit of Eugenia 
Pitnenta> a West Indian tree of the nat. ord. Myrtacese. The 
berries are nearly globular, about % inch in diameter, crowned 
with the remnants of the calyx, two-celled, each cell containing 
one reniform seed, odor and taste pungent and aromatic. They 
contain a Volatile Oil which is official, a green fixed oil, fat, 
tannin, gum, resin, etc. Dose, gr. x-xl. 

Oleum Pimento, the volatile oil, colorless or pale-yellow, of aromatic 
odor, pungent taste and slightly acid reaction. Is a constituent of Bay Rum 
(Spt. Myrciae). Dose, "ntij-vj. 

Physiological Action and Therapeutics. 

Allspice is a warm, aromatic stimulant, very useful as a condi- 
ment, improving digestion by increasing the vascularity of the 
gastric mucous membrane, and by stimulating the salivary secre- 
tion. The Oil is an agreeable remedy for flatulence, nausea and 
intestinal colic, and is used to prevent the griping of purgatives 
and to cover the taste of nauseous medicines. 



PIPER, Pepper, Black Pepper, — is the unripe fruit of 
Piper nigrum, or Pepper-vine, a perennial plant of the nat. ord. 
Piperaceae, growing in India, Siam, Java, Borneo, etc. It is 
about yi inch in diameter, of globular shape, reticulately wrinkled, 
aromatic, of pungent, spicy taste, and contains an alkaloid, 
Piperine, which is official, also a green, acrid, concrete oil, a 
balsamic volatile oil, starch, lignin, gum, extractive, etc. Dose, 
gr. v-xx. 

Preparations. 

Oleoresina Piperis, Oleoresin of Pepper, — contains almost all the volatile 
oil and acrid resin extracted by ether, with little of the Piperine. Dose, 

Piperina, Piperine, C 17 H 19 N0 3 , — a proximate principle of feeble alkaloidal 
power, prepared from Pepper, and occurring also in other plants of the natural 
order Piperaceae. Occurs in colorless or pale-yellowish prisms, of neutral 
reaction, almost insoluble in water, slightly so in ether, but soluble in 30 of 
alcohol at 59 F. Dose, gr.j-x. 

Physiological Action and Therapeutics. 

Pepper when applied to the skin acts as an irritant ; internally 
its effects are similar to those of other aromatics, being a warm 



300 PISCIDIA. 

carminative and stimulant, increasing slightly the action of the 
heart, stimulating the kidneys somewhat, and toning up the 
mucous membrane of the urinary and intestinal passages, by 
which channels it is eliminated. It has been thought to possess 
antiperiodic powers, and was formerly much employed in inter- 
mittents. Its chief medical use is to correct flatulence, and to 
excite the action of the stomach, being very commonly taken as 
a condiment with food. It is occasionally employed in gleet, but 
more extensively in hemorrhoids and other diseases of the rectum. 
Its active constituents are the concrete oil or resin and the vola- 
tile oil, the alkaloid having very slight action on the system, 
except as an antiperiodic and antipyretic, qualities which it cer- 
tainly possesses. 



PISCIDIA, Jamaica Dogwood (Unofficial), — is the bark 
of the root of Piscidia erythrina, a tree of the nat. ord. Legu- 
minosae, growing in the West Indies. It occurs as a tough, fibrous 
bark, externally blackish, internally greenish, of a heavy, narcotic 
odor, and a bitter, acrid and astringent taste, containing a yel- 
lowish, resinoid substance named Piscidifi. Its active principle 
has not yet been isolated. A fluid extract is on the market, of 
which the dose is 3 ss ~j> carefully increased. 

Physiological Action. 

Piscidia has a narcotic effect on many animals, and has been 
used in Jamaica for many years to stupefy fish that they may be 
easily taken. It produces muscular relaxation, incoordination of 
movement, lowered sensibility, increased action of the heart and 
increase of the arterial tension by stimulation of the vaso-motor 
centre. Soon, however, the heart is weakened, vascular tension 
falls, and a tetanoid state results from stimulation of the spinal 
cord, with reduced reflex action. On the brain its effects resemble 
those of Opium, causing deep sleep without any unpleasant after 
results. It relieves pain in less degree, however, than Opium 
does, but its hypnotic action is greater. It also relieves cough 
and spasm, produces diaphoresis and salivation, and dilates the 
pupils. From toxic doses death occurs by asphyxia. In man it 
probably causes the same effects but in decidedly less marked 
degree. 

Therapeutics. 

Jamaica Dogwood is used chiefly as a general nervous sedative. 
Its hypnotic and anodyne powers are somewhat uncertain, but 



pix. 301 

have in many cases been very decided. It is useful in whooping- 
cough and spasm, and has proved almost specific in many cases 
of neuralgia, while in others it has caused great gastric distress 
without the least anodyne effect. 



PIX, Pitch, — is a resinous exudation from the stem of cer- 
tain trees of the genera Pinus (Pines) and Abies (Firs and 
Spruces) ; and may also be obtained by the evaporation of wood- 
tar. [See Pix Liquida below.] The following varieties are offi- 
cial, viz. : 

Pix Burgundica, Burgundy Pitch, — the prepared, resinous 
exudation of Abies excelsa or Norway Spruce (nat. ord. Coni- 
ferae), a native of Europe and Northern Asia. Occurs in hard, 
brittle, opaque or translucent mass, with a shining, conchoidal 
fracture, reddish-brown color, aromatic and somewhat empyreu- 
matic, not bitter, almost entirely soluble in glacial acetic acid. 
It is very fusible, and at the body-heat it softens and becomes 
adhesive. Used for plasters. 

Pix Canadensis, Canada or Hemlock Pitch, — the prepared 
resinous exudation of Abies canadensis (nat. ord. Coniferae), the 
Hemlock Spruce of the U. S. and Canada. Its properties are 
much the same as those of the preceding. 

Pix Liquida, Tar, — is an empyreumatic oleo-resin obtained 
by the destructive distillation of the wood of Pinus palustris 
and other species of Pinus (nat. ord. Coniferae). Is thick, viscid, 
semi-fluid, blackish-brown, of acid reaction, terebinthinate odor, 
and sharp, empyreumatic taste, slightly soluble in water, soluble 
in alcohol, oils, and in solution of potassa or of soda. By dis- 
tillation it yields an acid liquor named Pyroligneous Acid and an 
empyreumatic oil called Oil of Tar (see Ol. Picis Liquids, be- 
low), the residue being pitch. Its granular appearance is due to 
crystals of Pyrocatechin, C 6 H 4 (OH) 2 , which occur either in the 
Pyroligneous Acid or in the tarry mixture. Dose, 5J~"U daily, in 
ten-grain doses. 

Pi'eparations. 

Oleum Picis Liquids, Oil of Tar,— a volatile oil distilled from Tar. 
Dark, reddish-brown (almost colorless when fresh), of tarry odor and taste 
and acid reaction, readily soluble in alcohol. Contains a great variety of 
compounds, including Hydrocarbons, Phenols, Paraffin, etc., among the 
phenols being Creasote and Carbolic Acid. Is used locally and as an atomized 
inhalation. 

Syrupus Picis Liquids, Syrup of Tar, — has of Tar 6 per cent., and is a 
sweetened Tar-water. Dose, ^ij-^ss. 

Unguentum Picis Liquids, Tar Ointment, — contains equal parts of Tar 
and Suet. 



302 PIX. 

Emplastrum Pi cis Burgundic^, Burgundy Pitch Plaster, — has of Bur- 
gundy Pitch 90, Yellow Wax 10 parts. 

Emplastrum Picis Canadensis, Canada Pitch Plaster, — has of Canada 
Pitch 90, Yellow Wax 10 parts. 

Emplastrum Picis cum Cantharide, Warming Plaster, — has of Bur- 
gundy Pitch 92, Cerate of Cantharides 8 parts. 

Infusum Picis Liquids, Tar Water (Unofficial), — made by shaking Tar 
1 with Water 4 frequently during 24 hours, decanting and filtering. Is stim- 
ulant and diuretic. Dose, Oj-ij daily. 

Vinum Picis Liquids, Wine of Tar (Unofficial), — Tar ^xvj, Glycerin, 
White Wine, Honey, aa ^viij, Acetic Acid gj, Boiling Water Ovj, shaken 
together and digested in a close vessel for two hours at 150 to 160 , then 
macerated for a few days, frequently shaken, strained and filtered. 

Oleum Pini Sylvestris, Oil of Scotch Fir (Unofficial), — a colorless, fra- 
grant oil, distilled from the leaves of Pinus sylvestris ', resembling Turpentine 
in action. Used by inhalation (^ss to Oj of boiling water), or locally. 

YJiysiological Action and Therapeutics. 

Pitch is a gentle rubefacient when applied to the skin, but in 
some constitutions the Burgundy variety causes a vesicular and 
pustular inflammation if used extensively. It is generally em- 
ployed as a basis for plasters, and is of benefit in lumbago, 
rheumatism, chronic pleurisy, painful joints, superficial neuralgiae, 
etc., protecting the part from variations of temperature, and 
perhaps by the gentle pressure exercised stimulating the lym- 
phatics and promoting absorption. It is supposed to have a 
special influence on the rectum, and in pill with Tar has been 
employed as a remedy for hemorrhoids. In applying adhesive 
plasters the hair should first be shaved off, and when about to be 
removed the plaster should be warmed, and a little Oil of Turpen- 
tine inserted between its edge and the skin. 

Canada Pitch is too soft for plasters, but is employed for the 
same purposes as the preceding. A volatile oil obtained from 
the same tree (Oil of Spruce, Oil of Hemlock) has been used for 
abortifacient purposes, endangering the life of the subject. 

Tar is a complex mixture of resins and hydrocarbons, contain- 
ing Creasote and Carbolic Acid which give to it irritant qualities. 
Internally it is expectorant and produces gastro-intestinal irrita- 
tion, sometimes severe headache, giddiness and febrile phenom- 
ena. It is eliminated by the kidneys chiefly, which it stimulates, 
and may cause their congestion and increased diuresis. Exter- 
nally it is a decided stimulant to the skin, often giving rise to 
considerable irritation and pain. It is also antiseptic, and in 
most of its effects it resembles the turpentines. 

Tar is used as a local application in chronic scaly skin dis- 
eases, especially psoriasis and chronic eczema. As an atomized 



PLANTAGO — PLUMBUM. 3O3 

inhalation it is of decided benefit in bronchitis, pharyngitis, 
laryngitis and winter cough. Internally it may be employed 
with advantage in these affections, in hemorrhoids, bronchial 
catarrh, and phthisis. The best preparation for internal admin- 
istration is the syrup, which is a sweetened tar-water, the sugar 
forming with the Tar a soluble compound. 



PLANTAGO, Plantain (Unofficial),— is the leaf of Plan- 
tago maj'or,3.nd Plantago lanceolata (nat. ord. Plantaginaceae), the 
common " Ribbed Grass." The pounded leaves applied as a 
paste, or the dry leaf powdered, are actively hemostatic, stopping 
hemorrhages speedily. Among the ancients it had a good repu- 
tation as a remedy for toothache and earache, which still adheres 
to it in Switzerland and many other parts of Europe. In many 
other painful affections it is extremely efficient, especially in 
mastitis, rhus-poisoning, erysipelas, burns, scalds, wounds and 
bruises. A poultice of the leaves may be applied to the affected 
part, and an infusion administered internally. A fluid extract is 
sold in the shops, of which the dose is ttiv-xv. 



PLUMBUM, Lead, Pb, — is not official, but several of its 
salts are, namely, — the Acetate, Carbonate, Iodide, Nitrate and 
Oxide, of which the Acetate is the only one administered inter- 
nally, the solutions of the Sicbacetate are the only liquid prepara- 
tions, the Oxide (Litharge) is used as Emplastrum Plumbi, the 
Nitrate is used as a local stimulant or escharotic, the Iodide as an 
ointment for absorbent purposes, and the Carbonate as an astrin- 
gent locally to inflamed surfaces. The metal occurs in nature 
chiefly as a Sulphide named Galena, also as an Oxide rarely, and 
in various saline combinations. 

Official Salts of Lead. 

Plumbi Acetas, Acetate of Lead, Sugar of Lead, Pb(C 2 H 3 2 ) 2 .3H 2 0, — 
colorless, shining, prismatic crystals or scales, efflorescent, of faintly acetous 
odor and acid reaction, and a sweetish, astringent and metallic taste. Soluble 
in 1.8 of water and in 8 of alcohol at 59 F., in 0.5 of boiling water and in I 
of boiling alcohol. Dose, gr. ss-v. 

. Plumbi Carbonas, Carbonate of Lead, White Lead, (PbC0 3 ) 2 Pb(HO) 2 , — 
a heavy, white, opaque powder, odorless, tasteless and insoluble in water or 
alcohol, but soluble with effervescence in dilute nitric acid. Used locally as 
ointment, powder, or white paint. 

Plumbi Iodidum, Iodide of Lead, Pbl 2 , — a heavy, bright citron-yellow 
powder, odorless and tasteless, fusible and volatilizable by heat, soluble in 



304 PLUMBUM. 

about 2000 of water at 59 F., and in about 200 of boiling water. Used ex- 
ternally as an ointment. May be given internally in doses of gr. \ twice daily. 

Plumbi Nitras, Nitrate of Lead, Pb(N0 3 ) 2 , — colorless, opaque, octahedral 
crystals, odorless, of sweetish, astringent and metallic taste and acid reaction, 
soluble in 2 of water at 59 F., almost insoluble in alcohol. Used locally as 
an astringent and deodorizer in solutions up to I per cent., also as an escha- 
rotic and a disinfectant. 

Plumbi Oxidum, Oxide of Lead, Litharge, PbO, — a heavy, yellowish or 
reddish yellow powder, odorless, tasteless and insoluble in water or alcohol, 
but almost wholly soluble with slight effervescence in dilute nitric acid. 
When heated in contact with charcoal it is reduced to metallic lead. Used 
as Lead- Plaster and sometimes with oil as an external application. 

Preparations. 

Liquor Plumbi Subacetatis, Solution of Subacetate of Lead, Goulard's 
Extract, — an aqueous solution containing about 25 per cent, of the salt, pre- 
pared from Acetate of Lead 170, Oxide of Lead 120, and Distilled Water q.s. 
ad 1000 parts. It is a clear, colorless liquid, of sweetish, astringent taste and 
alkaline reaction, of sp. gr. 1.228, and when added to a solution of acacia it 
produces a dense, white precipitate. Used locally as an astringent and cool- 
ing lotion, diluted usually with an equal quantity of water. 

Liquor Plumbi Subacetatis Dilutus, — Lead-water, — has of the preced- 
ing 3 parts to 97 of Distilled Water. Used locally as a mild astringent and 
cooling lotion. 

Linimentum Plumbi Subacetatis, — contains of Liquor Plumbi Subace- 
tatis 40 parts to 60 of Cotton-seed Oil. Used as an anodyne application for 
itching, etc. 

Ceratum Plumbi Subacetatis, Goulard's Cerate, — has of the same solu- 
tion 20 parts with 80 of Camphor Cerate, freshly prepared, as it becomes rancid 
easily. Used as an astringent and protective application. 

Emplastrum Plumbi, Lead-plaster, Diachylon Plaster, — Oxide of Lead 32, 
Olive Oil 60, rubbed together and boiled with 10 parts of water. Is white, 
pliable and tenacious, free from greasiness or stickiness, and should be entirely 
soluble in warm oil of turpentine. A good protective in abrasions and bed- 
sores, and the basis of many other plasters. 

Unguentum Diachylon, Diachylon Ointment, — has of Lead Plaster 60, 
Olive Oil 39, Oil of Lavender I. Used locally in eczema and other cutaneous 
disorders. 

Unguentum Plumbi Carbonatis, — has of the Carbonate in very fine pow- 
der 10, Benzoinated Lard 90. Used as a dressing for burns. 

Unguentum Plumbi Iodidi, — has of the Iodide in very fine powder 10, 
Benzoinated Lard 90. Used locally to promote absorption of glandular 
tumors. 

Oleatum Plumbi, Oleate of Lead (Unofficial), — a 20 per cent, solution of 
Oxide of Lead in Oleic Acid. A soft, yellowish ointment, for local use. 

Physiological Actions. 

Lead-salts are all more or less poisonous, but metallic Lead is 
inert until converted into a soluble salt by the acids of the 
stomach. The Acetate in large doses is emetic, so that acute 



PLUMBUM. 305 

lead-poisoning is rare. Its chief phenomena are intense gastro- 
intestinal irritation, vomiting, paralysis, coma and collapse. 

Chronic lead-poisoning (plumbism) has its principal sources 
mpure water conveyed by leaden pipes, the use of hair-dyes, 
handling of printing-type, working in the smelting of lead ores, 
etc. It produces loss of appetite, emaciation, pallor and consti- 
pation, followed by slowing of the heart's action, and accompa- 
nied by violent colic (enteralgia), muscular impairment evinced 
by paralysis of the extensor muscles of the forearm (drop-wrist), 
impaired sensibility and albuminuria. Occasionally aphonia, 
vertigo, gastralgia, headache, stupor and convulsions are mani- 
fested. Rheumatism without fever or tenderness in the joints, 
which however are red and swollen, is a frequent symptom. A 
blue line (sulphide) is seen along the margin of the gums in those 
who do not clean their teeth. Neuralgic troubles may arise, and 
amaurosis often occurs from impairment of the optic nerve. The 
metal becomes deposited in the affected muscles and other tissues, 
and probably acts by impairing the isolating power of the nerve- 
fibres, thus enfeebling the nerve-currents. It also produces con- 
traction of the smaller vessels, and may affect any muscles of the 
body, also the brain, producing delirium, coma and convulsions. 
Abortion is a frequent result, either through an influence on the 
muscular tissue of the uterus, or from a toxic action on the foetus. 
Death may occur from extension of the paresis to the muscles of 
respiration, from gradual impairment of nutrition, or from con- 
vulsions and coma, a form of disease known as Lead-encepha- 
lopathy. 

Astringency is the chief quality of the lead salts; they lessen 
secretion, contract muscular tissue and then destroy its contrac- 
tile power, slow both the heart and the respiration, and in time 
destroy the red blood-corpuscles. Lead enters the blood as an 
albuminate, in which form also it is retained by the tissues. It 
is slowly excreted by the liver, kidneys, skin and mammary 
glands. That which escapes by the bile is reabsorbed by the 
bowel, is again excreted by the intestinal glands, escaping with 
the faeces as a sulphide. It lessens the excretion of uric acid. 

Antidotes and Incompatibles. 

In acute poisoning, as by the Acetate, the antidotes are Sulphate of Sodium 
or of Magnesium, and Phosphate of Sodium. The stomach should be evacu- 
ated, and albuminous drinks and Opium given to allay irritation. Chronic 
poisoning is best treated by Iodides to saturation of the system. Sulphurated 
Potassa baths (§j or more in water) are also very useful. Incompatibles 
are mineral acids and salts, vegetable acids, alkalies, vegetable astringents, 

26 



306 PLUMBUM. 

Iodide of Potassium, albuminous solutions, Opium, and all natural waters 
containing lime, sulphates, carbonates, and Carbonic Acid. 

Therapeutics. 

Lead salts are chiefly used as astringents and hemostatics. The 
solution of the Subacetate diluted with 4 parts of glycerin and 
water is locally employed in many skin-diseases, especially in 
eczema, lichen, impetigo and erythema ; also in catarrhal dis- 
charges of muco-purulent character from the ear, vagina and the 
urethra, particularly in gonorrhoea and leucorrhcea. Inflamma- 
tions of external parts are constantly treated by the lotion of 
" Lead water and Laudanum M (Liquor Plumbi Subacetatis Dilutus 
7 parts to 1 of Tinctura Opii). Though the constituents of this 
lotion are chemically incompatible, it is a valuable sedative and 
astringent. The Acetate, in 5 -grain doses every 3 hours, is an 
efficient internal styptic in various hemorrhages, particularly in 
hemoptysis, hematemesis and gastric ulcer, lowering the action 
of the heart and constringing the vessels. Its astringent action 
is well manifested in bronchorrhcea and other pulmonary affec- 
tions with excessive secretion. It is well used in diarrhoeas, gr. 
ij with gr. j of pulverized Opium in choleraic diarrhoea, and smaller 
doses for the summer complaint of children. In caseous pneu- 
monia the Acetate is highly recommended as the best remedial 
agent, combined with Opium and Digitalis ; and in cardiac hyper- 
trophy it may be often used to lower the action of the heart. It 
is also serviceable in whooping-cough with profuse bronchial 
secretion, and in humid asthma. 

Carbonate of Lead is only used externally to protect irritated 
surfaces, as erythema, erysipelas, intertrigo, etc., in which it may 
be dusted over the surface if unbroken. The official ointment, 
or white paint mixed with linseed oil, is an excellent application 
to burns or scalds, but if applied on the broken cuticle it may 
prove rapidly poisonous. 

The Iodide is employed externally as an ointment to enlarged 
lymphatic glands and enlarged spleen, also to chronic eczema and 
psoriasis. It has been used internally to reduce a malarial spleen. 

The Nitrate is an efficient application to fissured nipples, gr. 
x to ^j of glycerin. In powder, dusted over unhealthy granula- 
tions, and sanious ulcers resulting from onychia, it gives prompt 
relief after a brief period of pain. It is said to have cured cases 
of epithelioma when used in the same manner. In solution (gr. 
x to the^f) it is a most efficient deodorizer against the fetor from 
gangrenWs sores, ozsena and other offensive discharges. Phar- 
maceutically it is used in the preparation of the Iodide. 



PODOPHYLLUM. 307 

The Oxide is used in the preparation of plasters, most of the 
other salts of lead, and Digitalin. It is not employed internally, 
but may be used as an external application mixed with sweet oil 
in superficial burns, but care should be taken that it is only 
applied to the unbroken skin. 



PODOPHYLLUM, May Apple,— is the rhizome and 
rootlets of Podophyllum peltatum (Mandrake), an herbaceous per- 
ennial of the nat. ord. Berberidacese, growing in the woodlands 
of Canada and the U. S., having a pale-green stem about a foot 
high, with a single white flower at its summit. The rhizome is 
horizontal, \ inch thick, consisting of joints about 2 inches long, 
of orange-brown color externally, white and mealy internally, 
inodorous, taste bitter and acrid. Its active principle is a Resin 
which is official, and is a compound of several resins. It prob- 
ably contains the alkaloid Berberine, which is also found in Ber- 
beris, Hydrastis and several other plants. Dose, gr. v-xx. 

Preparations. 
Abstractum PodophYlli,— Dose, gr. %-]. 

EXTRACTUM PODOPHYLLI, — Dose, gr. V-X. 
EXTRACTUM PODOPHYLLI FLUIDUM, — Dose, tttj-xxX. 

Resina PodophYlli, Podophyllin, — is precipitated from a concentrated 
tincture by acidulated water. Soluble in alkaline liquids and partly so in 
ether. Contains Podophyllotoxin, Picropodophyllin, Podophyllinic and Pro to- 
catechuic Acids. Dose, gr. ^-j, in pill. 

Physiological Action and Therapeutics. 

Podophyllum is a tonic-astringent and resin-bearing purgative, 
having an action similar to that of Jalap but slower like Calomel, 
taking 6 to 10 hours to produce its cathartic effect. It increases 
the intestinal secretions and the flow of bile, causing copious 
watery stools, with considerable griping pain and some nausea. 
The powder is irritant to the respiratory passages and the skin. 

Resina Podophylli is an excellent purgative in cases of 
habitual constipation or portal congestion, and is a useful chola- 
gogue. Laxative effects are produced by small doses (gr. J^-J^), 
but grain-doses are necessary for its full action. It should be 
combined with Hyoscyamus,* Belladonna or Cannabis Indica, in 
order to counteract its griping tendency. It is an efficient de- 
rivative in cases of catarrhal or malarial jaundice, and is recom- 
mended in very small doses for prolapse of the rectum, remittent 
fevers of children, dyspepsia, hepatic derangement, bilious vomit- 



308 POLYGONUM HYDROPIPEROIDES — PONGAMIA. 

ing and headache, and in the vomiting and diarrhoea of gastro- 
enteritis. 



POLYGONUM HYDROPIPEROIDES, Water-pep- 
per, Smart-weed (Unofficial), — is a plant of the nat. ord. 
Polygonacese, indigenous to the U. S., having narrow, lanceo- 
lated leaves and slender spikes of whitish flowers. It contains 
Tannin and an active principle, Polygonic Acid, which is green, 
crystallizable, insoluble in water, but soluble in alcohol, ether, 
and chloroform. 

Preparations. 

Extr actum Polygoni Fluidum (Unofficial), — Dose, ""Ix-^j. 
Extractum Polygoni (Unofficial), — Dose, gr. j-v. 

Physiological Action and Therapeutics. 

Smart-weed has a pungent, acrid taste, producing a sensation 
of heat in the stomach, and a peculiar tingling throughout the 
system. It stimulates the action of the heart, raises the arterial 
tension, increases the warmth of the surface, promotes the cuta- 
neous, bronchial and renal secretions and the menstrual flow. It 
is an efficient diuretic, emmenagogue and aphrodisiac. The juice 
applied to the skin excites inflammation and vesication. 

Amenorrhcea from functional inactivity of the uterine system 
is remarkably benefited by this remedy in 3ss doses of the fluid 
extract four times daily for a week before the expected period. 
It has considerable influence over functional impotence, but pro- 
duces aching pains in the hips and loins, and a sense of weight 
and fulness within the pelvis. It has also been used with bene- 
fit in diarrhoea, dysentery, gravel, and locally in mercurial sali- 
vation and the sore mouth of nursing women. 



PONGAMIA, Kurung Oil (Unofficial),— is a yellow oil 
expressed from the seeds of Po?igamia glabra, an Indian tree of 
the nat. ord. Leguminosae. It has been used for many years in 
India for skin affections, and in professional hands has proven an 
excellent application in pityriasis versicolor, rubbed in twice daily. 
It promises to be a valuable remedy in parasitic diseases of the 
skin, is not irritating and does not discolor the surface to which 
it is applied. 



POTASSIUM. 3C9 

POTASSIUM, Kalium, K, — is represented by a number 
of official salts, which are colorless or white, sometimes anhy- 
drous, and generally readily soluble in water. The metal itself 
is not official. The chief source of its salts is the ash remaining 
after the combustion of plants or trees, which contains the Car- 
bonate, from which most of the others are prepared. There are 
also two subsidiary sources, viz. — the Nitrate, which is found 
native ; and the Bitartrate, which, under the name of Crude Tar- 
tar or Argol, is deposited during the fermentation of wine. It is 
distinguished from all other bases (except Magnesium, Sodium 
and Ammonium) by not being precipitated by Ammonium Sul- 
phide or Ammonium Carbonate. It is positively known by the 
violet color it imparts to flame, by its very sparing solubility 
when converted into the Bitartrate, and by its precipitation by 
Platinum Perchloride. 

Potassium Compounds and their Preparations. 

PoTASSA, Potassium Hydrate, Caustic Potash, KHO, — a very deliquescent, 
white, hard and dry solid, of very acrid and caustic taste and strongly alka- 
line reaction, soluble in 0.5 of water and in 2 of alcohol. It is a powerful 
and deeply-acting escharotic, and should be kept in well-stoppered bottles 
made of hard glass. 

Potassa cum Calce, Potassa with Lime, Vienna Paste, — a grayish-white, 
deliquescent powder, consisting of equal parts of Potassa and Lime rubbed 
together. A milder and more manageable caustic than the preceding. 

Liquor Potassa, Solution of Potassa, — contains about 5 per cent, of Po- 
tassium Hydrate, and is prepared by dissolving 90 parts of Potassium Bicar- 
bonate in 400 of Distilled Water, 40 of Lime in the same quantity of Distilled 
Water, boiling, mixing the solutions gradually, again boiling, and when cold 
adding Water up to 1000 parts, straining, settling, and decanting the clear 
solution. Or, by dissolving 56 of Potassa in 944 of Distilled Water. Is a 
clear, colorless, odorless liquid of acrid and caustic taste, and strongly alka- 
line reaction. Dose, lUv-^ss, well diluted with water. 

Potassii Acetas, Acetate of Potassium, KC 2 H 3 2 , — a white, satiny, crys- 
talline mass, or a granular powder, very deliquescent, odorless, of pungent, 
saline taste, and a neutral or faintly alkaline reaction, soluble in 0.4 of water 
and in 2.5 of alcohol at 59 F. Dose, gr. v-^j. 

Potassii Carbonas, Carbonate of Potassium, (K 2 C0 3 1 2 .3H 2 0, — a white, 
crystalline or granular powder, very deliquescent, odorless, of alkaline taste 
and reaction, soluble in 1 of water at 59 F., insoluble in alcohol. Is a con- 
stituent of Unguentum Sulphuris Alkalinum. Dose, gr. ij-xx. 

Potassii Bicarbonas, Bicarbonate of Potassium, KHC0 3 , — colorless prisms 
of saline and alkaline taste and alkaline reaction, soluble in 3.2 of water at 
59° F., decomposed by boiling water, almost insoluble in alcohol. Dose, gr. 
v-xxx. 

Potassii Chloras, Chlorate of Potassium, KC10 2 , — colorless prisms or 
plates, of pearly lustre, of cooling, saline taste and neutral reaction, soluble in 
16.5 of water at 59 F. and in 2 of boiling water; slightly soluble in alcohol. 
It should not be triturated with readily oxidizable or combustible substances. 
Dose, gr. v-xx. [See page 314.] 



3IO POTASSIUM. 

Trochisci Potassii Chloratis, — each troche contains gr. v of Potassium 
Chlorate, with Sugar, Tragacanth and Spirit of Lemon. Dose, j-iij, slowly 
dissolved in the mouth. 

Potassii Citras, Citrate of Potassium, K 3 C 6 H 5 7 .H 2 0, — a white, granu- 
lar, deliquescent powder, of cooling, alkaline taste, and a neutral or faintly 
alkaline reaction, soluble in 0.6 of water at 59 F., slightly soluble in alcohol. 
Dose, gr. x-xxx. 

Liquor Potassii Citratis, — contains about 9 per cent, of the salt, with 
some free Citric Acid and Carbonic Acid gas. Prepared by dissolving 6 of 
Citric Acid and 8. of Potassium Bicarbonate each in 40 of water, filtering and 
adding to the filters in each case enough water to bring to 50 parts, then mix- 
ing the two solutions. Dose, ^ss-^j. 

Mistura Potassii Citratis, Neutral Mixture, — Lemon-juice, fresh and 
strained, 100, Bicarbonate of Potassium about 10 parts or enough to neutralize 
the Lemon-juice. Should be freshly made. Dose, ^ SS- S- 

Potassii Nitras, Nitrate of Potassium, Saltpetre, Nitre, KN0 3 , — colorless, 
transparent prisms or a crystalline powder, of pungent, cooling and saline 
taste and neutral reaction ; soluble in 4 of water at 59 F. and in 0.4 of boil- 
ing water ; almost insoluble in alcohol. Is a constituent of Argenti Nitras 
Dilutus. Dose, gr. v-xx, well diluted. 

Charta Potassii Nitratis, Nitrate of Potassium Paper, — is unsized paper 
immersed in a solution of 20 parts of the salt in 80 of distilled water, and 
dried. Used for inhalation, the fumes from the burning paper being inhaled 
in asthma. 

Potassii Sulphas, Sulphate of Potassium, K 2 S0 4 , — colorless, hard, rhom- 
bic prisms, of sharp, saline and bitter taste and neutral reaction, soluble in 9 
of water at 59 F., and in 4 of boiling water, insoluble in alcohol. Dose, gr. 
xx-^ss, well diluted. 

Potassii Tartras, Tartrate of Potassium (KgC^H^Og^.HgO, — small, trans- 
parent crystals, or a white powder, somewhat deliquescent, of saline, bitter 
taste, and neutral reaction, soluble in 0.7 of water, almost insoluble in alco- 
hol. Dose, gr. xx-^ss. 

Potassii Bitartras, Bitartrate of Potassium, Acid Tartrate of Potash, 
Creamor Tartar, Cream of Tartar, KHC 4 H 4 6 , — colorless rhombic crystals, 
or a white, gritty powder, of acidulous taste and acid reaction; soluble in 210 
of water at 59 F., and in 15 of boiling water, very slightly soluble in alcohol. 
Is a constituent of Pulvis Jalapae Compositus. Dose, gr. xx-^ss. 

Potassii et Sodii Tartras, Tartrate of Potassium and Sodium, Rochelle 
Salt, KNaC 4 H 4 6 .4H 2 0, — colorless, rhombic crystals, or a white powder, of 
cooling and slightly saline and bitter taste, and neutral reaction ; soluble in 
2.5 of water at 59 F., very soluble in boiling water, almost insoluble in alcohol. 
Is a constituent of the following preparation. Dose, Jfss-j. 

Pulvis Effervescens Compositus, Compound Effervescing Powder, Seid- 
litz Powder, — each has of the preceding salt 120 grains, of Sodium Bicar- 
bonate 40 grains, mixed in one paper; and of Tartaric Acid 35 grains in 
another paper. Dose, 1 or 2 pair, dissolved separately in water and the solu- 
tions poured together. 

Potassii Silicas, Silicate of Potassium, Soluble Glass, K 2 Si0 3 (Unofficial), 
— is used in solution of a syrupy consistence for the preparation of immovable 
dressings for fractured limbs, etc. (See under Silicates.) 

[The Arsenite of Potassium is described under Arsenic, page 85 ; — 
the Bromide under Bromum, page 103 ; — the Bichromate under Acidum 
Chromicum, page 23; — the Iodide under Iodum, page 231 ; — the Cyanide 



POTASSIUM. 3 1 1 

and Ferrocyanide under Acidum Hydrocyanicum, page 29 ; — the Hypo- 
phosphite under Phosphorus, page 289 ; — the Permanganate under Man- 
ganum, page 256; — the Sulphite under Acidum Sulphurosum, page 36 ; — 
the Nitrite under Amyl Nitris, page 65; — and Sulphurated Potassa 
under Sulphur.] 

Physiological Action. 

Caustic Potash, like other caustic alkalies, destroys the tissues 
by combining with their water, dissolving the albumen and 
saponifying the fats, and converting the tissue -to which it is 
applied into a moist, gray slough, with considerable surrounding 
inflammation. Internally it acts as a powerful corrosive poison, 
destroying the mucous membrane of the parts with which it 
comes in contact, and giving rise to intense pain, diarrhoea, con- 
vulsions and delirium. Unless speedily rejected or neutralized it 
causes death from inflammation of the larynx, the gastro-intestinal 
lesions, or after some time from stricture of the oesophagus. 
Liquor Potass^e, containing over 5 per cent, of the pure Potash, 
possesses in a degree the same caustic properties, and should 
never be administered undiluted. It neutralizes the acids in the 
stomach, and in the blood exists chiefly as the Carbonate, being 
eliminated with the urine which it renders alkaline. If its use 
be continued too long it impairs the blood, and renders the sub- 
ject anaemic. 

Potassium Salts in large doses are cardiac poisons, muscular 
paralyzers, poisonous to protoplasm, especially nerve-tissue, and 
destructive to the ozonizing function of the blood. They 
increase the saliva, promote oxidation and stimulate retrograde 
metamorphosis ; and are therefore waste-producers. In small 
doses on an empty stomach they promote the formation of acid 
gastric juice by favoring the outward osmosis of its constitu- 
ents from the blood ; in larger doses they act chemically on the 
stomach contents, neutralizing its free acids, and disordering 
digestion. The Bicarbonate, given on an empty stomach, 
enters the blood unchanged, meets the neutral phosphate of 
sodium and is decomposed, acid phosphate of sodium being 
formed, which renders the urine more acid. On a full stomach 
it is decomposed by the acids of the gastric juice, increases the 
alkalinity of the blood and makes the urine less acid. The Salts 
of Potassium with Vegetable Acids (Acetate, Citrate, Tartrate, 
etc.) enter the blood in their own form, are there converted into 
alkaline carbonates in which form they are eliminated, forming 
free carbonic acid, alkalinizing the blood and the urine, and are 
diuretics, increasing the urinary water and solids, but decreasing 
the uric acid by causing increased oxidation. The Mineral 



3 1 2 POTASSIUM. 

Salts (Nitrate, Chlorate, etc.) are not decomposed in the blood 
but are eliminated in their own form, the Nitrate being a most 
active diuretic, the Chlorate irritating the kidneys, depressing 
the heart, causing albuminuria, and impairing the ozonizing 
function of the blood. In large doses these salts decompose 
the red blood-corpuscles and paralyze the motor ganglia of the 
heart. The Chlorate does not part with its oxygen in the 
system, as generally believed. The Sulphate is chiefly purga- 
tive in its action, but acts harshly, and in overdoses has caused 
death. 

[The action of the remaining Potassium salts is described under 
the titles of their acid and other constituents, to which their effects 
are chiefly referable.] 

Antagonists and Incompatibles. 

Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as 
vinegar, cider, lemon-juice ; — then demulcent drinks and oils to protect the 
mucous membrane, and the usual measures to support vitality. The alkalies 
and their carbonates are incompatible with the acids and also with metallic 
salts, and the caustic alkalies decompose most of the alkaloids. 

Therapeutics. 

Caustic Potash is used locally to destroy morbid or cica- 
tricial tissue, to cauterize the wounds resulting from bites of 
animals or stings of insects, to form issues or to open deep-seated 
abscesses, and to destroy chancres, malignant pustules, naevi, 
warts, etc. Its action is deep and severe, and it is best employed 
in the form of Potassa cum Calce, which is far more manageable. 

Liquor Potass^: is used internally as a free alkali to neutralize 
excess of acid in the stomach, blood and secretions, as an anti- 
lithic in the uric acid diathesis, also for acne, boils, and obesity. 
Locally it is employed to soften the nail in in-growing toe-nail, 
and diluted to relieve pruritus and remove scales in various skin- 
diseases. In small doses with a vegetable bitter tonic before 
meals it acts well in atonic dyspepsia, increasing the flow of the 
gastric juice by direct stimulation of the gastric mucous mem- 
brane. If given after meals in acid dyspepsia large doses are 
necessary for temporary alleviation by neutralizing the food acids. 
These remarks concerning acidity and dyspepsia apply equally well 
to the Bicarbonate, which is used for the same purpose, and 
while possessing all the virtues of the potassium salts, is without 
any corrosive or irritant action. It is also useful in simple gas- 
tralgia or cardialgia ; and in cystitis, gonorrhoea, etc., where 
there is acid urine, it renders the urine less irritating and soothes 
the inflamed surfaces. Acute and chronic rheumatism and rheu- 



POTASSIUM. 313 

matoid arthritis are much benefited by an alkaline treatment 
in patients of sufficient bodily vigor to stand its lowering effects. 
The Bicarbonate is also used to alkalinize the blood and secre- 
tions in lithaemia, jaundice, many cutaneous eruptions, and in 
diabetes ; also locally as a lotion for fetid perspiration of the feet 
and axillae, acne and acute eczema. The Carbonate is diuretic, 
antacid and antilithic, but is seldom used internally, being too 
irritant, and the Bicarbonate having all its virtues without its 
objectionable qualities. Locally a solution (5j to the §) is said 
to be effectual as a remedy for pruritus vulvae, and one of half the 
above strength is used in freckles, sunburn and tan of the epi- 
dermis, in moist eczema and the itching of urticaria. 

The Acetate, Citrate and Tartrate are good purgatives in 
doses of Jij to %\v, and in smaller doses are much employed as 
alkalinizers of the blood and urine, diuretics, etc. Of these 
vegetable potassium salts the Acetate is the most certain diuretic, 
the Bitartrate is the most active cathartic, while the Citrate is the 
most reliable diaphoretic and the best agent to use to alkalinize 
the urine for any length of time, it having the least injurious 
effect on the blood or on the digestion. In lithaemia these salts 
are given to promote oxidation, and by keeping the urine alka- 
line they may reduce small calculi of the uric acid variety. In 
acute rheumatism and fevers they act as antacids in the blood, 
as febrifuges by promoting diaphoresis, and as sedatives to the 
general nervous system. As an agreeable laxative no preparation 
surpasses the Bitartrate in 2 to 4 drachm doses made into a paste 
with orange marmalade or any other conserve. It is also used 
in Infusion of Juniper as a diuretic in general cardiac dropsy, 
and without the Juniper in acute desquamative nephritis. 

Potassium Chlorate is much employed locally in solution 
(3ss to the g) as a deodorizer and detergent wash in inflamed, 
ulcerated and aphthous conditions of the mouth. On unhealthy 
mucous membranes generally it exercises an alterative action for 
the better, but if too long used it will keep up a state of chronic 
irritation. In mercurial salivation it is of great benefit, and in 
dilute solution (gr. x to the g) it is an efficient application to un- 
healthy sores and ulcers, as a wash for foul sinuses or cavities, and 
as an injection in chronic affections of the bladder. The powdered 
salt may be applied to aphthae, and dusted over epithelioma will 
alter the action, diminish the pain, check the growth and pro- 
mote cicatrization. Internally this salt has been administered in 
the mistaken idea that it parts with its oxygen in the system, 
but it is now shown that it is excreted unchanged. Setting up 
congestion and irritation of the kidneys it is highly dangerous 



314 PRINOS. 

in large doses or if used for any length of time, but is constantly 
administered in diphtheria, chronic bronchitis, purpura, hema- 
turia, ovarian tumor, pseudo-membranous laryngitis, scarlatina, 
typhoid fever, chronic cystitis, etc. When used internally it 
should be given in small doses (gr. xx in 24 hours for an infant, 
gr. xxx in 24 hours for a child of 2 to 4 years, and 3j ss f° r an 
adult in the same time), and the action of the heart and the kidneys 
should be carefully watched. It should never be prescribed with 
the Iodide of Potassium lest the poisonous Iodate be formed. 
Strong acids and acid sulphates decompose it, and it forms 
explosive compounds with easily oxidizable substances as Sugar, 
Sulphur, Tannin, Sodium or Potassium Hypophosphites, Catechu, 
Glycerin, etc. 

Potassium Nitrate has been much employed as a refrigerant 
diaphoretic and diuretic in febrile and inflammatory affections, 
especially in inflammation of the trachea and bronchi, pneu- 
monia and rheumatism, but its action is uncertain and it is now 
giving place in these disorders to more efficient agents. The 
fumes of burning nitre paper (Charta Potassii Nitratis) are a useful 
inhalation in some forms of spasmodic asthma. 

Potassium Sulphate is used in teaspoonful doses in water as 
an hepatic stimulant and a mild cathartic, increasing the secre- 
tions of the intestinal glandular apparatus. Its action is some- 
times harsh, and death has resulted from overdoses. 

The Tartrate of Potassium and Sodium, or Rochelle Salt, 
is the chief aperient agent in Seidlitz Powders. In doses of 
§ss-j it is a gentle and cooling laxative, and in drachm doses fre- 
quently repeated it is used to render the urine alkaline, and as 
an anti-lithic. 

[The uses of the other Potassium Salts are described as noted 
on page 312.] 



PRINOS, Black Alder, — is the bark of Prinos verticillatus 
or Winter-berry, a shrub of the nat. ord. Aquifoliaceae, indig- 
enous in Canada and the U. S., having small, white flowers, and 
a globose, six-seeded, bright-red berry, which grows in clusters 
and is persistent all winter. The bark occurs in thin, slender 
fragments, of a brownish-ash color externally, and a pale-green 
or yellow internally; taste bitter and slightly astringent. It 
contains an amorphous, yellow and bitter principle, also tannin, 
sugar, starch, wax, resin, etc. There are no official preparations, 
but the bark may be given in substance in doses of 5 s s, or a 
decoction (5ij in Oiij boiled to a quart) in doses of §i-ij. 



PRUNUM PRUNUS VIRGINIANA. 315 

Physiological Action and Therapeutics. 

Black Alder is astringent and tonic, and has been used in 
intermittent fever, diarrhoea, and chronic cutaneous diseases. In 
the latter class of disorders it may be applied locally. 



PRUNUM, Prune, — is the fruit of Prunus domesttca, the 
Plum tree (nat. ord. Rosacese), indigenous to Western Asia, but 
cultivated in most countries of temperate climate. The dried 
fruit (Prune) is oblong, shrivelled, of blackish-blue color, having 
an almond-shaped seed. Prunes contain sugar, pectin, albumen, 
malic acid and salts. They are a constituent of Confectio Sennae. 

Physiological Action and Therapeutics. 

Prunes are laxative and nutritious, and are freely used as a food 
and sweetmeat, but in excess may give rise to flatulent colic from 
the indigestibility of their skins. Stewed Prunes is an excellent 
dish for constipation in children, and may be made more effec- 
tive by the addition of a little Senna. 



PRUNUS VIRGINIANA, Wild Cherry— is the bark 
of Pru?ius serotina, or Wild Cherry, a large forest tree of the 
nat. ord. Rosacese, growing in Canada and the U. S. The bark 
should be collected in autumn from the large branches only, and 
comes in curved pieces y 1 ^ inch or more thick, of greenish or 
yellowish-brown color externally, and astringent, aromatic and 
bitter taste. On maceration in water it develops a distinct odor 
of bitter-almonds. It contains tannin, gallic acid, resin, starch, 
etc., also Amygdalin and Emulsin, which by their mutual reaction 
in the presence of water, produce Hydrocyanic Acid and a Vola- 
tile Oil resembling that of Bitter Almond. [See ante, Amygdala, 
page 63, and Acidum Hydrocyanicum, page 29.] Dose of the 
powdered bark, 5 s s-j. 

Preparations. 
EXTRACTUM PRUNI VIRGINIANS FLUIDUM, — Dose, ^SS-j. 

Infusum Pruni Virginians, — 4 per cent. Dose, g ss— ij . Should be 
made with cold water. 

Syrupus Pruni Virginians, — 12 per cent. Dose, 3J-iv. 

Physiological Action. 

Wild Cherry is an aromatic bitter tonic, increases appetite, 
aiding digestion, and thus promoting constructive metamorphosis. 



316 PULSATILLA. 

The presence of a volatile oil gives it a local stimulating action 
on the alimentary canal in common with Serpentaria, Cascarilla 
and other members of the same class. Hydrocyanic Acid being 
yielded by it in the presence of cold water, results in imparting 
a sedative action to its preparations, calming irritation and dimin- 
ishing nervous excitability. Very large doses reduce the action 
of the heart. 

Therapeutics. 

The preparations of Wild Cherry are used in catarrhal condi- 
tions of the bronchial mucous membrane, in the hectic of phthisis 
and scrofula, palpitation of the heart, and debilitated stomach, a 
collection of symptoms often observed in consumptive subjects, 
to whom it is a very useful palliative. Cough is supposed to be 
especially amenable to its influence, and hence it has become a 
matter of daily routine to prescribe the syrup as an ingredient of 
cough-mixtures. The infusion is an excellent stomachic tonic, 
and may be administered with great benefit in dyspepsia and in 
convalescence from acute disease. 



PULSATILLA, Pasque -flower, Meadow Anemone, 

— is the herb, collected soon after flowering, of Anemone Pulsa- 
tilla and Anemone pratensis (Pulsatilla nigricans), and of Anemone 
patens (Pulsatilla Nuttalliana), small herbal plants of the same 
natural order (Ranunculaceae) to which Aconite belongs. The 
first-named species inhabit Europe and Siberia, and have large, 
purple flowers ; the last-named is an inhabitant of the United 
States, and sometimes has whitish-colored flowers ; all are inodor- 
ous and very acrid. Pulsatilla contains a very acrid yellow oil, 
which in the presence of water is gradually changed to Anemonin, 
C 15 H 12 6 , a volatile, crystallizable, camphoraceous principle, sol- 
uble in chloroform, nearly insoluble in ether or water; and Ane- 
tnonic Acid, C 15 H u 7 , a white, crystalline, tasteless powder, which 
may be formed also by the action of alkalies on Anemonin. 

There are no official preparations, but a tincture may be made according 
to the pharmacopceial directions for Tincturse Herbarum Recentium (i in 2), 
of which die dose is TUJ-— TTLx. The imported homoeopathic tincture has 
equal parts of the expressed juice and alcohol, and is generally a very good 
preparation. 

ANEMONINUM, Anemonin (Unofficial), — the active principle. Dose, gr. ^- 
ij in pill. 

Physiological Action. 

Pulsatilla is a local irritant, the fresh juice producing numbness 
and tingling in the part to which it is applied, and may excite vio- 



PULSATILLA. 317 

lent inflammation of the skin with vesicular or pustular eruption, 
and if swallowed severe irritation of the gastro-intestinal mucous 
membrane. On the tongue it produces symptoms like those from 
Aconite, viz. — tingling and burning, followed by numbness. In- 
ternally it lowers the heart and arterial tension, reduces respira- 
tion and temperature, dilates the pupils, produces nausea and 
vomiting, diaphoresis and diuresis, and paralyzes motion and 
sensibility. Stupor, coma and convulsions may be caused by a 
toxic dose. Most of these effects have been observed on rabbits. 
The active principle (Anemonin) is volatile, hence the herb must 
be fresh to be suitable for medicinal use. 

Antagonists and Incompatibles. 

Alcohol, Opium and Digitalis are the physiological antagonists. Incom- 
patibles are the caustic alkalies, Tannic Acid and the metallic salts. 

Therapeutics, 

Pulsatilla is a very efficient remedy if a fresh preparation be 
employed. It was highly praised by Storck for amenorrhcea, 
corneal opacities, cataract, paralyses, rheumatism, old ulcers, 
constitutional syphilis and scaly skin diseases. On the generative 
organs it seems to have a specific action, and is an excellent 
remedy in functional amenorrhcea, dysmenorrhea, menstrual 
suppression from fright or chill, leucorrhceal discharges with back- 
pains and nervous depression. Epididymitis and orchitis are 
often controlled and even dissipated by very small doses (m T V~ 
%) every 2 hours. It quickly relieves dyspepsia or subacute 
gastritis, with white coated tongue, no taste or a greasy sensation 
in the palate, nausea, flatulence, heartburn, etc. Many acute 
inflammations of mucous surfaces with mucous or muco-purulent 
discharges, as coryza, otitis (externa and interna), rhinitis, bron- 
chitis, conjunctivitis, etc., are greatly benefited by 5 to 10-drop 
doses every 4 hours and locally 5j~ij °f tne tincture to %iv water 
as a lotion. A similar use of this remedy has proven of great 
benefit in many cutaneous affections, especially eczematous erup- 
tions, syphilides, and ulcers of indolent character. It is also 
said to be efficiently employed in acute cerebral and spinal me- 
ningitis, subacute rheumatism of the small joints, rheumatic gout, 
chronic vesical and nasal catarrhs, gastro-enteric symptoms of 
remittent fever and measles, ophthalmia neonatorum, strumous 
ophthalmia with profuse but bland discharge, acute and subacute 
inflammations of the middle ear, and in left-sided clavus, hemi- 
crania and inframammary pain. An extract of the root has 
proved efficient against tapeworm. 



3 1 8 PYRETHRUM. 

Coughs which are loose by day but dry and tickling on lying 
down at night are greatly benefited by Pulsatilla, and Anemonin 
in doses of gr. J^-j has been found extremely useful in whooping- 
cough and other coughs of irritative character. 



PYRETHRUM, Pellitory,— is the root of Anacyclus Py- 
rethruni, a plant of the nat. ord. Compositae, native of Northern 
Africa, but cultivated in Europe. The root is 2 to 4 inches long, 
y 2 inch thick, annulate above, wrinkled below, externally a dark 
grayish-brown, internally brownish-white ; the bark thick, con- 
taining two circles of resin-cells surrounding slender wood- 
bundles and medullary rays ; inodorous, pungent and acrid. It 
contains an alkaloid Pyrethrine, also inulin, tannin, mucilage, 
etc., with a brown Resin and two fixed oils. Dose, as a mastica- 
tory, 5ss-j. 

Pyrethrum Roseum, Persian Pellitory (Unofficial), — is indige- 
nous to Western Asia, and resembles Chamomile in appearance. 
The flower-heads are used in powder to kill insects, 4 grains kill- 
ing a fly in a vial in 2 or 3 minutes. 

Preparation. 
TiNCTURA PYRETHRI, — 20 per cent. Not used internally. 

Physiological Action. 

Pellitory is an irritant sialogogue. When chewed it causes a 
pricking sensation in the tongue and fauces with heat, acridity, 
pungency and a copious flow of saliva and buccal mucus. Large 
doses may cause bloody diarrhoea, tetanoid spasms, accelerated 
pulse, and profound stupor. Applied to the skin it acts as a ru- 
befacient, the powder inhaled as a sternutatory. It stimulates 
the local nerves and vessels of the mouth and salivary glands by 
direct irritant action, but soon depresses the nerves and blunts 
their sensibility. 

Therapeutics. 

Pellitory is chewed as a masticatory and sialogogue in paraly- 
sis of the tongue, rheumatic and neuralgic affections of the head 
and face, and pain from carious teeth. Its powder has been rec- 
ommended as a sternutatory in chronic catarrh of the frontal 
sinuses. As a gargle or lotion (3iij to Oj) it is very useful for 
relaxed uvula and as a mouth-wash. When used for toothache a 
few drops of the tincture should be inserted into the cavity on 
cotton wool. Used as a sialogogue it is an efficient agent to se- 



QUASSIA. 319 

cure the rapid elimination of Iodine from the system in chronic 
poisoning thereby. 



QUASSIA, — is the wood of Picrcena excelsa, a large tree of 
the nat. ord. Simarubacese, indigenous to Jamaica and other 
West Indian islands. Surinam Quassia, used in Europe, is the 
wood of Quassia amara. Both varieties, as met with in the 
shops, are in the form of chips or raspings, of a yellowish-white 
color, inodorous but of intensely bitter taste. The wood is also 
turned into cups, which are sold under the name of quassia- or 
bitter-cups. It contains a bitter principle, Quassin, C 31 H 42 9 , 
which is crystalline, soluble in hot alcohol and in chloroform, 
slowly in cold water, faster in alkaline or acidulated water. Dose 
of the powdered wood, gr. xx-xxx. 

Preparations. 

Extractum Quassia, — aqueous. Dose, gr. j-iij, 

Extr actum Quassia Fluidum, — Dose, ^ss-j. 

Tinctura Quassia, — strength 10 per cent. Dose, ""Iv-^j. 

Infusum Quassia (Unofficial), — made with cold water ^x, Quassia-chips 
gj, macerated for y z hour and strained. Or water poured into a quassia-cup 
and left standing will give a good infusion. Dose, ^j-iij. 

Physiological Action, 

Quassia is a simple bitter, having no flavor, but is intensely 
bitter and less agreeable than either Gentian or Chiretta. It is 
fatal to flies and fish, and makes an excellent anthelmintic enema 
against the thread-worm. A concentrated preparation is poison- 
ous to rabbits and dogs, and has produced very alarming narcotic 
symptoms in a four-year-old child. As usually administered its 
action is that of a bitter stomachic tonic, as described under 
Calumba (see ante, page 114). 

Therapeutics. 

The preparations of Quassia contain no tannin and hence may 
be prescribed with salts of Iron. It is chiefly employed in atonic 
dyspepsia with pain after eating, and vomiting or regurgitation 
of food, also in atonic diarrhoea depending on indigestion or an 
irritable condition of the intestinal mucous membrane. It is 
useful in convalescence to promote the appetite and digestion, 
and with Sodium Bicarbonate in gastric vertigo. As an enema 
the strong infusion is an effective remedy for ascarides of the 



320 QUEBRACHO. 

rectum. It has been used as a feeble antiperiodic, and in hys- 
teria its repulsiveness is an aid to its medicinal action. 



QUEBRACHO (Unofficial),— is the bark of Aspidosperma 
Quebracho, a large evergreen tree of the nat. ord. Apocynaceae, 
growing in Chili and the Argentine Republic. The name is one 
given in S. America to any very hard wood {quebrar hacho, to 
break the axe), and the particular tree above named is known as 
Quebracho bianco, from the white color of its wood. It contains 
several alkaloids, no one of which represents the action of the 
bark itself; the most important being Aspidospermine, C 22 H 30 N 2 O 2 , 
and Quebrashine, C 2l H 26 N 2 O r Several false Quebrachos are found 
on the market, that most frequently seen being the bark of Zox- 
opterygium Lorentzii, or Quebracho Colorado, an Argentine tree 
of the order Terebinthaceae. 

Preparations. 

Tinctura Quebracho (Unofficial), — 20 per cent. Dose, gj-§ss. 
Extr actum Quebracho Fluidum (Unofficial), — Dose, ""Iv-^j. 
Vinum Quebracho (Unofficial), — Quebracho 1, Alcohol 2, White Wine 16 
parts. Dose, 3J-3J. 

Extractum Quebracho (Unofficial), — Dose, gr. ij-viij. 

Physiological A ction . 

Quebracho is a bitter tonic of disagreeable taste, promoting 
appetite and increasing digestion. It lowers the action of the 
heart, reduces arterial tension, and slows respiration, also de- 
creasing the sensation of need of air after active exercise. In 
large doses it causes severe salivation, nausea, vomiting, vertigo 
and headache. In animals it paralyzes the motor nervous system 
and lowers the reflexes, producing great dyspnoea and finally 
death apparently from asphyxia. 

Aspidospermine is actively poisonous to the respiratory appa- 
ratus and circulation in both cold- and warm-blooded animals, 
in the former the respiration being chiefly affected, in the latter 
the motor ganglia of the heart. Lowered temperature, dyspnoea, 
stupor and convulsions occur before death. 

Therapeutics. 

Quebracho has long been used in Chili as an antiperiodic, a 
stomachic tonic, and a remedy for dyspnoea. In the latter con- 
dition it is reported to be remarkably palliative, especially when 
due to emphysema, ursemic and spasmodic asthma, spasmodic 



QUERCUS ALBA — QUILLAIA. 32 1 

cough and chronic bronchitis. It is not efficient in dyspnoea 
from organic disease of the heart, nor in that of aged subjects of 
atheroma. 

Aspidospermine has been used as an antipyretic, also in car- 
diac neuroses and in asthma. Its salts are freely soluble in water, 
but the alkaloid itself is only soluble in oils and fats, 6 to 8 parts 
being readily incorporated with 100 of cod-liver oil by the aid 
of heat. Its average dose is gr. j-ij. 



QUERCUS ALBA, White Oak,— is the bark of Quercus 
alba, the White-oak tree (nat. ord. Capuliferae), and occurs in 
nearly flat pieces deprived of the corky layer, of pale-brown color, 
tan-like odor, and strongly astringent taste ; or as a coarse, 
fibrous powder, which does not tinge the saliva yellow. It con- 
tains a variety of Tannin named Quercitannic Acid, C 28 H 24 12 , 
also Pectin and a bitter principle Quercin, but no Gallic Acid. 
There are no official preparations, but a decoction (gj ad Oj) 
may be used in doses of gss-j. 

Quercus Tinctoria, Black Oak Bark, — was formerly official. It contains 
a coloring principle Quercitrin, which stains the saliva yellow when the bark 
is chewed, also Quercitannic Acid, etc. 

Quercus Lusitanica is the source of Galls (see ante, Galla, page 199). 

Physiological Action and Therapeutics. 

Oak-bark is astringent and tonic, but is seldom used internally. 
Its action and uses are those of Tannic Acid (see ante, page 38). 
The decoction is much used in country practice as a cheap astrin- 
gent application or injection in leucorrhcea, prolapsus ani, hemor- 
rhoids, etc., and as a gargle in faucial inflammation and prolapsed 
uvula. It has also been used as an injection into dropsical cysts, 
and as a lotion for flabby ulcers and suppurating wounds. The 
powdered bark as a poultice has proved an excellent application 
in gangrene, and in finely pulverized state it is a useful ingredi- 
ent of tooth-powders. A concentrated fluid extract is used in 
the Heaton-Warren operation for the radical cure of hernia, by 
injection into the tissues around the margin of the ring, with the 
object of exciting inflammation and occlusion of the opening. 



QUILLAIA, Soap-Bark, — is the inner bark of Quillaia 
Saponaria, a tree of the nat. ord. Rosaceae, indigenous to Peru 
and Chili. It occurs in large, flat pieces, about \ inch thick, of 
a brownish -white color externally, very acrid and sternutatory, but 

27 



322 RESINA. 

inodorous. It contains Calcium Sulphate crystals, starch, and 
the glucoside Saponin, C 32 H 54 18 , a white, amorphous, sternuta- 
tory powder, soluble in water and in dilute alcohol. There are 
no official preparations, but a tincture may be prepared by ex- 
hausting one part of the bark with sufficient dilute alcohol to 
make 5 parts of tincture. 

Physiological Action and Therapeutics. 

Quillaia in powder is sternutatory and causes the water in 
which it is macerated to froth, making emulsions of oils, and 
being used instead of soap for washing purposes in various affec- 
tions of the skin, and to stimulate the growth of the hair in alo- 
pecia. Its properties are due to the glucoside Saponin, which is 
found also in Senega and in a number of other plants, and is a 
violent irritant of the respiratory passages, a local anaesthetic, an 
antipyretic, a powerful paralyzant of the heart and respiration, 
and a poison to the voluntary muscles. It has not been made 
use of in practical medicine. 

A decoction of the bark (5 to 200) has been employed in doses 
of 3j-ij according to age, as a substitute for Senega in the treat- 
ment of diseases of the respiratory organs where a pleasant 
expectorant is indicated. Its expectorant properties are well 
established, and children take it readily. It does not provoke 
diarrhoea or vomiting, and has a sweetish, agreeable taste. 



RESINA, Resin, Rosin, Colophony, C 44 H 62 4 , — is the 

residue left after distilling off the volatile oil from Turpentine. 
It is a transparent, amber-colored substance, of sp. gr. 1.070 to 
1.080, hard and brittle, with a glossy and shallow conchoidal 
fracture, and a faintly terebinthinate odor and taste, soluble in 
alcohol, ether, fixed or volatile oils, and in its own weight of oil 
of turpentine. Chemically it is considered as the Anhydride of 
Abietic Acid, C^H^Og, into which acid it is converted by agita- 
tion with warm diluted alcohol. Silvic, Pinic and Palmaric 
Acids are decomposition products, not constituents of the resin 
as formerly taught. Other official resins are Resina Copaiba, 
Resina Jalaps, Resina Podophylli and Resina Scammonii, 
which are severally described under the titles of the plants form- 
ing their respective sources. 

Preparations, 

Ceratum Resins, Resin Cerate, Basilicon Ointment, — consists of Resin 
35, Yellow Wax 15, and Lard 50 parts. It forms 65 per cent, of Turpentine 
Liniment, and is a constituent of Savine Cerate. 



RESORCINUM. 323 

Emplastrum Resin^e, Resin Plaster, Adhesive Plaster, — consists of Resin 
14, Lead Plaster 80, Yellow Wax 6 parts. Is the common adhesive plaster of 
surgery, and an ingredient of the official Arnica, Belladonna and Capsicum 
Plasters. 

Resin itself is an ingredient of Mercurial Plaster, Cantharides Cerate, and 
Cerate of the Extract of Cantharides. 

Physiological Action and Therapeutics. 

Resin gives consistence and adhesiveness to plasters and cerates, 
and generally acts as a mild local stimulant, but the writer has 
seen persons with so susceptible a skin that the ordinary adhesive 
plaster would produce on them a high degree of cutaneous irrita- 
tion. It is never employed internally, but in chronic bronchial 
catarrh the fumes from boiling resin are inhaled with considerable 
advantage. Resin Cerate is one of the most commonly used 
applications to promote the healing of indolent ulcers, blistered 
surfaces, burns, scalds, chilblains, etc. 



RESORCINUM, Resorcin, C 6 H 4 (HO) 2 (Unofficial),— is 
a diatomic phenol, isometric with Pyrocatechin and Hydroquinone 
(see ante, page 151), obtained by fusing certain resins with a 
caustic alkali, but best prepared by fusing Potassium Benzol- 
disulphonate with Caustic Potassa, the salt being decomposed 
into Potassium Sulphite and Resorcin. It crystallizes in color- 
less, rhombic prisms or plates of neutral reaction, odorless, and 
of sweetish, acrid taste, soluble in 1^ of water, also in alcohol, 
ether, etc. Dose, gr. v-xv \ — as an antipyretic 3j> not repeated 
for several hours, or gr. v every 2 hours. 

Physiological Action. 

Resorcin is closely allied to Carbolic Acid, but possesses the 
advantage over the latter in that it is odorless, more soluble and 
almost non-irritant. It is equally powerful as an antiseptic and 
antiferment, arresting decomposition and destroying low organ- 
isms. Injected beneath the integument in solution it produces 
very little irritation, and never causes inflammation or abscess. 
Vesication results from its application to the mucous membrane. 
Internally a 30- to 60-grain dose causes a sense of heat, discomfort 
and oppression, followed by profuse perspiration and languor; if 
fever be present the temperature of the body is lowered several 
degrees, but rises again after a rigor in from 2 to 4 hours. 
Larger doses (150 grains) have produced deafness, dizziness, sali- 
vation, confused vision, vertigo, unconsciousnes, general clonic 



324 RHEUM. 

convulsions, and tetanic rigidity of the muscles of the neck, with 
no decline of temperature in feverless subjects. Toxic doses (gr. 
xv to each §xxxv of weight) cause in animals trembling succeeded 
by epileptiform convulsions, which increase in severity and then 
decline, the respiration is quickened and enfeebled, the heart's 
action becomes rapid, weak, and irregular, and death results from 
paralysis of respiration, the drug paralyzing the motor tracts in 
the spinal cord, but not affecting the general sensibility. It is 
eliminated chiefly by the urine, which it colors a bluish-violet hue, 
and with great rapidity, about one hour serving for its excretion. 
The best test for its presence is the solution of the Perchloride of 
Iron, which produces with it a dark-violet, almost black color. 

Antagonists. 

Atropine and other cardiac and respiratory stimulants, cerebral excitants 
and agents which raise the arterial tension are physiologically antagonistic. 

Therapeutics. 

Resorcin is employed as an antipyretic and antiseptic, being 
preferred to Carbolic Acid for internal and subcutaneous use. A 
3 per cent, solution gives good results in stomach complaints, as 
gastralgia, gastric catarrh, gastric ulcer, fermentative indigestion, 
etc. It has given great satisfaction to some observers in intermit- 
tent fevers and malarial diseases generally, while others have been 
much disappointed with its action therein. As an antipyretic 
it has been used in erysipelas, puerperal fever, septicaemia 
and diphtheria, and in the latter disease it has been employed 
locally in crystals with decided benefit. A 2 per cent, solution 
has given great satisfaction as a local antiseptic application to 
wounds, parasitic skin diseases, cystitis, gonorrhoea, anthrax, and 
syphilitic sores of unhealthy character. As spray a similar solu- 
tion is well applied to catarrhal or ulcerative affections of the 
respiratory passages. As a caustic it may be applied in undiluted 
form to chancres, papillomata, carbuncles, etc. A saturated 
ethereal solution is a good application where the caustic action 
of the drug is required. 



RHEUM, Rhubarb, — is the root of Rheum officinale, a 
perennial plant of the nat. ord. Polygonaceae, a native of Thibet, 
and of other undetermined species of Rheum, many of which are 
cultivated in Europe and America, their leaf-stalks being used as 
a fruit. The commonly accepted medicinal Rhubarb is the 
Chinese variety, and is imported from Shanghai and Canton. It 



RHEUM. 325 

occurs in cylindrical or conical segments, sometimes flattened 
and bored with a hole, of a dirty-brown-yellow color externally, 
internally marbled with fine waving lines, of peculiar odor, gritty 
between the teeth, and of a bitter astringent taste. It imparts its 
virtues to water and alcohol, and contains several substances of 
greater or lesser activity, the least important being Phceoretin, 
C 32 H 32 O u , the rhubarb-resin, — Erythroretin, C 38 H 36 O u , and Chry- 
sophan, C 27 H 30 O u , the latter of which is split by acids into Sugar 
and Chrysophanic Acid. (See ante, Chrysarobinum, page 145). 
It also contains Rheo-tannic Acid, C 52 H 52 28 , Rheumic Acid, 
C 40 H 32 O 18 , and probably a principle which is identical with Ca- 
thartic Acid (see Senna), on which its purgative activity may 
depend. Dose of Rhubarb as a stomachic, gr. j-v ; — as a purga- 
tive, gr. x-xx. 

Preparations, 

Extr actum Rhei, — Dose, gr. x-xv. 

Extractum Rhei Fluidum, — Dose, gss-ij. 

Pilul^e Rhei, — composed of Rhubarb 3, Soap 1 ; each pill containing gr. 
iij of powdered Rhubarb. Dose, j-iij. 

Pilule Rhei Composite, — each contains of Rhubarb gr. ij, Aloes gr. 
\y 2 , Myrrh gr. j, Oil of Peppermint gr. -f^. Dose, ij— iv. A safe and efficient 
laxative. 

Tinctura Rhei, — has of Rhubarb 12, Cardamom 2, with diluted Alcohol 
to 100 parts. Dose, ^j— ^ss. 

Tinctura Rhei Aromatica, — has of Rhubarb 20, Cinnamon 4, Cloves 4, 
Nutmeg 2,. Diluted Alcohol to 100 parts. Dose, ^j-^iij. 

Tinctura Rhei Dulcis,— has of Rhubarb 8, Licorice 4, Anise 4, Carda- 
mom 1, Diluted Alcohol to 100 parts. Dose, .^ss-gij. 

Syrupus Rhei, — has of Rhubarb 90, Cinnamon 18, Potassium Carbonate 6, 
Sugar 600, Water to 1 000 parts. Or, it may be made extemporaneously thus: 
— Fluid Extract ^iij, Simple Syrup gxxix. Dose for an infant gj ; for older 
children gij-^ss. 

Syrupus Rhei Aromaticus, — has of the Aromatic Tincture 10, Syrup 90 
parts. Dose, as the Syrup. 

Vinum Rhei, — has of Rhubarb 10, Calamus I, Stronger White Wine to 100 
parts. Dose, ^j— gss. 

Pulvis Rhei Compositus, — has of Rhubarb 25, Magnesia 65, Ginger 10. 
Dose, a teaspoonful. 

Mistura Rhei et Sod,*:, — Sodium Bicarbonate 30, Fluid Extract of Rhu- 
barb 30, Spirit of Peppermint 30, Water to loop parts. Dose, ^ij-^ij- 

Physiological Action. 

Rhubarb is classed among the tonic-astringent and resin-bear- 
ing purgatives, which increase the secretions of the glandular 
appendages of the intestinal canal, and stimulate the muscular 
layer of the bowel. In small doses (gr. j-v) its action is that 
of a stomachic and intestinal astringent, the influence of the 



326 RHINACANTHUS. 

bitter principle and the rheo-tannic acid probably predominating. 
In larger doses (gr. xxx-lx),its cathartic action prevails, produc- 
ing in 6 to 8 hours copious yellow, pultaceous stools, with some 
griping and considerable hepatic stimulation. After the cathartic 
principle is expelled, the astringent quality of its tannin asserts 
itself and constipation is likely to result. The yellow color of 
the stools is partly due to the rhubarb pigment and partly to 
excess of bile, the drug having marked cholagogue properties, in 
all probability due to its resin, Phaeoretin. Its pigment stains 
the milk, urine and sweat, the milk acquiring a bitter taste and 
purgative properties. The cathartic action of Rhubarb may be 
obtained from its application locally to ulcers, by being rubbed 
into the moist skin, or applied to the abdomen as a poultice. 

Therapeutics. 

Rhubarb is highly esteemed as a cathartic for children, from the 
mildness of its action, as, though occasionally producing quite 
severe griping, it never inflames the gastro-enteric mucous mem- 
brane. Its tonic and astringent action following its catharsis 
makes it a valuable agent in diarrhoeas due to the presence of 
irritating matter in the bowel, and to correct atonic indigestion 
accompanied by diarrhoea. For hemorrhoids with constipation 
its gentle action makes it peculiarly suitable, its astringent after- 
effect being entirely overcome by 2 to 4 drachm doses of olive oil 
nightly. It may be combined with a mercurial or with Bicarbo- 
nate of Sodium, the latter being supposed to overcome its astrin- 
gent action and to disguise its taste in some degree. In small 
doses the tincture is a very efficient stomachic tonic, improving 
appetite, increasing the flow of the gastric juice, assisting diges- 
tion, and promoting the action of the liver without producing 
any cathartic results. The preparations most in use for children 
are the Aromatic Syrup and the Mistura Rhei et Sodae. 



RHINACANTHUS (Unofficial),— the leaves and root of 
Rhinacanthus communis, a shrub of the nat. ord. Acanthaceae, in- 
digenous to India and China. The root contains a quinone-like 
body named Rhinaca?ithin, C u H 18 4 , which forms with alkalies 
intensely red compounds which are decomposed by benzin. It 
is known in China as Hong-Pang-Chong, and is employed as a 
local remedy for ringworm and parasitic skin diseases, the leaves 
being bruised and mixed with lime-juice. Used internally a 
tincture of the root has some reputation as a feeble tonic and 



RHUS AROMATICA — RHUS GLABRA. 327 

antiperiodic. The same preparation is applied locally in chronic 
eczema, tinea and psoriasis. 



RHUS AROMATICA, Sweet Sumach (Unofficial),— 
is an indigenous shrub of the nat. ord. Terebinthaceae, growing 
about 5 feet high, and having yellow flowers in spikes. The 
root-bark contains a volatile oil, several resins, fat, tannin, etc. 
A fluid extract is prepared from the bark of the root according 
to the general pharmacopceial rule, and may be given in doses of 
nix-xxx, every 2 or 3 hours. 

Physiological Action and Therapeutics. 

Rhus Aromatica has astringent properties, and seems to pos- 
sess a selective action upon the urinary tract. Its action is not 
yet clearly made out. Therapeutically it has been used with 
advantage in cystitis, night-sweats, hematuria, menorrhagia, dia- 
betes insipidus, diarrhoea and dysentery. As a remedy for incon- 
tinence of urine in children it has attracted considerable atten- 
tion, having been extremely efficient in doses of mxv of a good 
fluid extract four times daily, administered in glycerin and wa- 
ter, or any other suitable excipient. It is reported to be equally 
effective in hysterical enuresis of adults, but larger doses (mxx- 
xxx several times a day) are required. Diabetes insipidus is 
remarkably benefited by its continued use, and even in diabetes 
mellitus its employment has occasionally seemed to have been 
followed by curative results. 



RHUS GLABRA, Smooth Sumach,— is the fruit of 
Rhus glabra, an indigenous shrub of the nat. ord. Terebinthacese, 
growing in rocky and barren soil to a height of 8 to 12 feet. 
The berries are about \ inch in diameter, subglobular, densely 
hairy, of crimson color and acidulous taste, but inodorous. The 
leaves and bark have an astringent and bitter taste, and are also 
used medicinally. It contains tannin, coloring matter, potassium 
and calcium malates. 

Preparation. 
EXTRACTUM RHOIS GLABRAE FLUIDUM, — Dose, ^j-ij. 

Physiological Action and Therapeutics. 

Sumach -berries form a useful acidulous and astringent drink or 
gargle in catarrhal pharyngitis, stomatitis, aphthae, etc. An in- 



328 RHUS TOXICODENDRON. 

fusion (§j to the pint) may be used, or the official fluid extract 
as a wash and dressing for ulcers and wounds. Internally they 
are useful remedies for mild catarrhal affections of the stomach 
and bowels. 



RHUS TOXICODENDRON, Poison Sumach,— is the 
fresh leaf of Rhus Toxicodendron, the Poison Oak, and of Rhus 
radicans, the Poison Ivy, shrubs of the nat. ord. Terebinthaceae, 
indigenous to Canada and the greater part of the United States 
east of the Rocky Mountains. The climbing plant (R. radicans) 
is not a distinct species, but a variety of the erect form, both 
when wounded exuding a poisonous, acrid, milky juice which 
turns dark on exposure. The leaves are trifoliate, on petioles 4 
or 5 inches long, the lateral leaflets sessile, entire and glabrous 
in R. radicans (or variously notched, toothed or lobed, downy 
beneath, in R. Tox.), inodorous, astringent and acrid. They may 
be confounded with the leaves of the hop-tree, Ptelea frifoliata, 
which are quite similar in appearance, but all its leaflets are ses- 
sile. The poisonous principle of the plant is Toxicodendric Acid, 
which is volatile, and also exists in Rhus venenata or Swamp 
sumach, Rhus pumila, and Rhus diversiloba, the former of which 
is probably the most poisonous of the four species. Dose of the 
]eaves is generally placed at gr. j-iv, but if old and dry they will 
generally prove to be inert. There are no official preparations. 

Preparations. 

Tinctura Rhois Toxicodendri (Unofficial), — may be prepared accord- 
ing to the formula of the Pharmacopoeia for Tincturse Herbarum Recentium 
(Tinctures of Fresh Herbs), one part of the fresh leaves to two of Alcohol. 
Dose, tti^ttuj. 

Extractum Rhois Toxicodendri, — has been used in France in large 
doses. It is probably inert. 

Physiological Action. 

The effects of Rhus Toxicodendron upon the skin are familiar 
to all who have suffered from contact with poison-oak or ivy. 
Some persons are so susceptible to the poison that the exhalations 
from the plant will produce on them its characteristic action. 
Others are apparently insusceptible to its influence, and can with 
impunity rub the juice into their skin, or even chew its leaves. 

The action of the plant when locally applied is that of a cuta- 
neous irritant, causing redness and swelling of the affected parts, 
with a vesicular eruption and intolerable itching, which may 



RHUS TOXICODENDRON. 329 

spread rapidly over the surface of the body and extend to the 
mucous membranes, producing conjunctivitis, redness and tume- 
faction of the mouth and throat, thirst, cough, nausea and vomit- 
ing, vertigo, stupefaction, etc. Colicky pains are experienced 
in the abdomen, are worse at night and are aggravated by food 
or drink. Diarrhoea may occur, with tenesmus and bloody stools, 
also diuresis, bloody urine, or even complete retention. Fever 
with delirium is frequently present, and may be typhoid in 
character, or intermittent with profuse perspiration. Pains of 
rheumatoid type are experienced throughout the body, but par- 
ticularly in the joints and lumbar region, apparently intensified 
by rest and heat. The fibrous structures are evidently the seat 
of its selective action, and a sensation of numbness in the lower 
extremities is frequently experienced. Similar phenomena attend 
its internal administration, but fatal results have not followed in 
any case of poisoning recorded. The effects of the poison usually 
last from ten to fifteen days, and are then followed by desquama- 
tion of the epidermis. 

Antidotes. 

Grindelia Robusta is the best local application in cases of Rhus poison- 
ing, but a solution of Mercuric Chloride is also a very serviceable lotion, 
and Lime-water with Linseed-oil, solution of Plumbum Acetate, solution of 
Chlorinated Soda, and Alum-curd are all very useful. Rest, low diet and 
laxatives are appropriate, and Opium or strong black coffee to relieve the 
irritability of the nervous system. 

Therapeutics, 

Rhus Toxicodendron was used medicinally by Dufresnoy in 
France and by Alderson in England about the close of the 
eighteenth century. The attention of the former was attracted 
to it by the accidental poisoning of a student who was afflicted 
with chronic eczema, which disappeared on the subsidence of the 
Rhus symptoms. It is a favorite remedy with the so-called 
homceopathists, who ascribe to it extraordinary virtues in acute 
cutaneous affections of vesicular type, subacute and chronic rheu- 
matism, vesicular erysipelas and typhoid fever. Among regular 
authorities it meets with very little favor as a remedial agent, but 
Dr. Phillips recommends it strongly in rheumatic affections of 
the fibrous tissues, erythema and erysipelas, eczema, herpes zoster 
and pemphigus. Dr. Piffard corroborates these opinions of its 
therapeutical value, and states that when rheumatic pain is "worse 
at night" prompt relief maybe expected from Rhus. It was 
used by Dufresnoy in paralyses with a certain degree of success, 
and Eberle reports a case of paralysis in which it proved curative. 

28 



330 RICINI OLEUM. 

It is admitted by many observers to be a useful remedy in paralytic 
affections of the lower extremities depending on a rheumatic dia- 
thesis, or resulting from exposure to cold and wet. As an exter- 
nal application it is efficacious in sprains and other affections of 
ligaments and tendons, also to extensive but superficial burns, 
stings of insects and chilblains. For these affections a lotion of 
about 3ss of the strong tincture to a pint of water is usually em- 
ployed. 



RICINI OLEUM, Castor Oil,— is a fixed oil expressed 
from the seeds of Ricinus communis, a tree of the nat. ord. 
Euphorbiaceae, indigenous to India, but extensively cultivated in 
the United States, where it is an annual plant about 5 or 6 feet 
high, bearing ovate seeds, smooth and shiny, of gray color 
marbled with brownish spots and stripes, three contained in a 
pod. The oil is an almost colorless, transparent, viscid liquid, of 
faint odor, bland or slightly acrid taste, neutral reaction, sp. gr. 
0.950 to 0.970, soluble in an equal weight of alcohol, and con- 
gealing at about 0.4 F. It consists mainly of Ricinoleic Acid, 
C 18 H 34 3 , combined with glycerin, but palmitin, stearin, choles- 
terin, and probably a resin and an alkaloid also occur in small 
quantities. Dose, 3J~Sj- It is contained in Collodium Flexile 
(3 per cent.) and in Linimentum Sinapis Co. (15 per cent.). 

Physiological Action. 

Used externally pure Castor Oil is perfectly bland. Internally 
administered it is non-irritant until it reaches the duodenum, 
where it is decomposed by the pancreatic juice, setting free the 
Ricinoleic Acid, which produces purgation by a mildly irritant 
action on the bowel, stimulating the intestinal glands and mus- 
cular coat, but not the liver. It is a simple purgative, acting in 
four to six hours, producing one or more liquid stools without 
pain or tenesmus, and followed by a sedative effect on the intes- 
tines. The leaves are believed to possess galactagogue properties 
when locally applied as a poultice to the breasts, Ricinoleic 
Acid enters the blood and the tissues, and is excreted with the 
various secretions of the body, imparting its purgative qualities 
to the milk of the nursing mother. 

Therapeutics. 

Castor Oil is the best of simple purgatives, and is used where 
a free evacuation of the bowels is alone indicated, or when only 



ROSA CENTIFOLIA. 33 I 

a laxative action is desired, as in the constipation of typhoid 
fever, in pregnancy and post-partum conditions, diarrhoea from 
the presence of irritating matter in the bowels, and after opera- 
tions on the abdominal or pelvic organs. It is often used as a 
purgative for children, also for the aged and infirm. Infants 
bear a larger relative dose than adults, probably from their ability 
to digest a larger quantity of what is taken. It is employed with 
great benefit as a laxative in irritation or inflammation of the 
bowels, in hemorrhoids, inflammatory or spasmodic affections of 
the genito-urinary organs, nephritis or cystitis, gonorrhoea, cal- 
culi, and stricture of the urethra and rectum. In cases of dys- 
entery 10 to 20 drops of Laudanum may be added to each dose 
to counteract the pain, tenesmus and exhaustion resulting from 
the frequency of the passages. If much depression exists, as 
shown by lowered arterial tension and a dry, glazed tongue, 5 
drops of Turpentine should also be added. 

Castor Oil is much used in the puerperal state and greatly 
abused. There is considerable evidence in support of the charge 
that it induces hemorrhoids by congesting the rectal vessels. Its 
purgative action is milder in proportion to the purity of the 
sample employed. Externally, the pure oil is employed as a local 
sedative and protective, as in neutralizing the effects of lime upon 
the conjunctiva. 

The leaves of the castor-oil plant are used to promote the secre- 
tion of milk. They may be applied to the breast in poultice, and 
a decoction or fluid extract given internally at the same time. 

Administration. 

The nauseous smell is best concealed by the Essential Oil of Bitter Almonds. 
Emulsions are not a success. Capsules containing the requisite dose are 
easily obtained. In the absence of these the best way to administer a dose 
of oil is to smear the sides of a clean wineglass with very thick cream, then 
to pour in the oil, covering it with a little more cream. A teaspoonful of cream 
being then taken into the patient's mouth, he is directed to bolt the dose at one 
gulp. Some prefer it floated on orange-juice, strong coffee, gruel or wine. 



ROSA CENTIFOLIA, Pale Rose,— the petals of Rosa 
centifolia, the Cabbage Rose, a well-known cultivated shrub of 
the nat. ord. Rosacea^. They are of pink color, fragrant odor, 
sweetish taste changing to slightly bitter and faintly astringent. 
The odor is due to a minute quantity of a Volatile Oil (Oil of Rose), 
besides which, the petals contain tannin, fat, resin, sugar, etc. 
If it is desired to keep Pale Rose fresh for any length of time, it 



332 ROSA DAMASCENA — ROSA GALLICA. 

should be mixed with half its weight of Sodium Chloride, pressed 
into a jar and kept, well closed, in a cool place. 

Preparations. 

Aqua Ros^, Rose-water, — Pale Rose 40, Water 200 parts, mixed and dis- 
tilled by steam to 100 parts. Dose, indefinite. 

Unguentum Aqu^e Ros^e, Cold Cream, — has of Expressed Oil of Almond 
50 parts, Spermaceti 10, White Wax 10, Rose-water 30. If Glycerin and 
Benzoic Acid were added, it would keep better and be much more efficient as 
an emollient and protective. 

Pale Rose is also an ingredient of the Compound Syrup of Sarsaparilla. 

Physiological Action and Therapeutics. 

Pale Rose is only used foi odoriferous and flavoring purposes. 
Rose-water has no strictly medicinal properties, but is an agree- 
able excipient for lotions, urethral injections and collyria. The 
ointment, commonly termed " cold cream," is an agreeable emol- 
lient and protective in chapped hands and other superficial skin 
affections. 



ROSA DAMASCENA,— is not official, but is the source 
of the official Oil of Rose. It is largely cultivated in Roumelia 
on the southern slope of the Balkan Mountains, from whence 
almost all of the product is supplied to commerce. 

Oleum Ros^e, Oil of Rose, Attar of Rose, — is a volatile oil distilled from 
the fresh flowers of Rosa daniascena. It is a pale-yellowish, transparent liquid, 
having a strong odor of rose, a sweetish taste and a slightly acid reaction, but 
slightly soluble in alcohol, of sp. gr. about 0.860. Slowly cooled to 50 F. it 
congeals to a transparent solid, interspersed with slender, iridescent, scale-like 
crystals. Rapidly cooled to 54 F., it congeals to a solid mass of feathery 
scales or plates. It consists of an aromatic oxygenated elaeopten and an odor- 
less solid stearopten (rose-camphor) Being very expensive it is much adul- 
terated with other volatile oils. It is used chiefly for perfuming cosmetic 
preparations, ointments and lotions. 



ROSA GALLICA, Red Rose,— the petals of Rosa gallica 
(nat. ord. Rosaceae), collected before expanding. They occur 
in small cones of roseate odor, and a bitter, slightly acid and dis- 
tinctly astringent taste, and contain an aromatic oil, tannic and 
gallic acids, quercitrin, coloring matter, salts, etc. 

Preparations, 

Extractum RoSjE Fluidum, — Dose, rn.v-gij. 

Confectio Ros^e, — has of Red Rose 8 parts, Sugar 64, Honey 12, Rose- 
water 16. A basis for pills. 



ROSMARINUS RUBUS. 333 

Mel Ros^e, Honey of Rose, — has of Red Rose 8, Honey 92, Diluted Al- 
cohol to 100 parts. For local use. 

Syrupus Ros^:, — has of the Fluid Extract of Rose 10 in Syrup 90. Dose, 
£j-ij, for flavoring. 

Red Rose is also an ingredient of Pilulae Aloes et Mastiches. 

Physiological Action and Therapeutics. 

Rosa Gallica is classed among the astringents as it contains an 
appreciable amount of Tannic and Gallic Acids. A compound 
infusion, containing sugar and dilute Sulphuric Acid, was for- 
merly official, and is used as an agreeable gargle for the throat 
and mouth in inflamed and ulcerated conditions. The chief uses 
of the rose preparations, however, are as vehicles for other agents, 
or to impart flavor and odor to extemporaneous prescriptions. 



ROSMARINUS, Rosemary, — the leaves of Rosmarinus 
officinalis ', a shrub of the nat. ord. Labiatae, cultivated in gardens 
for the sake of its large pale-blue flowers. The leaves are pun- 
gently aromatic and somewhat camphoraceous, containing, besides 
the official volatile oil, a little tannin, resin and a bitter principle. 
They constitute one per cent, of the ingredients of Vinum Aro- 
maticum (see ante, page 51). 

'Oleum Rosmarini, — is the volatile oil distilled from Rosemary, a colorless 
or yellowish liquid, of sp. gr. about 0.900, having the characteristic odor of 
the plant, a camphoraceous taste, and is readily soluble in alcohol. It con- 
sists of a terpene, isomeric with Turpentine, C 10 H 16 , and a body allied to Cam- 
phor. It is an ingredient of Linimentum Saponis, Spiritus Odoratus and 
Tinctura Lavandulae Composita. Dose, TUj-v. 

Physiological Action and Therapeutics. 

Rosemary w r as formerly considered emmenagogue, galacta- 
gogue and diuretic, but is now never employed in substance. Its 
oil is somewhat stimulant and carminative, and in excessive quanr 
tity has caused death. It is chiefly employed as an external 
stimulant in liniments and lotions, especially to the scalp in alo r 
pecia, where it is supposed to increase the blood-supply to the 
hair-bulbs, and is usually combined with cantharides. Inhaled 
it reduces the body temperature and gives the urine a violaceous 
odor. 



RUBUS, Blackberry-bark, — is the bark of the root of 
Rubus villosus, the common Blackberry, Rubus canadensis, the 



334 RUBUS ID^US RUMEX. 

Dewberry, and Rubus trivialis, the Bush Blackberry of the 
Southern States, all of the nat. ord. Rosacese. It occurs in thin, 
tough, flexible baads, blackish-gray externally, pale brown inter- 
nally, inodorous, strongly astringent and of somewhat bitter 
taste. It contains over 10 per cent, of Tannin. Dose, gr. xv- 

XXX. 

Preparations. 

Extractum Rubi Fluidum, — Dose, irL x -j-"2k 

Syrupus Rubi has of the Fluid Extract 20 parts, Syrup 80. Dose, gj-§j. 
Syrupus Rubi Aromaticus (Unofficial), — contains the root-bark, cinna- 
mon, cloves and mace. Each flg has gr, xxx of the drug. 

Physiological Action and Therapeutics. 

Blackberry-hark derives its virtues from its tannin. It is 
strongly astringent, and may be used in decoction, wine or the 
above-named official preparations. It is highly esteemed in 
summer and infantile diarrhoeas. 



RUBUS ID^EUS, Raspberry,— is the fruit of Rubus 
idceus, the Raspberry bush, Rubus occidentalism the Thimbleberry, 
or Rubus strigosus, the wild Red Raspberry, all of the nat, ord. 
Rosaceae. It contains sugar, malic and citric acids, proteids, 
pectin, etc., also a Volatile Oil consisting of compound ethers, to 
which the odor is due. Its sole use in medicine is to prepare a 
pleasantly flavored syrup. 

Preparation. 

Syrupus Rubi Id^i, Raspberry Syrup, — has of Raspberries and Sugar any 
convenient quantity, boiled (but not in tinned vessels) and strained. Dose, ad 
libitum. It has a bright-red color, a fruity, agreeable odor, a pleasant, acidu- 
lous taste and an acid reaction. It has no special medicinal virtues, but forms 
an agreeable flavoring for mixtures, and mixed with water a pleasant drink 
in febrile conditions. 

The leaves of the wild Red Raspberry {Rtibus strigosus) are considerably 
astringent, and in infusion, gj to the pint, are a popular domestic remedy for 
diarrhoeas. 



RUMEX, Yellow Dock,— is the root of Rumex crispus, 
and of other species of Rumex, plants of the nat. ord. Polygona- 
ceae, growing as common weeds along roadsides. Several species 
of Rumex have sour leaves, and are popularly called Sorrel 'to dis- 
tinguish them from the others which are called Dock. The official 
root is 8 to 12 inches long, ^ inch thick, somewhat fusiform and 



ruta. 335 

fleshy, annulate above, deeply wrinkled below, externally rusty- 
brown, inter::; sh, with hne medullary rays ; fracture 
short, odor slight, taste bitter and astringent. It contains tannin, 
mucilage, starch, calcium oxalate, and two principles named 
Rumicin and Z.:_~ :::':: n, which are shown to be identical with 
Chrysophanic Acid. (See ante, page 32^. Its constituents are 
nearly identical with those of Rhubarb. Dose, gr. xv-31. 

Preparations. 

Extractum Rumicis Fluedum, — E jse - xv-gj. 

Decoctum Rumicis (Unofficial), — gij of the fresh root, or §j of the dry 
root to Oj of water. Dose, 5J-1J. 

m Physiological Action and Therapeutics. 

Rumex is astringent, tonic and laxative. It has also been 
ndered alterative and anti-scorbutic. It has been employed 

chiefly in chronic cutaneous disorders, glandular swellings, and 
:r symptoms of the strumous diathesis. It seems to possess 

a selective action on the mucous membrane of the larynx, and in 

many cases of laryngeal irritation with catarrhal symptoms, dry, 
rnt cough, and a sense of soreness behind the sternum, it will 

give prompt relief. 



RUTA, Rue, — is the source of the official Oil of Rue, which 
is distilled from the leaves of Ruta graveolens, an herbaceous 
perennial of the nat. ord. Rutaceae. growing wild throughout South- 
ern Europe, and frequently cultivated in gardens for its yellowish 
flowers. The fresh leaves only should be used, and as drying 
impairs their qualities the oil is generally employed. 

Oleum Rut.e, Oil of Rue, — the volatile oil distilled from Ruta graveolens ; 
a colorless, or greenish-yellow liquid, of disagreeable but aromatic odor, pun- 
gent acrid taste and neutral reaction, sp. gr. about 0.880, soluble in an equal 
weight of alcohol. Dose, ill j-v, in mucilage. 

Physiological Action. 

Rue is an active irritant, locally a rubefacient, the oil producing 
heat, inflammation and vesication. In the ordinary dose it causes 
a sensation of heat in the stomach and skin, increases the action 
of the heart, and stimulates the bronchial, cutaneous and renal 
secretions, the odor of the oil being distinctly perceptible in the 
breath, sweat and urine. After toxic doses of the oil violent 
gastro-enteritis results, with extreme prostration, convulsions, 



33^ SABINA. 

strangury and suppression of the urine. Abortion may be pro- 
duced by large doses, but with great danger to life. Rue is an 
efficient emmenagogue, and in men aphrodisiac ; it is also con- 
sidered antispasmodic and carminative. 

Therapeutics. 

The Oil of Rue is employed internally in amenorrhoea, hys- 
teria, convulsions and flatulence. As an emmenagogue it is very 
efficient when the condition is one of functional inactivity of the 
uterus and ovaries. It has been well used in menorrhagia from 
debility and after abortion. A decoction of the fresh leaves is 
often employed by injection against ascarides, and internally to 
remove lumbricoid worms. Externally the same preparation has 
been applied to the chest in chronic bronchitis, also in various 
scaly eruptions and glandular enlargements. Used as an aborti- 
facient it has frequently caused death, preceded by symptoms of 
narcotic and irritant poisoning. 



SABINA, S a vine, — the tops of Juniperus Sabina, a small, 
evergreen shrub of the nat. ord. Coniferae, growing in Northern 
Europe, Asia and America. It closely resembles Red Cedar 
(Ju?iiperus virginiana), but is distinguished from the latter by its 
smaller size and by its larger fruit. It occurs in short, thin 
branchlets, having oveo-lanceolate leaves in four rows ; of pecu- 
liar, terebinthinate odor, and nauseous, bitter, resinous taste. It 
contains a Volatile Oil (which is official), also tannin, resin, 
extractive matters, chlorophyll, etc. Dose,gr. v-x. 

Preparations. 

Extractum Sabine Fluidum, — Dose, lUv-xv. 

Ceratum Sabine, — has of the Fluid Extract 25, Resin Cerate 90 parts, 
melted and cooled. 

Oleum Sabin^e, — a volatile oil distilled from Savine existing in the fresh 
tops in the proportion of 2^ per cent., and in the berries 10 per cent. It is a 
colorless, or yellowish liquid, isomeric with oil of turpentine, C 10 H 16 , having 
a peculiar, terebinthinate odor, a pungent camphoraceous taste, and neutral 
reaction, of sp. gr. about 0.910 and soluble in an equal weight of alcohol. 
Dose, ""Ij-v. 

Physiological Action. 

Externally the action of Savine resembles that of Turpentine, 
except that it is more irritant, the oil producing vesication if 
applied sufficiently long. Internally a full medicinal dose causes 
heat sensations, nauseous eructations, flatulence, increased car- 



SACCHARUM. 337 

diac action, stimulation of the cutaneous, bronchial and renal 
secretions, irritation of the kidneys, hyperaemia of the ovaries and 
uterus and increased menstrual activity. In large doses it pro- 
duces hematuria, dysuria, and intense gastro-enteritis, with vio- 
lent vomiting and purging. It may originate uterine contrac- 
tions in the pregnant female, but its abortifacient effect can only 
be produced by a quantity sufficient to endanger life. The oil 
diffuses into the blood and is excreted by the various excretory 
channels. 

Therapeutics. 

As an emmenagogue Savine is highly esteemed by many author- 
ities, Dr. Phillips considering it "one of the most certain and 
powerful" agents of this class, "with the additional advantage 
that it can be given with perfect freedom from risk of doing 
harm." So irritant an agent, however, requires the exercise of 
great caution in its use. It has been found extremely efficient in 
dysmenorrhcea when not due to mechanical causes; also, in 
menorrhagia and hemorrhage after abortion. In chronic gout 
and the joint affections of chronic rheumatism, it was formerly 
much employed. Externally the cerate is used to prolong the 
discharge from blisters, setons or issues, and to stimulate the 
healing of indolent ulcers. For these purposes it is considered 
safer than Cantharides, as its prolonged employment does not 
bring on strangury or vesical irritation. As a caustic it is effi- 
cient for the destruction of warts and other excrescences, and the 
moistened powder is used as a paste on venereal condylomata, in 
combination with burnt alum or cupric subacetate. The oil is 
the most efficient preparation for internal administration. 



SACCHARUM, Sugar, Cane-Sugar, C 12 H 22 O n ,— is the 
refined sugar of Saccharum officinarum, or Sugar-cane, a perennial 
plant of the nat. ord. Graminaceae, indigenous to India and ad- 
joining countries, but cultivated in tropical regions throughout 
the world. This sugar is also present in several grasses (as Zea 
Mays, maize, Sorghum saccharatum, etc.), in the juice of various 
trees (maple, birch, palm, etc.), and in many roots, particularly 
Beta vulgaris, the sugar-beet, which contains 12 per cent. 

Cane-sugar occurs in white, dry, hard, crystalline granules, permanent in 
the air, odorless, of purely sweet taste and neutral reaction, soluble in 0.5 of 
water and in 175 of alcohol at 59 F., in 0.2 of boiling water and in 28 of 
boiling alcohol, insoluble in ether. The aqueous solution, saturated at 59 
F., has the sp. gr. 1.345, and is miscible with alcohol in all proportions. Its 
freedom from Grape-sugar (glucose) and from more than a slight quantity of 



33 8 SACCHARUM. 

Inverted Sugar (glucose plus levulose) is ascertained by dissolving I gram in 
io c.c. of boiling water, then mixing with the solution 4 or 5 drops of test- 
solution of Silver Nitrate and about 2 c.c. of Aqua Ammoniae, and quickly- 
heating to boiling, when not more than a slight coloration, but no black pre- 
cipitate should appear after standing at rest for 5 minutes. 

Other Sugars. 

Saccharum Lactis, Sugar of Milk, Lactose, C 12 H 22 O n .H 2 0, — described 
on page 339. 

Glucose, Dextrose, Grape-sugar, Starch-sugar, C 6 H 12 6 , or hydrated 
C 6 H 12 6 .H 2 ( Unofficial ), also known as liver-sugar, diabetic sugar, — forms 
yellowish nodules or crystals, very soluble in water and in alcohol, has a sweet 
taste, less marked than that of cane sugar, may be obtained artificially from 
cane sugar or from starch, by boiling with a dilute mineral acid, or by the 
action of Diastase, a vegetable ferment formed during the germination of grain. 
Boiling solutions of the alkalies convert it into a brown substance (melassic 
acid). 

Levulose, Fruit-sugar, C 6 H 12 6 (Unofficial), — frequently found with grape- 
sugar in fruits, also in honey. 

Inosit, Phaseo-mannit, C 6 H 12 6 .2H 2 (Unofficial), — exists in the juice of 
some meats, in asparagus, etc. Is very sweet, but does not undergo alcoholic 
fermentation. 

Allied Substances. 

Theriaca, Treacle, Sugar-house Molasses (Unofficial), — is the uncrystal- 
lizable residue of the process for refining sugar, — a thick, brown, ferment- 
able syrup, very sweet, and of sp. gr. about 1.40. It is official in the B. P., 
and is used in making up some of the official pills of that pharmacopoeia. 

Amylum, Starch, C 6 H 10 O 5 , — when boiled with dilute mineral acids or when 
subjected to the action of diastase, ptyalin or pancreatin, starch is converted 
into glucose. (See ante, article Amylum, page 67.) 

Cellulose, C 6 H 10 O 5 (Unofficial), — forms the basis of all vegetable fibre, 
and is isomeric with starch. It exists almost pure in cotton and in Swedish 
filter paper. Pyroxylin (see ante, page 206), or gun-cotton, is dinitro-cellulose. 

Glycogen (Unofficial), — closely resembles starch in its properties, being 
converted into glucose by the same agents which so act on starch. It exists 
in the liver of all animals. 

Dextrin (Unofficial), — is produced by the action of dilute acids on starch, 
and is an intermediate product in the conversion of starch into glucose. It is 
a transparent, brittle solid, looking like gum, soluble in water and dilute alco- 
hol, is not fermentable, nor is it colored by Iodine. 

Preparations. 

Sugar is an ingredient of Pil. Ferri Carbonatis, Pil. Ferri Iodidi, Ferri Car- 
bonas Saccharatus, Mistura Ferri Composita, Pulvis Cretae Compositus, Pulvis 
Glycyrrhizae Compositus, and the Troches, Syrups, Compound Syrups, etc. 

Physiological Action and Therapeutics. 

Sugar is employed in pharmacy and therapeutics chiefly as a 
vehicle, a corrigent, a preservative and an antiseptic. Syrups 



SACCHARUM LACTIS — SALIX. 339 

protect the active ingredients against putrefaction, but not always 
against fermentation. They also protect certain ferruginous prepa- 
rations against oxidation. As an ingredient in troches, powders 
and extemporaneous mixtures sugar is used to cover the taste or 
to make insoluble substances more easily miscible with water. It 
increases the solubility of Lime in water. As a food it possesses 
well-known properties, being a nutrient to adipose tissue and a 
respiratory fuel. 



SACCHARUM LACTIS, Sugar of Milk, Lactose, 

C 12 H 22 O ir H 2 0, — is one of the constituents of the milk of mam- 
mals, and is officially described as a peculiar, crystalline sugar 
obtained from the whey of cow's milk by evaporation and purified 
by re-crystallization. Occurs in white, hard, crystalline masses, 
yielding a gritty, white powder, odorless, permanent in the air, 
of faintly sweet taste and neutral reaction, soluble in 7 of water 
at 59 F. and in 1 of boiling water, insoluble in alcohol, ether 
or chloroform. On adding to a solution of sugar of milk in an 
equal weight of boiling water some solution of soda, the liquid 
turns brownish, and on further addition of test-solution of Cupric 
Sulphate a brick-red precipitate separates. 

Sugar of Milk is the least soluble of all sugars in water and is insoluble in 
alcohol. It enters into alcoholic fermentation with difficulty. In the presence 
of decomposing albuminous matter and under certain other influences, it under- 
goes the lactic fer?nentation, which results in the formation of Lactic Acid, 
Carbon Dioxide and Alcohol. It readily reacts with the reduction tests. 

Preparations a?id Uses. 

Sugar of Milk is used in the Triturations, also in the Abstracts, 
Dover's Powder, Denarcotized Opium, etc., as a diluent. Being 
much harder than cane-sugar it is considered a valuable excipient 
for powders requiring fine trituration and the minute subdivision 
of their medicinal constituent. It is less sweet than cane-sugar, 
and being less apt to ferment in the stomach and bowels is better 
than the latter for use with infants 7 food. 



SALIX, Willow, — is the bark of Salix alba, the common 
White Willow, and of other species of Salix, trees of the nat. 
ord. Salicaceae. It occurs in fragments or quills, inodorous, bitter 
or astringent, and contains a large proportion of tannin, besides 
resin, gum, wax, lignin, etc., and the characteristic constituent 



340 SALIX. 

Salicin, which is official. Dose of the bark, gr. x~3j, or more, 
in infusion. 

Prepa 1'ations . 

Salicinum, Salicin, C 13 H 18 7 , — a neutral principle prepared from the bark 
of Salix Helix and of other species of Salix. White, shiny, silky crystals, 
odorless, of very bitter taste and neutral reaction ; — soluble in 28 of water 
and in 30 of alcohol at 59 F., in 0.7 of boiling water and in 2 of boiling 
alcohol; insoluble in ether or chloroform. Salicin is a glucoside, consisting 
of Saligenin and glucose, and is found in Carbolic Acid, Gaultheria (winter- 
green),^MpRpkf#^||HH^, as well as the willow-barks, and is contained in 
Oleum Caryophylli and in Oleum Gaultherise. Dose, gr. xx-^ij. 

Acidum Salicylicum. Salicylic Acid, HC 7 H 5 O s , — a derivative of Salicin, 
largely produced synthetically by acting on carbolic acid with sodic and car- 
bonic anhydrides, but the natural acid is the most efficient. Occurs in fine, 
white, needle-shaped crystals, of sweetish-acrid taste and acid reaction, soluble 
in 450 of water and in 2^ of alcohol at 59 F. ; 100 parts may be dissolved 
in 100 of water by the aid of 8 parts of Borax. Dose, gr. v-^j. 

Sodii Salicylas, Salicylate of Sodium, 2NaC 7 H 5 3 .H 2 0, — is soluble in 
\ l / z parts of water. Dose, gr. v-^j. 

Lithii Salicylas, Salicylate of Lithium, 2LiC 7 H 5 3 .H 2 0, — is very soluble 
in water or alcohol. Dose, gr. v-^j. 

Physostigmin^e Salicylas,— is described under Physostigma, ante, 
page 293. 

Physiological Actions, 

Willow-bark is highly astringent and antiperiodic and feebly 
tonic, but is never employed medicinally, owing to its bulk. 
Salicin is a bitter tonic, an antiferment, antiseptic, and is highly 
destructive to low organisms. It has slight antiperiodic power 
and is feebly antipyretic. It prevents the reaction between 
Amygdalin and Emulsin (see page 29), and also that of Ptyalin, 
etc., on Starch (see page 67). It seems to be devoid of toxic 
power on man, and is mainly excreted as Salicylic, Salicyluric and 
Salicylous acids, being first changed in the bowel into Saligenin 
and Glucose. Salicin is well borne by the stomach. 

Salicylic Acid has properties similar to the above, but is much 
more energetic in its action, being a powerful antipyretic and 
antiseptic. It is also anhydrotic, checking local perspiration 
when locally applied. Inhaled it causes irritation of the respira- 
tory passages, producing sneezing and cough. In small doses it 
stimulates the stomach, heart and respiration, but moderate quan- 
tities derange the stomach, causing nausea and vomiting, while 
large doses depress the heart's action and the respiration after a 
primary excitation of both, lower the arterial tension, relax the 
vessels, produce free perspiration, and reduce the temperature in 
fever. It causes vertigo, dilated pupils, tinnitus aurium, a sensa- 
tion of tension in the frontal cerebrum, delirium, and may pro- 



SALVIA. 34I 

duce bed-sores from depression of the circulation, but does not 
affect the peripheral nerves as to either motion or sensation. In 
the blood it is first changed to Salicylate of Sodium, but a por- 
tion is again set free and uniting with glycocoll forms Salicyluric 
Acid (HCgHgNOJ, coloring the urine green. It is slowly ex- 
creted through the secretions generally, especially in the urine, 
sweat, saliva and bile. It stimulates the kidneys, at the same 
time disinfecting them and increasing the acidity of the urine, 
but may so irritate the kidneys as to produce albuminuria and 
hematuria. 

Salicylate of Sodium is identical in action with the acid from 
which it is formed, as the latter is converted into the former 
before reaching the tissues. Internally used it is less irritating 
than the acid, and is remarkably antipyretic in 15 -grain doses 
given 4 or 5 times in the 24 hours; but-it has no antiseptic or 
disinfectant properties unless so combined with a mineral acid as 
to liberate the Salicylic Acid. It produces free diaphoresis. 

Therapeutics. 

SALiciNand its derivatives are chiefly used in acute rheumatism, 
to lower temperature, relieve pain, and reduce articular swelling. 
They are most suitable to strong, vigorous patients, and if not 
promptly efficient they should be abandoned. The acid is 
much used as an antipyretic in fevers, especially those of septi- 
cemic character. It is a useful local application in gangrenous 
wounds, eczema of the hands or feet, cancer, burns, and in fetid 
perspirations, in the last affection being used in solution with 
borax. 

Salicylate of Sodium is more soluble than the acid and less 
irritant to the stomach, while in doses about 50 per cent, larger 
it is equally efficient. 

Salicylate of Lithium is also non-irritant and is supposed to 
act towards uric acid in the same manner as the other salts of 
this metal. It is expected to be of especial value in acute rheu- 
matism and rheumatic gout. 



SALVIA, Sage, — the leaves of Salvia officinalis, the com- 
mon garden sage, a perennial plant of the nat. ord. Labiatae, 
native in Southern Europe, but cultivated in our gardens for its 
strong, fragrant odor. The leaves are about 2 inches long, finely 
crenulate, grayish-green, thick and wrinkled; soft, hairy and 
glandular beneath, of aromatic odor and bitterish, astringent 



34 2 SAMBUCUS — SANGUINARIA. 

taste. They contain tannin, resin, etc., and a volatile oil which 
consists of Salviol (C 10 H 16 O), camphor and terpenes. Sage is a 
constituent of Vinum Aromaticum. There are no official prepa- 
rations. Dose of the powdered leaves, gr. xx-xxx, in infusion. 

Physiological Action and Therapeutics. 

Sage is aromatic, stimulant, tonic, astringent, and a vulnerary. 
It was highly esteemed in ancient times, and even yet is popular 
as a domestic cure-all with many people. In an infusion it may 
be used as a beverage in febrile conditions and to check the 
night-sweats of phthisis. Like other members of the same class 
it has a slight influence over enteralgia and flatulence. It makes 
a good astringent and stimulating gargle. 



SAMBUCUS, Elder, — the flowers of Sambucus canadensis, 
the common elder, a shrub of the nat. ord. Caprifoliaceae, from 
6 to 10 feet high, having small white flowers disposed in loose 
cymes of five divisions, the cream-colored corolla being whorl- 
shaped with five stamens on the tube. The berries are small, 
globular, and when ripe of a deep purple color. The plant con- 
tains a small quantity of a volatile oil, also a resin and valerianic 
acid. The common elder of Europe (S. nigra) is more of a tree, 
and is official in the B. P. There are no official preparations. 
Dose, gr. xxx~3j, in hot infusion. 

Physiological Action and Therapeutics. 

Elder-flowers are stimulant and diaphoretic, also perhaps diu- 
retic in some degree. The berries are diaphoretic and laxative, 
while the inner bark is a hydragogue cathartic and in large doses 
emetic. Formerly the inspissated juice of the berries was employed 
as an alterative in rheumatism and syphilis, but at present the 
flowers are used only for flavoring purposes. Elder-flower Water 
(Aqua Sambuci, B, P.) is a nice vehicle for collyria and lotions. 



SANGUINARIA, Blood-root,— is the rhizome, collected 
in autumn, of Sanguinaria canadensis, a perennial plant of the 
nat. ord. Papaveraceae, which grows abundantly throughout the 
U. S., being one of the earliest and most beautiful of the spring 
flowers. It has a single white flower on an erect stalk, the petals 
often tinged with rose or purple. Leaf reniform, smooth, 
deeply lobed, yellowish-green above, paler beneath, and strongly 



SANGUINARIA. 343 

marked with orange-colored veins. The rhizome is about 2 inches 
long and fths inch thick, cylindrical, horizontal, wrinkled, red- 
dish-brown, fracture short, waxy, with numerous small red resin- 
cells, bark thin, odor slight, taste very bitter and acrid. It con- 
tains 3 alkaloids, — Sa?iguinarine, C 17 H 15 X0 4 , which is probably 
identical with Chelerythrine (see Chelidonium), Porphyroxine, 
and Puccine, combined with Chelidonic and Sanguinarinic Acids, 
— also resin, gum, albumen, sugar, etc. The salts of its alkaloids 
are of brilliant red and orange colors and are all soluble in water. 
Dose of the powdered root as expectorant, gr. j-v; as emetic, gr. 
x-xx, best given in pill. 

Py-eparations. 

Extractum Sanguinary Fluidum, — Dose, rrrj-v as expectorant and 
stimulant ; tt|_x-1x as emetic, cautiously. 

Tinctura Sanguinaria, — strength 15 per cent. Dose, as expectorant, 
TTiv-^j , as emetic 3J-iij. 

Acetum Sanguinary, — has of Sanguinaria 10. in Diluted Acetic Acid 
90. Dose, rri_x-xxx '■> a5 an emetic, gij— j|ss. 

Sanguinarina, Sanguinarine, C 17 H 15 NO + ( Unofficial), — is the chief alka- 
loid and probably the active principle of the plant. Dose as an expectorant, 
gr. T V—J; as an emetic, gr. }4 repeated in 10 minutes will produce vomiting 
after the second or third dose. 

Ph\ 's io logic a I A ctio?i . 

Sanguinaria is sternutatory, sialogogue, expectorant and em- 
menagogue, a systemic emetic, a cardiac paralyzer, a violent irri- 
tant, an acro-narcotic and an alterative. Its taste is bitter and 
acrid. It causes violent sneezing when inhaled, increases secre- 
tion by irritating the secretory organs as it is eliminated, and in 
full doses produces salivation, catharsis and vomiting with great 
depression. Overdoses are violently irritant, the heart's action 
being at first increased, together with the arterial tension, then 
markedly depressed, and finally paralyzed by stimulation of its 
inhibition. The reflexes are lowered by paralysis of the spinal 
centres, muscular contractility impaired, the pupils dilated, tem- 
perature lowered, cold sweats, great thirst and collapse supervene, 
and death occurs by paralysis of the cardiac and respiratory 
centres, o f ten preceded by convulsions. Locally used, Sanguin- 
aria is a feeble escharotic. 

Antagonists and hicompatibles. 

Opium, Amyl Xitrite, Atropine, etc., to antagonize the depression of the 
circulation and the local irritant action. Incompatibles are alkalies, tannin, 
and most of the metallic salts. 

Therapeutis. 
As a tonic to the stomach and a stimulant to the liver Sanguin- 
aria or its active principle is well employed in small doses (gtt. 



344 SANTALUM ALBUM. 

iij of the tincture or gr. -^ of the alkaloid) for atonic dyspepsia, 
duodenal catarrh and catarrh of the biliary ducts with jaundice. 
Respiratory affections are often remarkably amenable to its influ- 
ence, particularly chronic nasal catarrh, asthma and acute bron- 
chitis. In these affections expectorant doses are the best, namely 
gtt. x of the tincture, and in the former the powder locally as a 
sternutatory. A docoction is a very efficient gargle in the sore- 
throat of scarlet fever. Sanguinaria is a very serviceable remedy 
in chronic bronchitis and in amenorrhcea of functional character, 
also in functional impotence from irritability of the organs, with 
daily losses and relaxation of the genitalia. By many practitioners 
it is considered a specific emetic in croup, but others look upon 
it with disfavor as too uncertain and harsh in its action. It has 
been thought to have alterative properties, and hence is frequently 
used with Stillingia and other plants in the treatment of strumous 
and syphilitic affections. In pneumonia of typhoid type and in 
pleuro-pneumonia it has undoubtedly been of great service in 
many cases. 

Locally, the powdered root is well employed as an application 
to foul ulcers and fungous granulations, and by insufflation to 
nasal polypi, and for chronic hypertrophy of the nasal mucous 
membrane. 

Sanguinarine has been used with good results in pneumonia, 
bronchitis and atonic dyspepsia. Doses of gr. y 1 ^ to ^ are expec- 
torant without irritating the stomach ; and still smaller doses 
(gr. -^q to y 1 ^) are stimulating to the gastric and intestinal secre- 
tions. 



SANTALUM ALBUM, White Sandalwood,— is the 

source of the official Oil of Santal (see below), but is not itself 
official. It is a tree of the nat. ord. Santalaceae, having its 
habitat in India but now nearly exterminated there ; — Santalum 
citrinum, the yellow sandalwood, from the Sandwich and Feejee 
Islands, is more commonly met with in commerce. 

Preparations. 

Oleum Santali, Oil of Santal, Oil of Sandalwood, — a volatile oil distilled 
from the wood of Santalum album ; a pale-yellow liquid, of sp. gr. about 
0.945, soluble in alcohol, of peculiar and aromatic odor, pungent taste and 
acid reaction. Dose, TTlx-xxx, in emulsion or capsule. 

Extractum Santali Fluidum ( Unofficial j, — made with alcohol as a 
menstruum. Dose ; 3J-iij. 



SANTALUM RUBRUM — SANTONICA. 345 

Physiological Action and Therapeutics. 

Sandalwood is a very agreeable perfume. The Oil is astringent 
to mucous membranes, producing dryness of the fauces, thirst, 
colic, and a sense of fulness in the renal regions. In concen- 
trated form it is a local irritant, but the effects of large doses 
have not been studied. It is extensively used in chronic bron- 
chitis and in gonorrhoea, forming the contents of proprietary 
capsules which are sold for the cure of the latter disease in all 
drug stores. As found in the shops it is extensively adulterated 
with Oil of Cedar, and hence is a very unreliable remedy. 



SANTALUM RUBRUM, Red Saunders,— is the wood 
of Pterocarpus santalinus, a tree of the nat. ord. Leguminosae, 
native in India. It comes as a dark reddish-brown, heavy, coarse 
wood, in chips or as a coarse powder, nearly inodorous and taste- 
less, not imparting any red color to water when macerated in it, 
but coloring alcohol, ether and alkaline solutions a bright red. 
The wood has no medicinal properties and is employed solely for 
the purpose of coloring alcoholic preparations. It is a constituent 
of Tinctura Lavandulae Compositus. 



SANTONICA, Levant Wormseed, — the unexpanded 
flowerheads of Artemisia maritima, var. Stechmanniana, a small, 
perennial plant of the nat. ord. Compositae, which grows in Asia 
Minor, Turkestan, etc., and contains a volatile oil and the pecu- 
liar, crystalline principle Santonin, (see below). 

Flowerheads about y 1 ^ inch long, pale greenish-brown, smooth, 
resembling seeds in appearance, but consisting of imbricated 
involucral scales with a green midrib, enclosing 4 or 5 tubular 
florets ; odor strong and peculiar, somewhat camphoraceous, taste 
aromatic and bitter. Dose, gr. x-lx. 

Preparations. 

Santoninum, Santonin, C 15 H 18 3 , — the neutral principle prepared from 
Santonica. Occurs in colorless, prismatic crystals, turning yellow on expo- 
sure to light, odorless, of bitter after-taste, and neutral reaction, nearly in- 
soluble in cold water, but soluble in 250 of boiling water, in 40 of alcohol, 3 
of boiling alcohol, 160 of ether, 4 of chloroform, also in solutions of the 
alkalies. Dose, gr. j^-j for a child, gr. j-v for an adult, not repeated too soon 
as the action of the drug is slow. 

Sodii Santoninas, Santoninate of Sodium, 2NaC 15 H ]9 4 .7H 2 0, — colorless, 
rhombic crystals, turning yellow on exposure to light, slightly efflorescent, of 
saline taste and slightly alkaline reaction, soluble in 3 of water and in 12 of 

29 



346 sapo. 

alcohol at 59 F., in 0.5 of boiling water and in 3.4 of boiling alcohol. Dose, 
gr. ij-x, as per age. 

Trochisci Sodii Santoninatis, — each troche contains of the preceding 
gr. j, with sugar, tragacanth and orange-flower water. Dose, ij-x, as per age. 

Trochisci Santonini (Unofficial), — each troche contains gr. ss of San- 
tonin. Dose, j-v, as per age. 

Santonin and its preparations are sensitive to light and should be kept in 
amber-colored bottles tightly corked. 

Physiological Action. 

Santonin is anthelmintic to the round-worm (Ascaris lumbri- 
coides), also but in less degree to the thread-worm (Oxyuris ver- 
micularis). It is taken into the blood as Santoninate of Sodium, 
and affects the cerebral faculties and the vision, objects appearing 
at first blue, green or red, then yellow (chromatopsia). Large 
doses disturb the consciousness of the patient, produce a sort of 
intoxication, tremors, weakness, with enfeebled respiration and 
slowing of the pulse, coldness of the surface, vomiting, sweating, 
mydriasis, convulsions and death from failure of respiration. A 
dose of 2 grains is said to have proved fatal to a feeble child of 
five years old. It is excreted by the kidneys, coloring the urine 
if acid a greenish-yellow, if alkaline a reddish-purple, and pro- 
duces considerable enuresis. 

Santoninate of Sodium acts similarly, but being more soluble 
it is more rapidly absorbed and eliminated, and does not produce 
the constitutional symptoms of the drug in so marked a degree. 

Therapeutics. 

As an anthelmintic Santonin is the most certain agent against 
the round-worm, and is best administered in powder with Calomel 
at bedtime after a day of fasting, a Senna-draught or a dose of 
Castor Oil being used the following morning. It also acts fairly 
well in suppository against the thread-worm, but is inoperative 
against tape-worm. Some observers consider that it is more 
promptly efficient when given in Castor Oil, and that the oil 
lessens the risk of evil after-effects. It has also been prescribed 
with great benefit for nocturnal incontinence of urine, and for 
certain eye affections, particularly amaurosis from atrophic or 
inflammatory changes in the retina and optic nerve. 



SAPO, Soap, — is soap prepared from Soda and Olive Oil; 
a white solid, hard yet easily cut when fresh, of slight, peculiar 
odor free from rancidity, a disagreeable, alkaline taste, and an 



sapo. 347 

alkaline reaction, readily soluble in water and in alcohol. It is 
well represented by the best " white Castile soap." 

Sapo Viridis, Green Soap, — is soap prepared from Potassa 
and fixed oils \ a soft, greenish-yellow, unctuous jelly, having 
a peculiar odor and an alkaline reaction, soluble in water and in 
alcohol, does not impart an oily stain to paper. Incinerated it 
yields an ash which is very deliquescent. Green Soap is a bad 
name for it, as its color is usually brown. 

Saponification is a process of double decomposition between a fat (stear- 
ate, palmitate or oleate of glyceryl) and an alkali, in which glycerin and 
the metallic salt of the fatty acid are formed. The glycerin, not being saponi- 
fiable, is set free, but the fatty acid (stearic, palmitic or oleic) unites with the 
salifiable base to form soaps, which are therefore mixed stearates, oleates and 
palmitates of various bases. Nearly all soaps are oleates or palinitates (or 
both) of sodium or potassium (or both). Hard soaps are soda soaps, soft 
soaps are potassium soaps. [Compare the articles Oleum Olivae, Adeps, 
Acidum Oleicum, Glycerinum, etc.] 

Insoluble Soaps are combinations of the oily acids with earths 
and metallic oxides. Two of them are official, viz., — the Soap 
of the Monoxide of Lead (Emplastrum Plumbi) and the Soap of 
Lime (Linimentum Calcis). 

Unofficial Soaps. 

Sapo Mollis* Soft Soap, — official in the Br. Phar., is made with Olive Oil 
and Potash, the solution of the alkali being present in excess. It is often 
adulterated with starch. 

Sapo Animalis, Curd Soap, — official in the Br. Phar., — is made with Soda 
and a purified animal fat, consisting chiefly of Stearin. Used in pills and 
suppositories. 

Sapo Medicatus, — official in the Fr. Codex, — is a Soda soap prepared 
from expressed Almond Oil. 

Preparations. 

Emplastrum Saponis, Soap Plaster, — has of Soap to parts, Lead Plaster 
90, Water q. s* 

Linimentum Saponis, Soap Liniment, — has of Soap 10 parts, Camphor 5> 
Oil of Rosemary 1, Alcohol 70, Water q. s. ad 100 parts. Opodeldoc is a 
similar preparation. 

Tinctura Saponis Viridis, — has of Green Soap 65 parts, Oil of Lavender 
2, Alcohol q. s. ad 100 parts. For external use. 

Soap is also an ingredient of Chloroform Liniment and several of the offi- 
cial pills. 

Physiological Action and Therapeutics. 

Soap is a laxative, antacid and antilithic ; externally it is a 
stimulating discutient, and is used for cleansing the skin, remov- 
ing fatty substances and softening the epidermis, but if too long 



348 SARSAPARILLA. 

applied it may prove decidedly irritant. It is a good antidote in 
poisoning by acids, and should be administered freely in such 
cases until more energetic alkalies can be obtained. In aqueous 
solution it makes a useful enema for constipation, or a plug of 
soap may be inserted into the rectum. 

Green Soap is a powerful detergent stimulant and is much 
employed in skin diseases, especially eczema rubrum, in which 
the tincture is well rubbed on, the diseased skin well washed and 
then covered with a bland ointment. The tincture is the most 
elegant form for use, and may be diluted with three parts of alco- 
hol for shampooing the scalp. 

The Liniment is used with friction in sprains, bruises and stiff 
joints, being a little more stimulating than Camphor-liniment. 
It makes a good basis for extemporaneous liniment prescriptions. 



SARSAPARILLA, — is the root of Smilax officinalis, Smilax 
medica, and of other undetermined species of Smilax, plants of 
the nat. ord. Smilaceae, growing in Mexico, Central America, 
Brazil, etc. There are six commercial varieties on the market, 
which are generally put up in differently formed bundles. The 
roots are about as thick as a goose-quill, reddish- brown, several 
feet in length, covered with rootlets and folded in bundles about 
1 8 inches long, taste mucilaginous, bitter and acrid. It contains 
starch, resin, oxalate of calcium, an essential oil, and an acrid 
neutral principle named Parillin or Smilacin, which when acted 
on by dilute sulphuric acid affords another principle, Farige?iin. 

Preparations. 
EXTRACTUM SARSAPARILLA FLUIDUM, — Dose, gSS-^j. 

Ext. Sarsaparilla Compositum Fluidum, — contains Sarsaparilla 75, 
Glycyrrhiza 12, Sassafras bark 10, Mezereum 3, Glycerin 10, Water and Alco- 
hol up to 100. Dose, gss-^j. 

Syrupus Sarsaparilla Compositus, — Sarsaparilla 150, Guaiacum wood 
20, Pale Rose 12, Glycyrrhiza 12, Senna 12, Sassafras 6, Anise 6, Gaultheria 
6, Sugar 600, Alcohol and Water up to 1000 parts. Dose, ^j-^ss. A good 
vehicle for Potassium Iodide. 

Decoctum Sarsaparilla Compositum, — Sarsaparilla 10, Sassafras 2, 
Guaiacum Wood 2, Glycyrrhiza 2, Mezereum I, W 7 ater q. s. ad 100 parts. 
Dose, 5J-1V. 

Syrup of Sarsaparilla (Unofficial), — so much used in flavoring soda- 
water, is a mixture of the oils of sassafras and gaultheria. 

Physiological Action and Therapeutics, 

Those who believe that Sarsaparilla has any action ascribe to 
it properties as a diuretic, diaphoretic, tonic and alterative. So 
far careful physiological experiments with the drug and its prin- 



SASSAFRAS. 349 

ciple have given negative results. It has been used as a so-called 
"blood-purifier" in scrofula, chronic abscesses, necrosis, old 
ulcers, many cutaneous diseases, etc., but is generally combined 
with other agents of undoubted activity. The compound decoc- 
tion is considered a good agent in tertiary syphilis, especially in 
debilitated subjects ; while the other preparations are commonly 
employed as vehicles for Iodide of Potassium and Bichloride of 
Mercury in syphilis of any form. Whenever used, the compound 
decoction will give the best results, the hot water and its other 
constituents being each of medicinal value. 



SASSAFRAS, — is the root-bark of Sassafras officinalis, a 
tree of the nat. ord. Lauraceae, growing throughout the U. S., 
and occurs in irregular fragments of a bright, rust-brown color, 
strongly fragrant, taste sweetish, aromatic and somewhat astrin- 
gent. The volatile oil is official. 

Sassafras Medulla, Sassafras Pith, — is the pith of the tree 
described above. Occurs in slender, cylindrical pieces, often 
curved or coiled, light, spongy, white, inodorous, insipid. Mace- 
rated in water it forms a mucilaginous liquid which is not pre- 
cipitated on the addition of alcohol. 

Preparations. 

Mucilago Sassafras Medulla, — has of the pith 2 parts in 100 of water. 
Dose, indefinite. 

Oleum Sassafras, — is a volatile oil distilled from Sassafras, — a colorless 
or yellowish liquid, having the odor of Sassafras, a warm, aromatic taste and a 
neutral reaction, readily soluble in alcohol. Sp. gr. about 1.090. Treated 
with cold nitric acid it becomes of a dark-red color, and is finally converted 
into a red resin. Dose, rrij-iv. 

Infusum Sassafras ^ Unofficial), — a popular "tea" which maybe drank 
ad libitum. 

Sassafras is a constituent of the three compound Sarsaparilla preparations. 

Physiological Action and Therapeutics. 

Sassafras is a stimulant diaphoretic when used in quantity of 
the hot infusion. It enjoys a popular reputation as a ^blood- 
purifier," and has a destructive influence on infusoria. It is 
employed chiefly in combination with Sarsaparilla and Guaiacum 
in cutaneous disorders and rheumatic and syphilitic affections. 
The mucilage of the pith is an excellent demulcent drink in acute 
gastritis or enteritis, or in poisoning by irritant or corrosive 
agents. It may also be used in extemporaneous prescriptions to 



3S° SCAMMONIUM SCILLA. 

hold insoluble substances in suspension and for flavoring purposes. 
The oil is chiefly used for flavoring in mixtures and confec- 
tionery. The syrup popularly known as " Sarsaparilla ' ' is com- 
posed of Oil of Sassafras and Oil of Gaultheria. 



SCAMMONIUM, Scammony, — is a resinous exudation 
from the root of Convolvulus Scammonia, a plant of the nat. ord. 
Convolvulaceae, growing chiefly in Syria and Asia Minor. It 
occurs in irregular, angular pieces or circular cakes, of a greenish- 
gray or blackish color, a peculiar, cheese-like odor, and a slightly 
acrid taste ; easily triturated into a dirty-gray powder, and with 
water yields a smooth, greenish emulsion. It contains about 80 
per cent, of Resin, with gum, sugar, starch, etc. The active 
principle, Jalapin, is probably identical with the Convolvulin of 
Jalap, and is contained in the root, the resin, etc. Dose, gr. v-x. 

Preparations. 

Resina Scammonii, Resin of Scammony, — is wholly soluble in ether. 
Dose, gr. iij-viij. 

Extractum Colocynthidis Compositum, — (see ante, page 157) contains 
14 per cent, of Resin of Scammony, and is an ingredient of the Compound 
Cathartic Pill. 

Physiological Action and Therapeutics* 

Scammony is an active cathartic, stimulating the liver and the 
intestinal glands, and causing free purgation in a few hours, with 
considerable griping. Its solution in the bile is necessary to its 
action, and it combines with the soda in that secretion. Though 
quite drastic in action it is somewhat uncertain as a purgative 
and is generally employed in combination with similarly acting 
agents. It is anthelmintic against the tapeworm, and in over* 
doses produces a high degree of irritation. 

It is used as a drastic purgative for children with Calomel or 
Potassium Sulphate, when an active cathartic is indicated. In 
the same way it is the appropriate agent on the principle of deri- 
vation in dropsies and cerebral affections, also in torpid states of 
the intestines with much slimy intestinal mucus ■ but it is contra- 
indicated in cases attended by irritability of the stomach and 
bowels. 



SCILLA, Squill, — is the sliced bulb of Urginea Scilla, or 
Scilla maritima, a perennial plant of the nat. ord. Liliaceae, grow- 
ing on the shores of the Mediterranean. It comes in narrow 



SCILLA. 351 

segments about two inches long, of yellowish-white or reddish 
color, slightly translucent, inodorous, mucilaginous, bitter and 
acrid to the taste. Its active principle has not yet been definitely 
isolated, but it is probably the acrid, bitter glucoside Scillitin. 
Other principles have been obtained and named Scillipicrin, Scil- 
litoxin and Scillin, also Sim'strin, a peculiar carbohydrate or 
mucilage, and the usual constituents of plants. Dose, in powder, 

Preparations. 

Extractum Scill,e Fluidum, — Dose, Tit j-v. 

Tinctura Scill^e, — 1 5 per cent. Dose, ni v-xxx. 

Acetum Scill^e, — io per cent. Dose, rn, x-gj. 

Syrupus Scill^e, — has of the Acetum 40 parts with Sugar 60 and Water. 
Dose, gss-j. 

Syrupus Scill^e Compositus, — has of Squill 120, Senega 120, Tartar 
Emetic 3, Sugar 1200, Calcium Phosphate 9, Diluted Alcohol and Water up 
to 2000 parts. Is known as Coxe's Hive Mixture, and each fluid ounce con- 
tains about gr. ^ of Tartar Emetic. Dose, ni v-gj, for children, the lat- 
ter being an emetic dose ; as an expectorant for adults 1U xx-xxx. 

Physiological Action. 

In small doses Squill is expectorant, in larger doses emetic and 
diuretic, and in overdoses it is a violent irritant poison, producing 
nausea, vomiting, purging, gastro-enteritis, strangury, bloody 
urine, perhaps suppression of urine, paralysis and convulsions, 
with death by paralysis of the heart in systole. Medicinal doses 
slow the heart, making the pulse stronger and slower, and increase 
the flow of urine (like Digitalis). Its active constituents diffuse 
into the blood, and its systemic effects follow on its application 
to the skin and seem to be exerted upon the mucous membrane 
of the secretory organs, especially affecting the bronchial, gastro- 
intestinal and genito-urinary. 

Therapeutics. 

Squill is employed in medicine for its expectorant and diuretic 
effects. It is especially applicable in cardiac dropsy, combined 
with Digitalis or the saline diuretics, and in chronic bronchitis 
associated with Ipecac or Ammonia, Asafcetida, Benzoin, etc. It is 
also used in croup, but is usually combined in this affection with 
some other emetic, as Tartar Emetic in the Compound Syrup, a 
mixture which may produce very depressing effects and should 
be used with caution. In whooping-cough and other irritant 
coughs with tickling sensations in the throat the Syrup or Vinegar 
of Squill is often of great service. 

The actions and uses of Squill should be studied in connection 
with those of Digitalis and Ipecacuanha. 



352 SCOPARIUS — SCUTELLARIA. 

SCOPARIUS, Broom, — the tops of Sarothamnus Scoparius, 
or Broom-plant, a common garden shrub of the nat. ord. Legu- 
minosae, having small, downy leaves and numerous large golden- 
yellow flowers. It occurs in thin, flexible twigs, usually free 
from leaves, nearly smooth, tough, of a peculiar odor when 
bruised and a disagreeably bitter taste. It contains Scoparin, 
C 21 H 22 O 10 , a neutral, crystallizable principle ; and Sparteine, 
C 15 H 26 N 2 , a volatile, liquid alkaloid, having no oxygen, but pos- 
sessing very decided basic qualities and being highly poisonous. 
There are no official preparations, but a decoction may be pre- 
pared in the proportion of ^j to the pint, and administered in 
doses of 3j every three hours until its diuretic effect is produced. 

Physiological Action and Therapeutics. 

Broom is diuretic and laxative, in large doses cathartic and 
emetic. It is classed with Buchu, Uva ursi, Pareira, Pipsissewa, 
etc., all being tonic, astringent diuretics. The alkaloid Spar- 
teine is a powerful narcotic, but exists in the plant in such small 
quantity that its share in the action thereof is not determin- 
able. Broom-tops are a favorite remedy for dropsies of cardiac 
origin, and for the general anasarca of chronic kidney disease, 
but are inadmissible in acute renal affections or where there is 
pulmonary congestion or inflammation. 



SCUTELLARIA, Skull-cap,— is the plant Scutellaria lat- 
eriflora, an indigenous, perennial herb of the nat. ord. Labiatae, 
growing in moist places and along ditches ; having small, pale- 
blue flowers disposed in long, leafy racemes, of slight odor and 
bitterish taste. It contains a little volatile oil, traces of a bitter 
principle, besides fat, tannin, sugar, etc. 

Preparation. 
Extractum Scutellaria Fluidum, — Dose, gss-ij. 

Physiological Action and Therapeutics. 

Scutellaria produces no very obvious effects when taken inter- 
nally. By some practitioners it is said to have tonic, nervine 
and antispasmodic powers, and it has been used in domestic prac- 
tice to calm the nervous system in diseases characterized by rest- 
lessness, tremors, spasms, twitching of the muscles, hypersesthesia, 
etc., as chorea, delirium tremens, nervous exhaustion from fatigue 
or over-excitement, hydrophobia, hysteria and epilepsy. The 



SENEGA. 353 

Scutellarin of the Eclectics is not a proximate principle, but an 
extract precipitated by alum from a concentrated aqueous tincture. 
It is given in dose of from one to four grains. 



SENEGA. — is the root of Polygala Senega, an indigenous, 
perennial plant of the nat. ord. Polygalaceae, having small, white 
flowers in a close spike at the summit of the stem. The root is 
about 4 inches long, with a knotty crown and tortuous, spreading 
branches, thick bark inclosing a porous, yellowish wood ; odor 
slight but unpleasant, taste at first sweetish, afterwards acrid. Its 
principal constituent is the glucoside Senegin, CggH^O^, which is 
identical with Saponin, and closely allied to Digitonin. It is a 
white, amorphous powder, readily soluble in alcohol and hot 
water, forming a soapy emulsion when mixed with boiling water, 
and decomposed by HC1 into sugar and Sapogenin, C u H 22 2 . 

Preparations. 

Abstractum Senega, — Dose, gr. v-x. 

Extractum Senega Fluidum, — Dose, irix-xx. 

Syrupus Senega, — has of the fluid extract 160, Aqua Ammoniae 4, Sugar 
600, Water to 1 000 parts. Dose, gj-ij. 

Syrupus Scill^: Compositus, — contains 6 per cent, of Senega. (See page 
351.) Dose for children, ^v-^j ; for adults as an expectorant, rttxx-^ss. 

Physiological Action. 

Senega is a stimulating expectorant, a diuretic and a diapho- 
retic. It causes irritation of the throat, with some salivation and 
gastro-intestinal irritation, an inclination to cough, increased 
bronchial secretion, and perhaps some diuresis and diaphoresis. 
Inhaled as a snuff it is very irritant to the mucous membrane of the 
nose, causing cough, sneezing and nasal catarrh. Senegin is 
violently irritant and a powerful depressant to the heart, vessels, 
nervous and muscular systems. It is excreted by the bronchial 
mucous membrane, the kidneys and the skin, all of which it stim- 
ulates and in large quantity irritates. 

Therapeutics. 

The use of Senega is chiefly that of a stimulating expectorant 
in chronic bronchitis, the second stage of acute bronchitis, ty- 
phoid pneumonia, asthma, croup, and as a diuretic *n dropsy due 
to renal disease. It removes the tightness and oppression expe- 
rienced in subacute chest affections, relieves the cough and rap- 
idly promotes expectoration. When the mucus is tough and 

30 



354 SENNA. 

scanty this remedy is of no value. It has been used with great 
benefit in amenorrhcea, given in saturated decoction for two 
weeks before the expected period. In chronic rheumatism and in 
rheumatic paralysis its stimulating and diaphoretic powers have 
been of great value. Senegin has been successfully used in 2- 
grain doses as a remedy for uterine hemorrhage. 



SENNA, — the leaflets of Cassia acutifolia (Alexandria Senna), 
and of Cassia elongata (Indian Senna), shrubs of the nat. ord. 
Leguminosae, growing in Egypt and India. The leaflets are from 
1 to 2 inches long, lanceolate, brittle, dull green, of peculiar 
odor, and nauseous, bitter taste. They contain an amorphous 
glucoside, Cathartic Acid, C 180 H 192 N 2 SO 82 , which forms salts with 
bases and may be decomposed into glucose and Cathartogenic 
Acid. Other constituents are Sennapicrin and Sennacrol, both 
glucosides; — Catharto-mannite, a peculiar unfermentable sugar; 
also a coloring matter allied to Chrysarobin (see page 145), and 
various vegetable salts. 

Preparations, 

Extractum Senn^e Fluidum, — Dose, 3j. 

Syrupus Senn^e:, — has of Senna 33 parts, Sugar 60, Alcohol 4, Oil of 
Coriander and Water to 100 parts. Dose, £ss-ij. 

Confectio Senn^:, — has of Senna 10, Coriander 6, Cassia Fistula 16, 
Tamarind 10, Prune 7, Fig 12, Sugar 50, Water 60 parts. Is sold under the 
titles " Tamar-Indien," "Tropical Fruit Laxative," etc. Dose, £j-ij. 

Infusum Senn^e Compositum, Black Draught, — has of Senna 6, Manna 12, 
Magnesium Sulphate 12, Fennel 2, Water 100 parts. Dose, Jfj-iij. 

Pulvis Glycyrrhiz^e Compositus (see ante, page 205), — contains 18 per 
cent, of Senna. Dose, gr. xx-^j. 

Syrupus Sarsaparill^ Compositus (see ante, page 348), — contains 12 
per 1000 of Senna. Dose, 3J-iv. 

Physiological A ction. 

Senna is a very efficient and safe cathartic, producing, when 
taken internally, copious yellow stools in about 4 hours, with 
considerable griping and flatulence, which may, however, be les- 
sened by combining it with carminatives. Its action is chiefly 
expended on the small intestine, and it increases both peristalsis 
and secretion. 'It has no irritant qualities in ordinary medicinal 
doses, and does not produce hypercatharsis, nor leave constipa- 
tion as an after result. Its infusion injected into the veins causes 
both vomiting and purging ; and in large doses per orem it pro- 
duces nausea, vomiting, flatulence, excited pulse, drastic purga- 
tion with severe tenesmus, but its effects are never poisonous. It 



SERPENTARIA. 355 

may produce hemorrhoids and increase the menstrual flow in 
women. Given to a nursing mother her milk will acquire purga- 
tive powers. In some very susceptible persons the odor of the 
leaves or of the infusion will cause an evacuation of the bowels. 
Its odor and taste are particularly disagreeable, especially when 
administered in infusion. 

Therapeutics. 

Senna would probably take rank as our best and safest cathartic 
but for the nauseousness of its smell and taste. It is a favorite 
laxative in England for children, and is used with great benefit 
in habitual constipation or where prompt evacuation of the bowels 
is required. In hemorrhoids and anal fissures it is employed to 
produce soft and easy motions. It should never be used where 
fever exists, nor in any such conditions as hemorrhage or inflam- 
mation of the intestinal mucous membrane, hemorrhoids, menor- 
rhagia, abortion, etc. The least disagreeable of its preparations 
are the Confection of Senna and the Compound Liqourice Powder. 



SERPENTARIA, Virginia Snake-root,— is the rhizome 
and rootlets of Aristolochia Serpentaria and of Arisiolochia reticu- 
lata, indigenous herbaceous plants of the nat. ord. Aristolo- 
chiacese, growing in rich, shady woods, with purple flowers 
arising from joints near the root. The rhizome is about an inch 
long, thin and bent, having on the upper side short stem-rem- 
nants, on the lower side numerous thin, branching rootlets ; odor 
and taste are aromatic and camphoraceous. It contains a volatile 
oil, a camphor-resin and a bitter principle named Aristolochine, 
which is soluble in both alcohol and water. All its preparations 
should be made from the fresh root, as it deteriorates by keeping. 

Preparations. 

Extractum Serpentaria Fluidum, — Dose, "rn, x -xxx. 
Tinctura Serpentaria, — 10 per cent. Dose, .^ss-ij. 
Tinctura Cinchona Composita, — has 2 parts of Serpentaria in 1 00. (See 
ante, page 149). Dose, £j-ij. 

Physio log ical A ction . 

Serpentaria is a stimulant expectorant and tonic, also a cardiac 
stimulant, a diaphoretic, diuretic, emmenagogue, aphrodisiac, 
and somewhat of an antiperiodic. Its taste is warm and pungent, 
its odor characteristic. Small doses promote appetite and diges- 
tion, increase the bronchial and intestinal secretions, the action 



35^ SESAMI OLEUM — SEVUM. 

of the heart, the cutaneous circulation and the surface tempera- 
ture, and produce considerable mental exhilaration. Large doses 
are irritant, causing nausea and vomiting, vertigo and headache, 
colic, borborygmi, rectal tenesmus, flatulent distention and fre- 
quent but not watery stools. The irritant action seems to produce 
gas rather than fluid. Pruritus ani and hemorrhoids are occa- 
sionally caused by its use. 

Therapeutics. 

Serpentaria is chiefly employed as a vehicle for other stimulant 
drugs, but has many uses of its own. In bronchial affections it 
is extremely valuable as a stimulating expectorant. In typhoid 
pneumonia it is a good vehicle for carbonate of ammonium, and 
in the exanthemata is extremely useful when much depression 
exists. It is indicated in typhoid conditions generally, and in 
the amenorrhoea of anaemia and chlorosis it is an efficient em- 
menagogue in many cases. It will often restore the waning sexual 
power in functional impotence, while in bilious vomiting it fre- 
quently checks the nausea and settles the stomach. It is used as 
a vehicle for Cinchona in remittent fever. In diphtheria, scar- 
latina, etc., the infusion forms an excellent gargle. Its diapho- 
retic and diuretic properties, though slight, are sometimes of 
avail in chronic rheumatism. 



SESAMI OLEUM, Oil of Sesamum, Benne Oil,— is 
a fixed oil expressed from the seeds of Sesamum indicum, or 
Benne plant (nat. ord, Pedaliaceae), which is a native of India, 
but is cultivated in the southern portions of the U. S. It is a 
yellowish or yellow, oily liquid, inodorous or nearly so, having 
a bland, nut-like taste and a neutral reaction. It is a bland fixed 
oil, very similar in its properties to olive oil, and may be used for 
the same purposes. It is rich in Olein (76 per cent.) and keeps 
better than olive oil. It is chiefly employed as a hair-oil. 



SEVUM, Suet, — is the internal fat of the abdomen of Ovis 
Aries (the Sheep), purified by melting and straining. It should 
be kept in well-closed vessels and not used after it has become 
rancid, as it will on exposure to air. It is a white, smooth, solid 
fat, of bland taste and neutral reaction, soluble in 24 of boiling 
alcohol, 60 of ether, and slowly in 2 of benzin. It consists chiefly 
of Stearin, but also has Palmitin and Olein, and is a constituent 



SILICATES — SINAPIS. 357 

of Unguentum Hydrargyri and Unguentum Picis Liquidae. It is 
a harder fat than lard and more liable to turn rancid. It is used 
in ointments and liniments to give them greater consistency, but 
may be applied alone as a dressing. to ulcers. In physiological 
action and therapeutics it follows the other oils and fats (see ante, 
pages 265, 273). 



SILICATES of Sodium (Na 2 Si0 3 ) of Potassium (K^SiC^, 
and of Magnesium (2Mg03Si0 2 ) are used in medicine and sur- 
gery, a solution of the Silicate of Sodium being official. 

Liquor Sodii Silicatis, Soluble Glass Solution, — is a semi- 
transparent, colorless or yellowish, viscid liquid, odorless, of sharp 
saline and alkaline taste and alkaline reaction, of sp. gr. 1.300 
to 1.400. A small quantity should not produce any caustic effect 
when applied to the skin. It usually contains about 20 percent, 
of Silica and 10 per cent, of Soda, and is used on bandages to 
make immovable dressings, being lighter than plaster-of-Paris 
and stronger than starch. 

Liquor Potassii Silicatis (Unofficial), — also known as Soluble Glass 
Solution, — is used for immovable dressings in the same manner as the preced- 
ing. A mixture of 2 parts of this solution with one of the soda salt solution 
is said to set more quickly and firmly than either solution separately. Diluted 
( I to 4) the solution of the Potassium Silicate has been applied locally in ery- 
sipelas, gonorrhoea, cystitis, vaginitis, etc., as an antiseptic, and with good 
results. 

Magnesii Silicas Hydratus, Hydrated Silicate of Magnesium, Meer- 
schaum, 2MgO,3Si0 2 4-2H 2 (Unofficial), — a mineral used for the manufac- 
ture of smoking-pipes, and employed in France as a substitute for Bismuth 
Subnitrate in obstinate choleraic diarrhoea, to protect the intestinal mucous 
membrane or as an absorbent. It is given in tine powder and in doses of ^j- 
iv per diem. 



SINAPIS, Mustard, — is official under the two following 
titles, but all the pharmacopceial preparations are made from 
Black Mustard only. 

Sinapis Alba, White Mustard, — the seed of Sinapis Alba, an 
annual plant of the nat. ord. Cruciferae, cultivated in our gar- 
dens. It has yellow flowers in racemes, and ribbed pods with a 
long, ensiform beak. The seeds are about A inch in diameter, 
yellowish, hard, almost globular with a circular hilum ; embryo 
oily, with a curved radicle and two cotyledons, one folded over 
the other ; inodorous, taste pungent and acrid. 



358 sinapis. 

White Mustard contains Myrosin, a ferment, and Sinalbin, a crystalline 
substance, which reacting on each other in the presence of water produce 
Sulpho-cyanate of Acrinyl, a rubefacient principle allied to the volatile oil of 
black mustard. It also contains Sinapine, an alkaloid, Erucic or Brassic 
Acid, and a bland, fixed oil, all three contained also in Black Mustard. 

Sinapis Nigra, Black Mustard, — is the seed of Sinapis nigra, 
an annual plant of the nat. ord. Cruciferae, native of Europe but 
naturalized in the U. S. It has small, yellow flowers standing 
closely together on peduncles at the ends of the branches, also 
smooth, erect pods with a short beak. The seeds are about one- 
half the size of those from white mustard, black and hard, almost 
globular with a circular hilum ; embryo as in Sinapis Alba ; in- 
odorous when dry, but when moist of a pungent, irritating odor ; 
taste pungent and acrid. 

Black Mustard contains My rosin, a ferment, and Sinigrin (Potassium My- 
ronate), which reacting on each other in the presence of water produce the 
Sulpho- cyanide of Ally I, or Volatile Oil of Mustard. It also contains Sina- 
pine, an alkaloid, Erucic or Brassic Acid, and a bland, fixed oil ; all three of 
which are contained also in White Mustard. 

Commercial Flour of Mustard (Unofficial), — is a mixture 
of white and black mustard seeds ground to a fine powder. It 
may be employed in lieu of either variety. Dose, as emetic, 
3ij-iv. 

Preparations. 

Oleum Sinapis Volatile, Sulpho-cyanide of Allyl, C 4 H 5 NS, — a colorless 
or pale yellow liquid, of very pungent and acrid odor and taste and neutral 
reaction, sp. gr. 1.017 to 1.021, almost insoluble in water but freely soluble in 
alcohol and ether. Dose, ""l^-X* 

Charta Sinapis, Mustard Paper, — consists of Black Mustard, the fixed 
oil removed by percolation with Benzin, mixed with Solution of Gutta-Percha 
and spread on paper. Each square inch should contain about gr. vj of Mus- 
tard. For local use. 

LinimEntum Sinapis Compositum,— has of the Volatile Oil 3, Extract of 
Mezereum 2, Camphor 6, Castor Oil 15, Alcohol to 100 parts. For local use. 

Physiological Action. 

Locally used, Mustard is rubefacient, counter-irritant, and a 
nervous stimulant, causing heat, redness and severe burning pain. 
Its prolonged application produces vesication by inducing local 
inflammation. Internally it is a local emetic in full doses, in 
smaller a condiment and carminative. Its irritant effect on the 
gastric mucous membrane is much less powerful than on the skin. 

Therapeutics. 

Mustard is commonly used as a local application to relieve 
local pain, to stimulate the viscera, and to produce counter-irri- 



sodium. 359 

tation. These objects find their application in muscular rheu- 
matism, neuralgia, colic, gastralgia, inflammation of the throat, 
larynx, bronchi, lungs, pleurae and pericardium, also as a deriva- 
tive in headache, cerebral congestion, and suppressed menstrua- 
tion. It may also be used as a stimulant to the heart, vascular 
system and respiratory apparatus. When action of a mild char- 
acter is desired it may be diluted with flaxseed or flour. 

Internally it may be employed as an emetic in indigestion or 
narcotic poisoning. Its use as a condiment is familiar, acting by 
stimulation of the gastric mucous membrane. In overdoses it 
may excite severe gastritis. White mustard seed, unground, has 
been used as a laxative, as it produces no irritation. 

The Oil is one of the most irritant of the volatile oils, producing 
severe gastro-enteritis. It is used chiefly as an ingredient of stimu- 
lating liniments, but may be employed internally in small doses. 



SODIUM, Natrium, Na., — This metal is not official, but is 
represented by a number of official salts, which are generally 
colorless or white, and with very few exceptions are readily soluble 
in water. Some of them are found native, as the Chloride (in 
sea-water, salt lakes, salt mines), — the Nitrate (in Peruvian 
deserts, etc.) and the Borate (in lakes of Persia, California, etc.). 
The Carbonate is found in the ashes of marine plants. From the 
Chloride is prepared the Sulphate, from this the Carbonate, and 
from the latter most of the other salts are prepared. All sodium 
salts impart a yellow color to flame, which should not appear 
more than transiently red when observed through a blue glass, 
which cuts off the yellow rays but allows the violet ones of 
Potassium to be seen. 

Sodium Compounds and their Preparations. 

Soda, Sodium Hydrate, Caustic Soda, NaHO, — a white, hard, opaque solid, 
deliquescent in moist air, efflorescent in dry air, odorless, of intensely acrid 
and caustic taste and strongly alkaline reaction, soluble in 1.7 of water at 59 
F., and in 0.8 of boiling water, very soluble in alcohol. Is a powerful caustic 
but milder than Potassa, and should be kept in well-stoppered bottles made 
of hard glass. 

Liquor Sod^e, Solution of Soda, — contains about 5 per cent, of the 
hydrate, and is prepared by dissolving 180 parts of Sodium Carbonate in 400 
of boiling Distilled Water, also 60 of Lime in the same quantity of Distilled 
Water, boiling, mixing the solutions gradually, again boiling and when cold 
adding water up to 1000 parts, straining, settling, and then removing the clear 
solution. Or, by dissolving 56 of Soda in 944 of Distilled Water. It is a 
clear, colorless liquid, odorless, of acrid and caustic taste and strongly alkaline 
reaction. Dose, "niv-^ss, well diluted with water. 



360 



SODIUM. 



Sodii Acetas, Acetate of Sodium, NaC 2 H 3 O r 3H 2 0, — large, transparent 
prisms, efflorescent in dry air, odorless, of saline, bitter taste, and a neutral 
or faintly alkaline reaction, soluble in 3 of water and in 30 of alcohol at 59 
F., in I of boiling water and in 2 of boiling alcohol. Dose, gr. xx-^j. 

Sodii Carbonas, Carbonate of Sodium, Na 2 C0 3 .ioH 2 0, — large, colorless 
crystals, rapidly efflorescent, with a harsh alkaline taste and strongly alkaline 
reaction ; very soluble in water, insoluble in alcohol. By heat it undergoes 
aqueous fusion and then dries up, losing 63 per cent, of its weight. Of it 20 
grains will neutralize 9.7 grains of Citric Acid, or io^J grains of Tartaric Acid. 
Dose, gr. v-xxx. 

Sodii Carbonas Exsiccatus, Dried Carbonate of Sodium, — is the Car- 
bonate 200 parts dried at a heat of 113 F., until it is converted into a white 
powder weighing 100 parts. Is chiefly used for pharmaceutical purposes. 

Sodii Bicarbonas, Bicarbonate of Sodium, NaHC0 3 , — an opaque, white 
powder, permanent in the air, odorless, of cooling, saline taste, and a slightly 
alkaline reaction; soluble in 12 of water at 59 F., insoluble in alcohol, 
decomposed by hot water. It is distinguished from the Carbonate by its solution 
in cold water giving a white and not a colored precipitate with solution of per- 
chloride of mercury. Of it 20 grains neutralize 16.7 grains of Citric Acid, or 
17.8 grains of Tartaric Acid. It is a constituent of Mistura Rhei et Sodae ( see page 
325) and of Pulvis Effervescens Compositus (see page 310;. Dose, gr. x-gj. 

Sodii Bicarbonas Venalis, Commercial Bicarbonate of Sodium, — should 
contain 95 per cent, of the pure bicarbonate, which it resembles in appearance 
and properties. It is employed solely for external applications. 

Trochisci Sodii Bicarbonatis, — each troche contains of the Bicarbonate 
3 grains, with Sugar, Nutmeg and Mucilage of Tragacanth. Dose, as of the 
bicarbonate. 

Sodii Chloras, Chlorate of Sodium, NaC10 3 , — colorless, transparent tetra- 
hedrons of the regular system, permanent in dry air, odorless; of cooling, 
saline taste and neutral reaction, soluble in 1.1 of water and in 40 of alcohol at 
59 F. also in 0.5 of boiling water and in 43 of boiling alcohol. When heated 
it melts and then gives off a portion of its oxygen, leaving a residue of 
sodium chloride. Should be kept in well-stoppered bottles, and should not 
be triturated with readily oxidizable or combustible substances. Dose, gr. 

V— XX. ' 

Sodii Chloridum, Chloride of Sodium, Common Salt, NaCl, — white, hard, 
cubical crystals or a crystalline powder, permanent in the air, odorless, of a 
purely saline taste and neutral reaction ; soluble in 2.8 of water at 59 F., and 
in 2.5 of boiling water. Almost insoluble in alcohol. Dose, gr. x-^j. 

Sodii Nitras, Nitrate of Sodium, Cubic Nitre, Chili Nitre, Chili Saltpetre, 
NaN0 3 , — colorless, transparent crystals, slightly deliquescent, odorless, of 
cooling, saline and bitter taste, and neutral reaction; soluble in 1.3 of water 
at 59 F., and in 0.6 of boiling water, scarcely soluble in cold alcohol. Dose, 

Sodii Sulphas, Sulphate of Sodium, Glauber's Salt, Na 2 S04.ioH 2 0,— 
large, colorless, transparent, monoclinic prisms, rapidly efflorescent in air; of 
cooling, saline taste and neutral reaction ; soluble in 2.8 of water at 59 F., in 
0.25 of water at 91.4 F., and in 0.4 of boiling water, insoluble in alcohol. 
Dose, gr. v-xx ; as purgative ^ss-j, or a third of a teaspoonful in a large glass 
of water. 

Sodii Ethylas, Ethylate of Sodium, Caustic Alcohol, C 2 H 5 NaO, (Unof- 
ficial), — is a white powder, often having a brownish tinge, dissolving in water 
with a hissing sound. Upon contact with the smallest quantity of w r ater or 



SODIUM. 361 

moist living tissue it splits into alcohol and caustic soda. An alcoholic solu- 
tion is made by dissolving sodium in absolute alcohol, and fs used as a 
caustic. Chloroform decomposes it at once into ether and chloride of sodium. 
It should be kept in a cool place as it is liable to explode. 

The Arseniate of Sodium is described under Arsenic, page 85 ; — the 
Benzoate under Benzoin, page 99 ; — the Borate under Ac. Boricum, page 
20; — the Bromide under Bromum, page 103;— the Solution of Chlori- 
nated Soda under Chlorum, page 143; — the Iodide under Iodum, page 
231; — the Hypophosphite, Phosphate and Pyrophosphate under Phos- 
phorus, page 289; — the Salicylate under Salicin, page .340; — the San- 
toninate and its Troches under Santonica, page 345;— the Sulphite, 
Bisulphite and Hyposulphite under Acidum Sulphurosum, page 36; 
and the Sulpho-carbolate under Carbolic Acid, page 22. 

Physiological Action. 

The action of the Sodium salts is similar to that of the Potas- 
sium salts, except that the former are feebler as alkalies, are not 
so depressant, and are not so poisonous to the cardiac muscle or 
the nerves'. They are diffused more slowly, are neither absorbed 
nor excreted so readily, and have not so marked a diuretic action. 
Locally applied in large doses to muscular and nervous tissue 
they are paralyzant, but not so powerfully as potassium salts. 
Urate of Sodium is not soluble like the urates of lithium or potas- 
sium, being therefore much less readily excreted, and forming the 
masses called " chalk-stones " in gouty subjects. Soda is a less 
active escharotic than potash, having less affinity for water. 
Liquor Sodte renders the blood and secretions more alkaline, but 
does not alter nutrition to the extent that liquor potassae does. 
The Acetate is converted into the Carbonate in the blood, and 
is a less active diuretic than the corresponding potassium salt. 
The Carbonate is chiefly used in the preparation of the other 
salts. The Bicarbonate is slightly irritant, stimulates the secre- 
tion of gastric juice, acts as an antacid and will increase the alka- 
linity of the blood. The Chloride is a most important food. 
It exists normally in the blood, where it keeps the fibrin and 
albumen in solution, and plays an important part in tissue change. 
In inflammation, being thus needed, it accumulates at the seat of 
the morbid action, disappearing from the urine ; its reappearance 
therein being a sign of improvement. A solution of 0.65 part to 
100 of water does not destroy animal tissues like water alone, 
and may be mixed with blood without destroying the corpuscles, 
though strong solutions are intensely irritating. Internally used 
in quantity it is emetic and hemostatic. As an enema it is des- 
tructive to ascarides. 

Nitrate of Sodium is a mild cathartic, and in solution is a 
solvent of false membranes. The Sulphate is generally cathartic 



362 SODIUM. 

in action, though in small doses and with little water it may be 
passed off by the kidneys. It is mixed with the Bicarbonate to 
imitate the salts obtained by evaporation of Carlsbad water. The 
Ethylate is an antiseptic, and a powerful but almost painless 
caustic. 

[The actions of the other Sodium salts are respectively de- 
scribed under the titles of their other constituents, to which their 
effects are mainly referable.] 

Antagonists and Inco??ipatibles. 

Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as 
vinegar, cider, lemon-juice ; then demulcent drinks and oils to protect the 
mucous membrane, and the usual vital supporters. The alkalies and their 
carbonates are incompatible with the acids and also with metallic salts, and 
the caustic alkalies decompose most alkaloids. 

Therapeutics. 

The Sodium salts treated of in this article are not much used 
internally, the corresponding Potassium salts being preferred, 
especially when it is desired to alkalinize the urine or to promote 
oxidation. In the alkaline treatment of stomach affections the 
Sodium salts are the most efficient, especially the Bicarbonate 
before meals or on an empty stomach to increase the secretion of 
the gastric juice. This same salt is used in diabetes to lessen the 
amount of sugar, in frontal headache with constipation, the pain 
being seated at the junction of the forehead with the hairy scalp, 
— also as a wash (gr. ij ad §j) in itching skin-affections and as 
a lotion in burns and eczema. The Chloride is used internally 
as an antidote in poisoning by Nitrate of Silver and as an emetic, 
and will often relieve hemoptysis. In bilious diarrhoea it is em- 
ployed in doses of gr. x~3j, thrice daily. Locally in baths it is 
a good stimulant to the skin, and in solution {J/ 2 to 1 per cent.) 
to wash wounds in place of water, to cleanse the nasal cavities, or 
to destroy ascarides, in which case it is given by enema of the 
strength of two tablespoonfuls to the pint. The Carbonate may 
be used in dilute solution locally to prevent itching, but is chiefly 
employed in the preparation of the other salts. The Sulphate is a 
good purgative, either alone or with the Bicarbonate in imitation 
of Carlsbad Salts, for bilious disorders, gouty affections, chronic 
constipation, obesity and diabetes mellitus. The Chlorate has 
similar uses to those of the Potassium Chlorate, but being more 
soluble can be used in stronger solutions, but this is of doubtful 
benefit for internal use as it has all of the irritating power on the 
kidneys and destructive action on the blood possessed by the other 
salt. . (See a?ite, page 312). The Nitrate is employed as a mild 



SPIGELIA — STAPHISAGRIA. 363 

cathartic, and in solution by atomization to destroy the false 
membrane in croup. The Ethylate has been of service as a 
caustic in cancer, lupus and naevi, for the latter affection being 
painted over the growth with a glass rod. Caustic Soda is a 
better caustic than Potassa as it has less affinity for water and 
hence does not destroy the tissues so deeply, nor has it the same 
tendency to run over adjacent parts. 

[The therapeutics of the other Sodium Compounds are de- 
scribed as noted on page 361.] 



SPIGELIA, Pink-root, — is the rhizome and rootlets of 
Spigelia marilandica, the Carolina Pink, an herbaceous perennial 
of the nat. ord. Loganiaceae, native of the southern states ; hav- 
ing large, showy flowers, scarlet or crimson externally, yellow 
within. The rhizome is 2 inches long, y% inch thick, horizontal, 
bent and branched ; having cup-shaped scars above and numer- 
ous thin rootlets below. It contains a bitter principle and a 
volatile oil, also tannin, wax, resin, lignin and salts. Dose, 
3j-ij for an adult, gr. x-xx for a child of 3 years. 

Preparations. 

Extractum Spigelia Fluidum, — Dose for an adult, gj-ij ; for a child of 
3 years, Ttix-xx. 

Infdsum Spigelee Compositum, Worm Tea (Unofficial), — has of Spigelia 
15, Senna 10, Fennel 10, Manna 30, Water, 500. Dose, gjss-v. 

Physiological Action and Therapeutics. 

Spigelia is anthelmintic against the round worm (Ascaris lum- 
bricoides), and is in popular use as a vermifuge, administered 
usually with Senna. In large doses it is an uncertain cathartic, 
and may produce quite serious symptoms, as vertigo, dimness 
of vision, dilated pupils, spasms and even convulsions. These 
effects are most apt to occur when the drug fails to produce pur- 
gation, hence it is usually administered with an active cathartic. 



STAPHISAGRIA, Stavesacre,— is the seed of Delphi- 
nium Staphisagria, an annual or biennial plant of the nat. ord. 
Ranunculaceae, a native of Europe, having bluish or purple 
flowers, in terminal racemes; and seeds in straight, oblong cap- 
sules. The seeds contain an alkaloid Delphi nine, probably 3 
other alkaloids, a bitter principle, a volatile and a fixed oil, etc. 
There are no official preparations. 



364 STILLINGIA. 

Preparations. 

Unguentum Staphtsagria (Unofficial), — contains of the powdered seeds 
I part with 2 each of olive oil and lard. 

Delphinina, Delphinine, C 22 H 35 N0 6 (Unofficial), — is the active alkaloid, 
and exists in the fatty oil which is extracted by ether. Dose, gr. ^~\- 

Physiological Actions. 

Stavesacre is a violent emetic and cathartic, also parasiticide. 
The alkaloid is irritant to the skin if locally used, producing 
tingling, burning, and inflammation. Internally, it lowers the 
activity of the heart and respiration and produces a most pro- 
found adynamia, and may* prove fatal from paralysis of the spinal 
cord and asphyxia. In many respects its alkaloid resembles 
Aconitine and Veratrine. 

The?'apeutics. 

The ointment is often employed as a parasiticide against pedi- 
culi and the acarus scabies. The fixed oil is probably equally 
effective. Delphinine has been used internally in asthma, rheu- 
matism and neuralgia, and in the latter affection is well employed 
as an ointment (gr. xx to §j), applied over the course of painful 
superficial nerves. It has been suggested as an antipyretic and 
for dropsy. A tincture or fluid extract is a very efficient applica- 
tion against pediculi. 



STILLINGIA, Queen's Root, — is the root oiStillingia syl- 
vatica, or Queen's Delight, an indigenous, perennial plant of the 
nat. ord. Euphorbiaceae, with yellow flowers on a spike, and a 
large, thick and woody root, of peculiar and unpleasant odor, 
and an acrid, pungent, bitter taste. It contains a resin and a 
volatile oil, but its active principle has not yet been isolated. 
The fresh root should be used in making the preparations, as 
those from the dried root are almost inactive. Dose of the pow- 
dered root, gr. x~3j. 

Preparations. 

Extractum Stillingi^e Fluidum, — Dose, "ntx-gj. 

Tinctura Stillingia (Unofficial), — Dose, ^ss-ij. 

Decoctum Stillingia (Unofficial), — gj ad Oj. Dose, §j-ij. 

Syrupus Stillingia Compositus (Unofficial), — is composed of Stillingia, 
Corydahs, Iris, Chimaphila, Coriander, Xanthoxylum, Samhucus, Sugar, Water 
and Alcohol. For the formula, see U. S. Disp., page 1363. 

Physiological Action. 

Stillingia in large doses is emetic and cathartic, in smaller 
doses it is expectorant, diaphoretic, diuretic, sialogogue and 



STRAMONIUM. 365 

cholagogue, possessing the various properties which are con- 
sidered " alterative." Its taste is acrid and pungent, and it in- 
creases the action of the heart, skin, kidneys, and bronchial 
mucous membrane ; and the gastric, hepatic, intestinal and sali- 
vary secretions. Full doses often excite epigastric pain, nausea 
and vomiting. 

Therapeutics. 

Stillingia is much employed with Sarsaparilla and similar act- 
ing drugs as an alterative in syphilitic affections, particularly in 
chronic cases of the tertiary form, in which the system is greatly 
reduced by the abuse of mercurials and iodides. In these cases 
it possesses considerable power and frequently cures. It is also 
valuable in strumous affections, in ascites due to hepatic changes, 
portal congestions with jaundice following malaria, habitual con- 
stipation, hemorrhoids from hepatic obstruction, and intermit- 
tents. In the latter affection the fluid extract with Quinine or 
Arsenic is a very useful combination. A strong decoction is said 
to ward off an impending paroxysm of ague. 

STRAMONIUM, Thornapple,— The plant Datura Stra- 
monium, Jamestown Weed or Thornapple (nat. ord. Solanaceae), 
is official in two forms, the leaves and the seed. It is an annual, 
of rank and vigorous growth, having a green stem with large 
white flowers, and numerous seeds in a large, fleshy, four-celled 
capsule, open at the summit. It grows wild in Southern Russia 
and the middle United States, and contains an alkaloid, Datu- 
rine, which is generally considered identical with Atropine both 
physiologically and chemically, — also malic acid, albumen, gum ? 
resin, etc. 

Stramonii Folia, — the leaves of Datura Stramonium, are 
about 6 inches long, smooth, petiolate, ovate, pointed, unequal 
at the base, coarsely toothed, of bitter and nauseous taste. Dose, 
gr. ij-xx. 

Stramonii Semen, — the seed of Datura Stramonium, is about 
y^ inch long, reniform, flattened, pitted and wrinkled, the testa 
blackish and hard, enclosing a curved embryo embedded in a 
whitish, oily albumen ; of unpleasant odor when bruised and an 
oily, bitter taste. Dose, gr. j. The official preparations are all 
made from the seed. 

Preparations. ■ 

Extractum Stramonii, — Dose, gr. >^-^. 
Extractum Stramonii Fluidum, — Dose, m j-v. 
Tinctura Stramonii, — 10 per cent. Dose, m v-xxx. 



366 STYRAX. 

Unguentum Stramonii, — has of the Extract 10, Water 5, Benzoinated 
Lard 85 parts. 

Daturina, Daturine, C 17 H 23 N0 3 (Unofficial), — is the alkaloid found in all 
parts of the plant, also in Datura Tatula. It is a Tropate of Tropin, isomeric 
and identical with Atropine. Dose gr., y^-^V 

Physiological Action. 

The action of Stramonium is similar to that of Belladonna in 
almost every particular, except that Stramonium is more powerful 
and chiefly influences the sympathetic nervous system, not affect- 
ing the motor or sensory nerves. It excites a greater degree of car- 
diac irregularity and a more furious delirium, and seems to have 
a special affinity for the generative apparatus, being decidedly 
aphrodisiac in full doses. [Compare Belladonna, ante, page 96.] 

As previously stated the alkaloids Atropine, Daturine, Hyoscy- 
amine, and Duboisine are chemically alike and almost identical 
physiologically. They all produce dilatation of the pupil, increase 
the cardiac action, the pulse and respiration rate, and cause deli- 
rium. Poisoning by one of them is indistinguishable from that 
by another. 

Antagonists and Incompatibles. 

These are the same as for Belladonna. Poisoning by Stramonium is not 
uncommon as children may eat the seeds, which should be evacuated by an 
emetic. If physiological symptoms follow Opium must be exhibited as the 
antagonist, but cautiously lest opium-narcosis be substituted. 

Therapeutics. 

Stramonium is chiefly used as an antispasmodic and to relieve 
pain. In asthma the leaves are smoked with advantage at the com- 
mencement of a paroxysm, the smoke being drawn into the lungs. 
In other spasmodic affections, as hepatic colic, laryngeal cough, 
chorea and stammering it is very beneficial. In dysmenorrhcea 
and neuralgia it is used in combination with Opium and Hyoscy- 
amus, and in tic douloureux and sciatica it is often very efficient. 
In nymphomania with great mental depression it is often very 
effective, and in mania of furious character, particularly the puer- 
peral form with suicidal tendency, it is highly serviceable in 10-20 
minim doses of the tincture every 3 or 4 hours. The ointment 
is much used in irritable ulcers, and as an anodyne application 
in painful hemorrhoids and certain cutaneous diseases. 

STYRAX, Storax, — is a balsam prepared from the inner 
bark of Liquidambar orientalis, the Oriental Sweet-gum, a tree of 
the nat. ord. Hamamelaceae, growing in Asia Minor. It is semi- 
liquid, sticky, opaque and gray-colored, of agreeable odor and 



SUCCINUM. 367 

balsamic taste, completely soluble (except accidental impurities) 
in an equal weight of warm alcohol. It consists of a volatile oil 
named Styrol, C 8 H 8 , — a crystalline solid Styracin, which is a cinna- 
mate of cinnamic ether, — two peculiar resins, one hard, the other 
soft, — and Cinnamic Acid, C 9 H 9 2 , a colorless, odorless, crystal- 
line body, closely allied to Benzoic Acid, excreted in the urine 
partly as Hippuric Acid, and occurs also in the Balsams of Peru 
and Tolu. Dose of Storax, gr. v-xx. 

Preparation. 

Tinctura Benzoini Composita, Friar's Balsam, — contains 8 per cent, of 
Storax. (See ante, page 99.) Dose, ^ss-ij. 

Physiological Action and Therapeutics. 

Storax is a stimulant expectorant, an antiseptic and a disin- 
fectant, acting both locally and remotely, like Benzoin and the 
Balsams of Tolu and Peru. It is used with benefit in chronic 
bronchitis and other affections of the respiratory organs, also in 
chronic catarrhs of the genito-urinary passages, in gonorrhoea and 
in amenorrhcea. Externally it is employed in ointment as a 
detergent for foul ulcers, and as a parasiticide for scabies and 
phthiriasis. 



SUCCINUM, Amber,— the source of the official Oil of 
Amber, is a fossil resin, occurring in alluvial deposits, chiefly in 
Prussia, Bohemia and Courland. It is usually associated with 
lignite, sometimes encloses insects and parts of vegetables, and 
consists of a volatile oil, a yellow resin, another resin, succinic 
acid and a bituminous principle. Its source is thought to be an 
extinct coniferous tree, the Pinites succinifer, of which amber 
represents the exudation. 

Preparation. 

Oleum Succini, Oil of Amber, — is a volatile oil obtained by the destructive 
distillation of Amber, and purified by subsequent rectification ; — a colorless 
or pale yellow, thin liquid, of sp. gr. about 0.920, of empyreumatic and balsamic 
odor, a warm, acrid taste, and a neutral or faintly acid reaction, and readily 
soluble in alcohol. Dose, gtt. v-x. 

Physiological Action and Therapeutics. 

Oil of Amber is stimulant, antispasmodic and diuretic, when 
used internally. Externally it is irritant and rubefacient. It has 
been employed with benefit in epilepsy, hysteria, convulsions, 
amenorrhoea, whooping-cough, etc. As a liniment it is often used 
in chronic rheumatism, and has been applied along the spine in 



368 SULPHUR AND SULPHIDES. 

infantile convulsions, mixed with an equal part of laudanum and 
diluted with olive oil or brandy. 

SULPHUR, and SULPHIDES.— The non-metallic 
element Sulphur, S, is a brittle solid of a pale yellow color, per- 
manent in the air, of crystalline texture and susceptible of several 
allotropic states, which are for the most part induced by heat. 
It is obtained native in several volcanic districts, or from the 
native Sulphides of Iron and Copper (iron and copper pyrites) 
by roasting, as it sublimes at about 238 F. It is official in three 
forms, viz. : 

Sulphur Sublimatum, Sublimed Sulphur, S, — is prepared 
from crude Sulphur by sublimation and condensation. It is a 
fine citron-yellow powder, of faintly acid taste and acid reaction, 
insoluble in water or alcohol. Ignited it burns with a blue flame, 
forming sulphurous acid gas, and leaving no residue or only a 
trace. Dose, gr. x-xx-lx. 

Sulphur Lotum, Washed Sulphur, S, — prepared by digesting 
sublimed Sulphur with dilute Water of Ammonia, thoroughly 
washing with water and passing through a No. 30 sieve. In this 
process the Ammonia dissolves out any Sulphide of Arsenic which 
maybe present and neutralizes any Sulphurous or Sulphuric Acid. 
[For solubility and dose see S. Pr^cipitatum, below.] 

Sulphur Praecipitatum, Precipitated Sulphur, Lac Sul- 
phuris, Milk of Sulphur, S, — prepared by boiling sublimed Sul- 
phur with slaked lime and water, thus forming the Sulphide and 
Hyposulphite of Calcium. These are then decomposed by HC1, 
and Sulphur is precipitated as a very fine powder which is next 
washed until the washings are tasteless, and it is dried with a 
gentle heat. The result is a very fine, yellowish-white, amor- 
phous powder, odorless and almost tasteless, insoluble in water 
or alcohol, but completely soluble in disulphide of carbon or a 
boiling solution of soda. By heat it is completely volatilized. 
Dose, gr. x~3j. 

Preparations of Stilphur, 

Unguentum Sulphuris, — has of Sublimed Sulphur 30, Benzoinated Lard 
70 parts, rubbed together. 

Unguentum Sulphuris Alkalinum, — has of Washed Sulphur 20, Potas- 
sium Carbonate 10, Water 5, Benzoinated Lard 65 parts, thoroughly rubbed 
together. 

Pulvis Glycyrrhiz^e Compositus (see ante, page 205) contains 8 per 
cent, of Sulphur Lotum ; and Emplastrum Ammoniaci cum Hydrargyro 
(see ante, page 59) contains 1 per 1000 of Sulphur Sublimatum. 

Sulphuric Acid is described under Acidum Sulphuricum, ante, page 35 ; 
Sulphurous Acid and the Sulphites under Acidum Sulphurosum, ante, 
page 36. The Sulphates are noted under the titles of their respective bases. 



SULPHUR AND SULPHIDES. 369 

Sulphides and their Preparations. 

Calcii Sulphidum, Sulphide of Calcium, CaS (Unofficial), — is the prepa- 
ration named " Hepar Sulphtiris, Liver of Sulphur," by the homceopathists, 
who prepare it by mixing equal parts of powdered oyster-shell and sublimed 
sulphur, and heating at a white heat in a crucible hermetically closed. It is 
a constituent of the following official compound, viz. : 

Calx Sulphurata, Sulphurated Lime, — is commonly misnamed Sulphide 
of Calcium. It is a mixture of Calcium Sulphide and Calcium Sulphate, 
CaS-|-CaS0 4 , in varying proportions, but containing not less than 36 per cent, 
of the former, and is prepared by heating together in a closed crucible Pow- 
dered Lime 100 parts and Precipitated Sulphur 90 parts, at a low red heat for 
one hour. The result, rubbed to powder, is grayish-white, of offensive taste 
and alkaline reaction, very slightly soluble in water, insoluble in alcohol. 
Dose, gr. T L-i. 

Potassa Sulphurata, Sulphurated Potassa, — formerly called Hepar Sul- 
phuris, — is a mixture of Potassium Trisulphide with small quantities of Potas- 
sium Hyposulphite and Sulphate, formed by heating together 1 part of Sub- 
limed Sulphur with 2 of Potassium Carbonate, until melted. Of a liver-brown 
color gradually changing with age to greenish- or brownish-yellow, of dis- 
agreeable odor, alkaline and repulsive taste and alkaline reaction. Soluble 
in 2 of water, excepting a small residue, partly soluble in alcohol. Dose, gr. 
ij-x, in pill or solution 

Sulphuris Iodidum, Iodide of Sulphur, Iodine Disulphide, I 2 S 2 , — is pre- 
pared by fusing together Washed Sulphur I part, and Iodine 4. It is a 
grayish-black crystalline solid, having the odor of iodine, an acrid taste and a 
faintly acid reaction, insoluble in water, but very soluble in disulphide of 
carbon and in about 60 of glycerin. Alcohol and ether dissolve out the 
iodine, leaving the sulphur. Only used as ointment, gr. xxx to the ^. 

Hydrogen Sulphide, Sulphuretted Hydrogen, H 2 S (Unofficial), — is used 
only as a test. It is a colorless gas having the smell of rotten eggs, prepared 
by the action of dilute Sulphuric Acid on Sulphide of Iron, the gas being 
passed into water a solution is obtained. It precipitates most of the metals 
from acid solutions as sulphides, that with Arsenic being yellow; with Anti- 
mony, orange ; with Cadmium, yellow ; with Copper, Lead, Mercury and 
Silver, black ; with Bismuth, brown ; with Gold and Platinum, brownish-black. 

Bisulphide of Carbon is described under Carbo, ante, page 124; Sul- 
phide of Antimony and Sulphurated Antimony under Antimonium, 
ante, page 70. 

Physiological Action. 

Sulphur is a mild laxative and a diaphoretic. In contact 
with living protoplasm it enters into combination and produces 
either sulphuretted hydrogen or sulphurous acid ; taken into the 
intestinal canal a large portion passes out unchanged, some of it 
being converted by the alkaline bile into sulphuretted hydrogen 
and sulphides. The former is excreted by the lungs, giving to 
the breath the smell of rotten eggs, and by the skin, discoloring 
silver articles carried about the person by forming a sulphide of 
silver. The Sulphides are partly absorbed into the blood, and 
are excreted in the urine, chiefly as sulphates, and in the feces 

31 



370 SULPHUR AND SULPHIDES. 

which they blacken and render soft. Given in full doses they are 
irritant to the stomach and intestines, extremely nauseous to the 
taste and smell, increase the secretions of the intestinal glands, 
and peristaltic action, and if used for any length of time they 
impair the blood, causing anaemia, emaciation, tremor and great 
debility. 

Sulphuretted Hydrogen is very destructive to plant life, and 
in animals it destroys the tissue functions, decomposing the 
blood and paralyzing the nervous and the muscular systems. 
The symptoms of poisoning are those of asphyxia; muscular 
tremors occur and are followed by convulsions and death. This 
gas is often found in cesspools in large quantities, but in one case 
poisoning occurred from its excessive formation in the intestines 
and subsequent absorption into the blood. 

Calx Sulphurata and Potassa Sulphurata act like the sul- 
phides as local irritants and in large doses as irritant poisons, 
producing narcotic symptoms and convulsions. In small doses 
they act like sulphur and are supposed by many observers to 
have a peculiar influence on suppuration to limit or prevent it 
if given in small doses frequently repeated. 

The Iodide is believed to possess some of the properties of 
both its elements. It is doubtful whether it is a distinct chemi- 
cal compound or merely a physical mixture. As a parasiticide it 
is very efficient, and has been found remarkably alterative in 
many local affections of chronic character, but may prove very 
irritant to the skin if improperly prepared. 

[The actions of Sulphuric Acid, Sulphurous Acid and the Sul- 
phites are respectively described on pages 35 and 36, ante.~\ 

Antagonists and Inco??ipatibles. 

Solutions of the Sulphides are decomposed by the mineral acids and by so- 
lutions of metallic salts. Antidotes are Chlorine-water, Chlorides of Sodium 
and Potassium, Sulphate of Iron, etc. Poisoning by Sulphuretted Hydrogen 
is best treated by artificial respiration. 

Therapeutics. 

Sulphur is chiefly used as a laxative when pultaceous rather 
than liquid stools are required, as in hemorrhoids, anal fissure, 
or constipation. Scabies has long been treated by its local and 
internal use, but sulphur alone does not kill the itch insect. The 
older sulphur ointments were made with sublimed sulphur and 
probably contained a considerable amount of sulphurous acid on 
which their parasiticide property depended. The recent oint- 
ments, made with purified sulphur, all contain an alkaline ingre- 
dient and develop sulphides which are powerful insect poisons. 



SUMBUL TAB ACUM. 3 7 1 

Sulphur fumigations are practically applications of volatile sul- 
phurous acid, while most of the sulphur baths and mineral waters 
are solutions of sulphuretted hydrogen or of the alkaline sulphides. 
They are of value in lead poisoning to favor the elimination of 
that metal, in chronic constipation, chronic rheumatism and sci- 
atica, and many skin diseases especially chronic psoriasis, eczema, 
pityriasis and. prurigo. The Ointment and the Alkaline Oint- 
ment are both used in scabies. 

The Iodide has been used internally in scrofula, glanders and 
cutaneous disorders, but it is chiefly employed as an ointment in 
lupus and parasitic skin diseases, especially herpes circinatus. 

Calx Sulphurata is extremely efficient as an internal remedy 
in crops of boils, scrofulous sores, glandular enlargements, acne, 
etc., and will prevent or limit suppuration. For these purposes 
it must be used in small doses (gr. -^) frequently repeated. 

Potassa Sulphurata is only used externally as baths or oint- 
ment in skin diseases and mucous discharges, also in chronic 
rheumatism. 



SUMBUL, — is the root of Ferula Sumbul, a very large plant 
of the nat. ord. Umbelliferae, which grows to the height of 8 feet 
in the mountains of northern Asia. The root occurs in trans- 
verse segments of a strong and musk-like odor and a bitter, bal- 
samic taste, and contains Angelic Acid, C 5 H 8 2 , Valerianic Acid, 
C 5 H 10 O 2 , also a volatile oil, two balsamic resins, a bitter substance, 
etc. Dose, gr. xxx-5j or more in infusion, decoction, etc. 

Preparation. 
Tinctura Sumbul, io per cent. Dose, £j-iv. 

Physiological Action and Therapeutics. 

Sumbul is an efficient nerve tonic, having qualities closely re- 
sembling musk and valerian. It is used by the Russian physicians 
in very many morbid conditions, and seems to be a favorite rem- 
edy in that country for almost any disease. It is probably of 
some value in hysteria and other nervous derangements in deli- 
cate females, and may be used as a substitute for musk in typhoid 
conditions and fevers, asthma, delirium tremens and perhaps in 
epilepsy. 



TABACUM, Tobacco, — the commercial, dried leaves of 
Nicotia?ia Tabacum, an annual plant of the nat. ord. Solanaceae, 



372 TABACUM. 

native of tropical America, but cultivated in several parts of the 
world, especially in Cuba and Virginia. The leaves are large, 
as long as 20 inches, mottled-brown, ovate or lanceolate, glan- 
dular-hairy ; having a heavy, peculiar odor, and a nauseous, bitter 
and acrid taste. It contains a very powerful and poisonous fluid 
alkaloid named Nicotine, C 10 H U N 2 , also a concrete, camphora- 
ceous, volatile oil, Nicotianin, besides alkaline salts (nitrates, phos- 
phates), and other less important substances. Its combustion 
gives rise to several empyreumatic products, of which Pyridin, 
C 5 H 5 N, and its compounds are the chief, having somewhat the 
same action as Nicotine, but of less severity. Besides these pro- 
ducts, tobacco-smoke contains Creasote, Hydrocyanic and Hy- 
drosulphurous acids, etc., but little or no Nicotine. 

Unofficial Preparations. 

Enema Tabaci, — gr. xx infused in §viij Boiling Water, and administered 
as one enema. 

Vinum Tabaci, — %] to the pint. Dose, rav-gj. 

Oleum Tabaci, — is an empyreumatic product, obtained by distillation at a 
temperature above that of boiling water, and a most virulent poison. 

Nicotina, Nicotine, C 10 H U N 2 , — the alkaloid and active principle ; a col- 
orless, oily-looking fluid, having the odor of tobacco and an acrid taste ; 
readily soluble in water, and forming soluble salts with acids. Dose, tti-^q- 
^0 in strychnine-poisoning, up to tti ij in 2 hours. 

[Other Liquid Alkaloids besides Nicotine are — Coniine, Muscarine, Spar- 
teine, Lobeline and Lupuline.] 

Physiological Action. 

Tobacco is a very depressant nauseant, an emetic by irritant 
as well as systemic action, and an antispasmodic ; also sternuta- 
tory, diuretic, diaphoretic, cathartic, sedative and narcotic. It 
paralyses the motor nervous system, its action commencing at 
the periphery and extending to the spinal cord. It increases the 
salivary and intestinal secretions, and produces diuresis, tremor, 
clonic spasms and a tetanic stage followed by paresis. It contracts 
the pupils, depresses the heart, lowers arterial tension, reduces 
body-temperature, and causes profuse sweating, cold and clammy 
skin, collapse and death usually by paralysis of respiration, some- 
times by paralysis of the heart. It does not impair the muscular 
irritability, nor does it act upon the cerebrum directly. Its em- 
pyreumatic products act similarly but less powerfully. Fatal re- 
sults have followed on the inhalation of its vapor into the lungs. 

Nicotine is almost as rapidly fatal as Prussic Acid, death hav- 
ing occurred from a toxic dose in three minutes, with no symp- 
toms except a wild stare and a deep sigh. 

The continued use of Tobacco in excess by smoking or chew- 



TAMARINDUS. 373 

ing produces granular inflammation of the fauces and pharynx, 
atrophy of the retina, dyspepsia, lowered sexual power, nervous 
depression, and occasionally angina pectoris. Used by the young 
it hinders the development of the higher nerve centres, and im- 
pairs the body nutrition by interfering with the processes of 
digestion and assimilation. 

Strychnine is the true physiological antagonist to Nicotine (or Tobacco) 
and vice versa. Alcohol, Ammonia, Ergot, Digitalis, Belladonna, etc., 
antagonize its action on the circulation. In poisoning by Tobacco the means 
resorted to are evacuation of the stomach, Tannin, Iodides, and artificial 
respiration. A curious synergism has been observed by the author between 
Opium and Tobacco. If a person, habituated to the use of the latter, either 
by smoking or chewing, begins to use Morphine, the smallest quantity of To 
bacco will make him sick, the symptoms being those experienced by a novice 
in its use. 

Therapeutics. 

Tobacco is now but little used in medicine; the dangers at- 
tending its employment either internally or externally have caused 
it to be superseded by less violently acting agents. The chief 
indications for its use are to relax spasm and to relieve local pain. 
It may be employed with advantage in habitual constipation, for 
the dyspnoea of spasmodic asthma and emphysema, and in nym- 
phomania and chordee. Intestinal affections like impaction of the 
caecum, intussusception and strangulated hernia may be overcome 
by a tobacco-enema to relax spasm, but it is a dangerous expe- 
dient. In dropsy, especially the renal form, it makes a very 
efficient diuretic. In tetanus there is no more effective remedy 
than minim-doses of the alkaloid every two hours by the stomach, 
or iuij by the rectum, or better still the wine in io-minim doses 
repeated for effect. Strychnine-poisoning is best met by minute 
doses of Nicotine (gr. ^) hypodermically, as a physiological 
antagonist. 

The use of Tobacco in moderation, when under excessive ex- 
ertion, aids in supporting the system and lessening the sense of 
fatigue. Smokers rarely suffer from constipation, but generally 
experience an immediate laxative result from their morning cigar. 



TAMARINDUS, Tamarind,— is the preserved pulp of 
the fruit of Tamarindus indie a, a. large tree of the nat. ord. 
Leguminosse, native in the East and West Indies. It occurs as 
a reddish-brown, sweet-acid and pulpy mass, containing strong, 
branching fibres and brown, quadrangular seeds, each enclosed 
in a tough membrane. It contains citric, tartaric and malic 
acids, sugar, gum, potassium bitartrate, etc. 



374 TANACETUM TARAXACUM, 

Preparation. 

Confectio SENNiE (see ante, page 354), — contains Tamarind to the 
amount of 10 per cent. Dose, 3J-ij. 

Physiological Action and Therapeutics. 

Tamarind is a laxative and refrigerant fruit. In infusion it 
may be used by convalescents as a pleasant acidulous drink, or 
the pulp may be boiled with milk as a whey for the same pur- 
pose. As a laxative it is usually prescribed in connection with 
other agents having the same action. 



TANACETUM, Tansy,— the leaves and tops of Tanace- 
tum vulgare, a perennial, herbaceous plant of the nat. ord. Com- 
posite, having yellow flowers in dense terminal corymbs, indige- 
nous in Europe, but cultivated in our gardens, and growing wild 
in roads and old fields. It contains a volatile oil, a bitter prin- 
ciple named Tanacetin, a tannic acid, etc. There are no official 
preparations, but a fluid extract may be prepared according to 
the general rule and administered in doses of ^lx~3J. The dose 
of the volatile oil (Oleum Tanaceti) is 1 to 3 drops. An infu- 
sion (Tansy Tea) may be made in the proportion of Jj to the pint, 
and used in doses of 3j-ij. 

Physiological Action and Therapeutics. 

Tansy is emmenagogue, diuretic and anthelmintic, an aromatic 
bitter and an irritant narcotic. Fatal results have frequently 
followed upon overdoses of the oil ( 5 ss— j ) , or strong decoctions, 
preceded by clonic spasms, disturbed respiration and cessation 
of the heart's action. It is a useful remedy in amenorrhcea, but 
is in popular repute as an abortifacient, a virtue which it does 
not possess except in quantity dangerous to life. 



TARAXACUM, Dandelion, — is the root, gathered in 
autumn, of Taraxacum Dens-leonis, an herbaceous plant of the nat. 
ord. Compositse, with a perennial fusiform root, long, sinuate- 
toothed or runcinate leaves, and slender peduncles, each bearing a 
single head of yellow flowers. All parts of the plant contain a 
bitter, milky juice, exuding from any break or wound. Its con- 
stituents are a bitter amorphous principle named Taraxacin, a 
crystalline principle Taraxacerin, with potassium and calcium 
salts, inulin, and resinoid bodies, etc. The French name for 
the plant is " Pissenlit. M 



TEREBINTHINA. 375 



Preparations. 
EXTRACTUM Taraxaci. — Dose, gr. v-xxx. 
Extractum Taraxaci Fluidum, — Dose, 5J-3J, 



Physiological Action and Tlierapeutics. 

Taraxacum is a bitter tonic, a diuretic and an aperient. It 
has been supposed to act especially on the liver, and is chiefly 
used in dyspepsia with hepatic torpor. As found in the shops it 
is usually inert. The extract is probably only of value as an 
excipient for pills. 

TEREBINTHINA, Turpentine,— means a vegetable 
exudation, liquid or concrete, which consists of resin combined 
with a peculiar essential oil named Oil of Turpentine, and gener- 
ally procured from various species of pine, fir, or larch. Two of 
the many turpentines are official, viz.: 

Terebinthina, Turpentine, — a concrete oleoresin obtained 
from Pinus australis, the Yellow Pine, and from other species of 
Pimts, nat. ord. Coniferse. Occurs in tough, yellowish masses, 
brittle when cold, crummy-crystalline interiorly, of terebinthinate 
odor and taste. Dose, gr. v-xxx as a stimulant, antispasmodic or 
diuretic; 5U~* V as an anthelmintic. 

Terebinthina Canadensis, Canada Turpentine, Balsam of 
Fir, — a liquid oleoresin obtained from Abies balsamea, the Silver 
Fir, or Balm of Gilead, a tree of the nat. ord. Coniferae. A yel- 
lowish, transparent, viscid liquid, of agreeable, terebinthinate 
odor, and a bitterish and slightly acrid taste, slowly drying on 
exposure, forming a transparent mass ; completely soluble in 
ether, chloroform or benzol. Dose, gr. x-xxx. 

Preparations. 

Oleum Terebinthina, Oil of Turpentine, C 10 H 16 , — a volatile oil, distilled 
from Turpentine ; a thin, colorless liquid, of characteristic odor and taste ; sp. 
gr. 0.S55 t0 0.S70, soluble in 6 of alcohol. Bromine and powdered Iodine act 
violently on it. and when brought into contact with a mixture of Nitric and 
Sulphuric Acids, it takes fire. Commonly called "Spirits of Turpentine.'' 
Consists of a mixture of several hydrocarbons. Dose, tti v-xv as a stimulant 
or diuretic in emulsion 3 to 6 times daily ; as a cathartic or anthelmintic 555 
or more, combined with other cathartics. A little Glycerin and Oil of Gaulthe- 
ria with each dose will disguise the taste. 

Linimentum Terebinthina, — Resin Cerate 65, Oil of Turpentine 35 
parts, thoroughly mixed. 

Linimentum Cantharidis (see ante, page 120), — Oil of Turpentine 85, 
Cantharides 15 parts. 

Unofficial Turpentines. 

Chian Turpentine, — from the Pistacecz Terebinthus, a small larch tree 



376 TEREBINTHINA. 

growing in the islands of Chio and Cyprus ; a thick, tenacious, greenish-yel- 
low liquid, concreting on exposure to the air into a translucent solid. Dose, 
gr. iij-v in emulsion. 

Venice Turpentine, — procured in Switzerland from the Larix Europcea 
or European Larch ; — a viscid liquid of the consistence of honey, does not con- 
crete on exposure, and is entirely soluble in alcohol. The Venice Turpentine 
of commerce is usually prepared by dissolving Rosin in Oil of Turpentine. 

Physiological Action. 

Turpentines are stimulant, diuretic, anthelmintic, and hemo- 
static ; in large doses laxative and irritant, and externally used are 
rubefacient and antiseptic. Their virtues depend entirely on the 
volatile oil. 

Oil of Turpentine in small doses causes a sense of heat at the 
epigastrium, burning in the mouth, and by reflex action saliva- 
tion. In moderate doses it at first stimulates the vaso-motor 
nervous system, afterwards paralyzing these centres, thus causing 
a rise and then a fall of the arterial tension. It lowers the functions 
of the brain, spinal cord and medulla in the order stated, causing 
diminution of voluntary movement and reflex action, dilatation 
of the vessels, lowered blood-pressure, and slowed respiration, the 
latter often becoming spasmodic. The pulse is sometimes slowed, 
sometimes quickened. Large doses produce gastro-enteritis, with 
vomiting and diarrhoea, suppression of urine, pain in the lumbar 
regions, burning in the urethra, hematuria, and strangury. The 
muscular power is diminished, coordination impaired, and a state 
of intoxication induced. Toxic doses cause complete muscular 
relaxation, profound insensibility, with abolished rtflexes, 
dilated pupils, cyanosed face, labored and stertorous breathing 
and death by paralysis of respiration. It is excreted by the 
various organs of excretion, all of which are highly irritated, the 
kidneys suffering particularly. Its vapor inhaled produces nasal 
and renal irritation, frontal headache, and frequently strangury 
and hematuria. Locally to the skin it is rubefacient, and even 
vesicant if applied for any length of time or if evaporation be 
prevented. 

Turpentine-oil when exposed to the air readily absorbs oxygen 
in the form of ozone, which it retains tenaciously. This Ozo- 
nized Oil of Turpentine is an antidote to Phosphorus, pre- 
venting the formation of phosphoric acid, and converting the 
phosphorus into an insoluble substance resembling spermaceti. 
Worn about the neck in an open vial it is believed to prevent 
necrosis of the jaw and steatosis of the organs in workmen ex- 
posed to phosphorus-fumes. It is also supposed to dissolve gall- 
stones. 



THEOBROMA OLEUM. 377 

Antagonists. 

In cases of poisoning the stomach should be emptied, anodynes and demul- 
cents administered, elimination favored, and special symptoms met as they 
arise. 

Therapeutics. 

The Oil of Turpentine is employed externally as a rubefacient 
and counter-irritant in many conditions producing pain and in- 
flammation. Cloths wrung out of hot water and then sprinkled 
with the oil (turpentine-stupes), are useful applications in sciatica 
and other neuralgiae, lumbago, chronic rheumatism, chronic 
bronchitis, peritonitis with tympanites, pleurisy, renal colic, etc. 
It is one of the most efficient agents in hospital gangrene applied 
in full strength to the part affected. The liniment is in con- 
stant use for sprains, neuralgia, and other slight local affections. 

Internally it is best employed in ulceration and hemorrhage of 
the intestines and in hemorrhages of a passive character from 
other organs. Active bleeding with a plethoric condition and he- 
maturia are states in which it is contraindicated. It is often used 
with Ether (i to 3) in biliary and flatulent colic, as an anodyne 
and antispasmodic. As a vermifuge against tape-worm it must 
be employed in large doses (*ss-ij), with Castor oil to promote its 
rapid passage through the intestinal canal. The French acid oil, 
which is old and contains ozone, is used in phosphorus poisoning. 
It is well employed as a stimulant to the heart and vaso-motor 
system in puerperal fever, yellow fever, traumatic erysipelas, 
pneumonia, capillary bronchitis, etc. It is also useful in chronic 
bronchial catarrh, chronic cystitis, subacute gonorrhoea and 
similar affections of the mucous surfaces generally. 

Inhalations of the vapor or atomized oil are extremely bene- 
ficial in chronic affections of the larynx and bronchi. The pure 
vapor is too irritating for inhalation, but it may be diluted with 
steam from a steam atomizer. 

Chian Turpentine is one of the many remedies which have 
been used for cancer. 

Terebene is a substance which is prepared by the action of 
Sulphuric Acid on Oil of Turpentine. It is a disinfectant with 
a very agreeable balsamic odor. Mixed with Thymol and Car- 
bolic Acid in equal parts, it is used as an inhalation (3ss to the 
pint of hot water) in phthisis. 



THEOBROMiE OLEUM, Oil of Theobroma, Cacao- 
butter, — is a fixed oil expressed from the seed of Theobroma 
Cacao, the Chocolate-tree, nat. ord. Sterculiaceae, growing in 

32 



378 THUJA. 

Mexico, the West Indies and South America. The oil is a yel- 
lowish-white solid, of faint odor, bland taste and neutral reaction, 
and melting at 86° to 95° F. 

The seeds are oval, about the size of almonds, and consist of shells and 
kernels, in both of which is found the alkaloid Theobromine C 7 H 8 N 4 2 , which 
closely resembles Caffeine, the latter being its methyl derivative. Chocolate 
is prepared by roasting the seeds, removing the shells, then crashing or grind- 
ing the kernels to a smooth paste, which is cast in molds. 

Cacao-butter consists chiefly of Stearin with a little Olein. 
Its action is demulcent, and it does not become rancid on expo- 
sure to the air. Its chief use is as a basis for making suppositories. 
A cerate is prepared by melting together Cacao-butter 35, White 
Wax 35, Oil of Almond 30, adding a drop of Oil of Rose and 
coloring with a minute quantity of Carmine previously triturated 
with a drop of Water of Ammonia. This is known as Red Lip- 
salve. 

Theobromine has the same action and uses as Caffeine. (See 
ante, page 109.) 



THUJA, Arbor Vitse, — the fresh tops of Thuja occidentalis, 
a tree of the nat. ord. Coniferae, commonly though incorrectly 
called White Cedar, and growing in swampy ground in Canada 
and the northern U. S. Its twigs are flattish and two-edged, 
with scale-like leaves appressed and closely imbricate in four rows, 
rhombic-ovate, obtusely pointed, having a roundish gland upon 
the back; of a balsamic, somewhat terebinthinate odor, and a 
pungently aromatic, camphoraceous and bitter taste. They con- 
tain a volatile oil, tannin, wax, resin, etc. ; also Pinipicrin, 
C 22 H 18 O n , a bitter principle, and Thujin, C 20 H 22 O 12 , a yellow, 
astringent and crystallizable coloring principle, which is separ- 
able into glucose and Thujetin, C u H u 8 . 

Preparatio7ts. 

There are none official. The dose of a saturated, fresh tincture or fluid 
extract is ^j 3-6 times daily. The Volatile Oil may be given in doses of 
TTlj-v. 

Physiological Action. 

Thuja resembles Savine in action very closely. It is a stimu- 
lant, irritant, astringent, aromatic, diuretic and emmenagogue. 
The oil is a gastro-intestinal irritant, and produces epileptiform 
convulsions in warm-blooded animals, and paralysis in cold- 
blooded ones. It causes rhythmical contraction and dilatation of 



THYMI OLEUM. 379 

the vessels, lowers the temperature, and is anthelmintic. Thuja 
is indirectly an abortifacient when given in doses sufficient to 
cause violent gastro-enteritis, and is reported to have produced 
an acute urethritis resembling gonorrhoea. 

Therapeutics. 

Thuja in decoction has been usefully employed in coughs, rheu- 
matic and arthritic pains, dropsy and amenorrhcea. It has also 
been given with benefit in intermittent fever and as an alterative 
blennorrhetic in chronic catarrh and bronchorrhcea. It is highly 
praised by Dr. Phillips for the cure of warts with narrow base and 
pendulous body, a strong tincture being applied locally and given 
internally at the same time in 5 -minim doses twice daily. Dr.Pif- 
fard speaks strongly in its favor as a valuable agent for non-syphi- 
litic warts (condylomata acuminata) of the penis and vulva, for 
papillomatous growths in general, and for gleets dependent on 
granular urethritis. It has been used in chronic gonorrhoea and 
prostatitis with asserted success, and is said to have cured epithe- 
lioma. The oil has been employed as a vermifuge. 



THYMI OLEUM, Oil of Thyme,— is a volatile oil dis- 
tilled from Thymus vulgaris, Garden Thyme, a common shrub 
of the nat. ord. Labiatae, indigenous in France but cultivated in 
our gardens. The oil is a pale yellow or colorless, thin liquid, 
having a strong odor of thyme, a warm, pungent and afterward 
cooling taste, and a neutral reaction, of sp. gr. about 0.880, and 
readily soluble in alcohol. It consists of two portions, the more 
volatile being a mixture of the hydrocarbons Cymene and Thy- 
mene, the less volatile being chiefly Thymol, which is official. 

Thymol, C 10 H 13 HO, — is a stearoptene contained in Oil of 
Thyme and in the volatile oils of several other plants. It occurs 
in large, colorless, hexagonal crystals, of aromatic odor, pungent 
taste and neutral reaction ; soluble in 1200 of water, 900 of boil- 
ing water, and in 1 of alcohol at 59 F., freely in fats and oils, 
solutions of chloral and alkalies, ether, chloroform, etc. It 
liquefies with camphor. Dose, gr. ss-ij. 

Unofficial Preparations. 

Thymol Solution, — for antiseptic spray, 1 in 1000. 

Thymol Gauze, — contains 1 per cent, of Thymol. 

Thymol Ointments, — vary from 5 to 30 grains to the j§. 

Thymol Inhalation, — Thymol gr. xx, Alcoholis giij, Magnesium Car- 
bonate gr. x, Water to giij. A teaspoonful to a pint of water at 150 F. for 
each inhalation. 



38O TIGLII OLEUM. 

Physiological Action, 

Oil of Thyme has the same properties as the oils of other 
mints, and containing a large quantity of Thymol it is similar 
to the latter in action. 

Thymol in its action stands between Carbolic Acid and Oil of 
Turpentine. Like the former it is a powerful antiseptic and dis- 
infectant. It is a local irritant and anaesthetic to the skin and 
■ mucous membranes, paralyzing the end-organs of the sensory 
nerves. When absorbed it paralyzes the nerve-centres in the 
spinal cord and in the medulla, lessening reflex action, slowing 
respiration, lowering the temperature and the arterial tension, 
and in poisonous doses causing weakness, coma and death. In- 
ternally administered in doses of 20 to 30 grains per diem it 
produces a sensation of epigastric heat, sweating, singing in the 
ears, deafness, a sense of constriction in the forehead, and in- 
crease of the urinary discharge, which assumes a dark, greenish 
hue. It is eliminated by the respiratory and urinary organs 
which it irritates considerably during the process of its excre- 
tion. As an antiseptic it is much more powerful and permanent 
than Carbolic Acid and much less poisonous. 

Therapeutics. 

Thymol is chiefly employed in lieu of Carbolic Acid as an 
antiseptic for dressing wounds ; as a gargle, spray or inhalation 
in laryngitis and diphtheria ; as an ointment in ringworm, ec- 
zema and psoriasis, and as an injection in ozaena. A solution of 
1 part in 1000 is the strength usually employed. Internally it 
has been used with success in diphtheria, typhoid fever, diabetes, 
phthisis and vesical catarrh. Its fragrant odor renders it a very 
agreeable antiseptic application for ulcerated conditions of the 
mouth and fauces, but makes it very attractive to flies; which 
fact, together with its high price, will prevent it becoming a fa- 
vorite in hospital practice. 



TIGLII OLEUM, Croton Oil, — is a fixed oil expressed 
from the seed of Croto7i Tiglium, a small tree of the nat. ord. 
Euphorbiaceae, a native of India. The oil is of a pale or brown- 
ish-yellow color, somewhat viscid and slightly fluorescent, of 
fatty odor, acrid taste and slightly acid reaction ; sp. gr. 0.940 
to 0.955, soluble in 60 of alcohol, freely in ether, chloroform, or 
carbon disulphide. Its composition is very complex and has not 
been thoroughly made out, but it is known to contain the gly- 



TONGA. 381 

cerides of several fatty acids, also a peculiar acid named Tiglinic 
Acid, C 5 H 8 2 , which is isomeric with Angelic Acid. Dose of 
the oil, -ni^-ij, in pill, emulsion or tincture. 

Physiological Action. 

Externally Croton Oil is highly irritant, producing a pustular 
eruption which heals by scabbing and may leave unsightly cica- 
trices. Internally it is a powerful drastic cathartic, producing 
in one or two hours copious watery stools, in overdoses causing 
great congestion of the intestinal canal and perhaps death from 
gastro-enteritis. Vomiting usually occurs after large doses, so 
that the irritant hyper-catharsis is not always observed. It is 
absorbed into the blood, and produces glandular hypersemia as 
well as direct inflammation of the intestinal mucous membrane, 
together with increased peristaltic action. Its cathartic power is 
increased by the addition of an alkali, and is manifested, though 
in less degree, when applied to the integument. 

Therapeutics. 

Croton Oil is used as a hydragogue cathartic when a speedy and 
complete evacuation of the bowels, diminution of arterial pres- 
sure and prompt derivative action are desired, as in apoplexy, 
impaction of the intestines, dropsy, lead constipation, paralysis, 
etc. It is contraindicated where there is debility, organic ob- 
struction, and inflammatory conditions of the stomach and bowels. 
The smallness of the dose makes it a very easily administered 
and manageable purgative. A considerable fraction of a drop is 
absorbed by a pellet of sugar, and may be given thus in repeated 
doses until the desired effect is obtained. It has been used as a 
vermifuge against tapeworm. 

Externally it is used as a counter-irritant in ovaritis, bronchi- 
tis, pleurisy, rheumatism, neuralgia, glandular swellings, and in 
laryngeal and pulmonary diseases. The Linimentum Crotonis 
of the British Pharmacopoeia contains 1 part of the oil in 3^ 
each of Alcohol and Oil of Cajuput, and is a useful pustulant 
preparation, being more manageable than the oil itself. 



TONGA (Unofficial), — is a mixed drug said to be obtained 
from the Fiji Islands, consisting of thin barks, root-fibres and 
leaves tied into long bundles. The fibrous material is believed 
to be derived from Rhaphidophora vitiensis, a creeping plant of 
the nat. ord. Araceae, containing starch, potassium chloride and 



382 TRAGACANTHA — TRITICUM. 

a volatile alkaloid Tongine. The barky portion is referred to 
Premna tatiensis, a shrub or tree of the nat. ord. Verbenaceae, 
and contains a little volatile oil, sugar, pectin, etc. A fluid 
extract is prepared by Parke, Davis & Co. of Detroit, and may 
be given in doses of mxxx-3j thrice daily. 

Tonga was introduced by Drs. Ringer and Murrell as a remedy 
for neuralgia in 1880, stating that they had used it with gratify- 
ing results. Since then reports have differed considerably in 
regard to its efficacy, and from the fact that Dr. Ringer does not 
mention it in the last edition of his Handbook of Therapeutics, 
it may be inferred that his further experience with it has not 
borne out the claims first made. 



TRAGACANTHA, Tragacanth, — is a gummy exudation 
from Astragalus gummifer and from other species of Astragalus, 
shrubs of the nat. ord. Leguminosae, growing chiefly in the 
mountainous regions of Asia Minor and Persia. It occurs in 
shell-like, curved or contorted bands, translucent, faintly yellow- 
ish, horn-like, tough, swelling with water to a gelatinous mass, 
which is tinged blue by test-solution of iodine, and consists of a 
mixture of Arabin, or gum-arabic, which is soluble in water, and 
Bassorin, a gum which is insoluble in water but swells up in it, 
also a little starch. 

Preparation. 

Mucilago Tragacanth,*;, — Tragacanth 6, Glycerin 18, water to 100 parts* 
Dose, ^j or more. 

Physiological Action and Therapeutics* 

Tragacanth is demulcent, but in large quantities it may cause 
indigestion. It is chiefly employed to suspend resins and heavy 
powders in emulsion. The mucilage may be used as a vehicle 
for active agents in gargles for pharyngitis, and to cause cohesion 
in the preparation of pills, troches, etc. It is a constituent of 
13 of the 16 official troches, and is a better agent than acacia for 
making emulsions of cod-liver oil. 



TRITICUM, Couch-grass, — is the rhizome, gathered in 
the spring and deprived of its rootlets, of Triticum repens, the 
Couch-grass, a perennial plant of the nat. ord. Graminaceae, 
abounding in meadows and cultivated grounds, where it ranks as 
a weed, though of the same genus as wheat. The rhizome is very 
long, but as met with in the shops is cut into two sections about 



ULMUS — UVA URSI. 383 

§ ths inch in length and y^th inch thick, creeping, smooth, hollow- 
in the centre, of straw color, and sweet taste. It contains much 
sugar and a gum-like principle Triticin. Dose, 3J~oj> in infusion 
or decoction. 

Preparation. 

Extractum Tritici Fluidum, — Dose, ^j-^j, well diluted. 

Physiological Action and Therapeutics. 

Couch-grass is demulcent, emollient and a feeble diuretic. It 
is chiefly used in cystitis and irritable bladder. The infusion is 
a popular fever-drink in Europe, and has had of old a consid- 
erable reputation in dysuria. 



ULMUS, Elm, Slippery Elm,— is the inner bark of 
Ulmusfulva, an indigenous tree of the nat. ord. Urticacese, and 
occurs in flat pieces of various sizes, having a slight, peculiar 
odor and a mucilaginous, insipid taste. It contains a large quan- 
tity of mucilage which it readily parts with to water. 

Preparation. 

Mucilago Ulmi, — Elm 6, Boiling Water 100 parts, macerated for two 
hours and strained. Dose, ad libitum. 

Physiological Action and Therapeutics. 

Slippery-elm bark is demulcent, slightly astringent and. some- 
what tonic. It is used internally in diarrhoea, dysentery and 
affections of the urinary passages, and externally in the form of 
poultice as an emollient application in cases of inflammation. It 
is also employed in the dilatation of fistulae, strictures and the os 
uteri. 



UVA URSI, Bearberry, — the leaves of Arctostaphylos Uva- 
ursi y a low, evergreen shrub, of the nat. ord. Ericaceae, inhabit- 
ing the northern latitudes and high mountains of Europe, Asia 
and America. The leaves are small, obovate, nearly sessile, 
shining, reticulated beneath, of a faint but hay-like odor, and a 
strongly astringent taste. They contain Tannic and Gallic Acids 
and 3 principles, viz. — Arbutin, C 24 H 32 O u , a bitter glucoside, 
neutral, crystalline, soluble in warm water and resolvable into 
glucose and Nydroquinone, C 6 H 6 2 ; — Ericolin, C 34 H 5B 2 , bitter 
and amorphous; — (frsone, C 20 H 34 O 2 , resinous, neutral, crystalline 



384 VALERIANA. 

and tasteless. The Californian Manzanita (Arctostaphylos glauca) 
is an allied plant and also contains Arbutin and Tannin. Dose 
of the powdered leaves, gr. x-3j i n infusion or decoction. 

Preparations. 

Extractum UvA^iRSi Fluidum, — Dose, "nix-^j. 
Infusum Uva^ursi (Unofficial), — gj-Oj. Dose, ^j-ij. 
Arbutinum, Arbutin (Unofficial), — Dose, gr. iij-v. 

Physiological Action and Therapeutis. 

Uva-ursi is astringent, tonic and feebly diuretic. Used in 
large quantity it produces vomiting and purging, and is alleged 
to have oxytocic power. Arbutin is an efficient diuretic, and is 
decomposed in the body, yielding Hydroquinone which is ex- 
creted by the kidneys as Hydroquinone-sulphuric Acid. This is 
non-toxic, imparts a brown color with antiseptic and slightly 
irritant qualities to the urine. 

Bear-berry was formerly used in all calculous affections and 
chronic disorders of the urinary passages. It has some reputa- 
tion as an antilithic, and is no doubt useful in gravel, chronic 
nephritis, cystitis, urethritis, and kindred diseases. It relieves 
incontinence of urine, dysuria and strangury, and has proved 
serviceable even in uterine hemorrhages. Arbutin has been 
successfully employed in cardiac dropsy as a diuretic, also in 
urethritis. 



VALERIANA, Valerian, — is the rhizome and rootlets of 
Valeriana officinalis, a large, herbaceous plant of the nat. ord. 
Valerianaceae, having small, white, or rose-colored flowers, and 
opposite pinnate leaves on an erect, round and channelled stem. 
The plant is a native of Europe but is cultivated in Vermont and 
New York. The root is perennial, its rhizome about an inch 
long, upright, truncate at both ends, internally whitish or pale- 
brownish with a narrow circle of white wood under the thin bark. 
Odor peculiar, taste camphoraceous and bitter. It contains a 
complex Volatile Oil, from which are developed by oxidation 
Valerene, C ]0 H 16 , which is a terpene, Valerol or Baldrian Cam- 
phor, C 12 H 20 O, and Valerianic Acid, C 5 H 10 O 2 , which occurs also 
in many other plants and in cod-liver oil. The Valerianic Acid 
of pharmacy is obtained as a product of the oxidation of Amylic 
Alcohol, and from it are formed the various Valerianates. It is, 
however, not identical with the natural acid. Dose of the pow- 
dered root, gr. x-xxx. 



VALERIANA. 385 

Preparations of Valerian. 

Abstractum Valeriana, — Dose, gr. v-xx. 

Extractum Valeriana Fluidum, — Dose, ttu-xxx. 

Tinctura Valeriana, — Strength 20 per cent. Dose, ^ss-ij. 

Tinctura Valerianae Ammoniata, — Valerian 20, Aromatic Spirit of 
Ammonia to 100 parts. Dose, ^ss-ij. 

Oleum Valerianae, — the volatile oil, sp. gr. about 0.950, a greenish or 
yellowish, thin liquid, having the odor of valerian, an aromatic taste and a 
slightly acid reaction, readily soluble in alcohol. Dose, ""lij-v. 

The Oil is by far the best preparation for use, as the tinctures are extremely 
nauseous and the fluid extract is too bulky. The taste is best covered by 
Cinnamon. 

Preparations of the Valerianic Acid. 

Ammonii Valerian as, Valerianate of Ammonium, NH 4 C 5 H 9 2 , — de- 
scribed on page 60. Dose, gr. ij-x. 

Ferri Valerianas, Valerianate of Iron, Fe 2 (C 5 H 9 2 ) 6 , — described on 
page 192. Dose, gr. j-iij. 

Quinine Valerianas, Valerianate of Quinine, C 20 H 24 N 2 O 2 C 5 H 10 O 2 .H 2 O, 
— described on page 149. Dose, gr. j-iij. 

Zinci Valerianas, Valerianate of Zinc, Zn(C 5 H 9 2 ) 2 .H 2 — described on 
page 395- Dose, gr. X-iij. 

The Valerianates are made with the acid produced from Amylic Alcohol, 
and do not represent the action of the plant, but rather that of the bases from 
which they are prepared. 

Physiological Action. 

Valerian is antispasmodic, and a gentle stimulant to the ner- 
vous and circulatory systems. It is sedative to reflex excitability, 
antagonizing the action of Strychnine, Brucine, Thebaine, etc., 
and is laxative, diaphoretic and anthelmintic. 

Its taste and odor are very disagreeable, but cats are extrava- 
gantly fond of it. In these animals it greatly excites the sexual 
appetite, probably from a resemblance between its odor and 
theirs when under venereal excitement. After a time it pro- 
duces in them violent spasms and convulsions. 

In full doses it increases the action of the heart and raises the 
temperature, in most persons producing exhilaration (in some, 
slight mental disturbance), with formication of the hands and 
feet. Long used it induces a condition of low melancholy and 
hysterical depression. Large doses cause hiccough, diarrhoea, 
nausea and vomiting, frequent micturition with tenesmus of the 
bladder and lithates in the urine, mental disturbance even to de- 
lirium, reduced motility and sensibility, and lessened reflex ex- 
citability. The oil in large doses is paralyzant to the brain and 
the spinal cord, lowers the blood-pressure and slows the pulse. 

The Valerianates follow their bases in general action, but 
are supposed to combine therewith some of the sedative qualities 
of the acid. 



386 VANILLA. - 

Therapeutics. 

Valerian was formerly much used in epilepsy, -but it was proba- 
bly only useful in the hysterical form of that disease (hystero- 
epilepsy). It is a valuable remedy in all forms of hysteria, espe- 
cially when occurring in young and delicate women. It is also 
useful in flatulence of infants and in that of hypochondriacal and 
hysterical subjects, and in coughs of nervous type, whooping- 
cough, diabetes insipidus, convulsions due to worms and in de- 
lirium with vital depression. In the coma of typhus fever the 
oil proved remarkably efficient in a series of 135 cases out of 172 
treated by it. 

Valerianate of Ammonium is used in the same class of disor- 
ders as is Valerian. It is often a good remedy for nervous head- 
ache, administered in 10-grain doses and in an elixir. 

Valerianate of Zinc has been supposed to combine the anti- 
spasmodic power of valerian with the nerve-tonic effect of a zinc 
salt. It has been used in chorea, epilepsy and neuralgia, fre- 
quently with considerable success. 

The Valerianates of Iron and Quinine are used as the salts 
of their respective bases. 



VANILLA, — is the fruit of Vanilla planifolia, a perennial, 
climbing plant of the nat. ord. Orchidaceae, a native of the West 
Indies anc} tropical America, but cultivated in Java, etc. It has 
dark green, tough leaves, pale greenish-yellow sessile flowers, and 
long pods (6 to 10 inches), wrinkled, warty, one-celled, contain- 
ing a blackish-brown pulp with numerous small seeds and acicular 
crystals, of peculiar and fragrant odor and taste. Its character- 
istic odorous principle is Vanillin, or the methyl-ether of proto- 
catechuic aldehyd, which oxidizes slowly in damp air toTfanillic 
Acid, and may be resolved into methyl chloride and protocate- 
chuic acid. Vanillin may be made synthetically from Coniferin 
or from Eugenol. Dose, indefinite. 

Preparations. 

Tinctura Vanilla, — 10 per cent. Dose, a few drops according to the 
strength of flavor desired. 

Trochisci Ferri, — contains about ^ per cent. o£ Vanilla. 

Physiological Action and Therapeutics. 

Vanilla is an aromatic stimulant, with considerable influence 
on the nervous system. It is chiefly employed as a perfume and 



VERATRUM VIRIDE. 387 

for flavoring purposes, but has been used in hysteria and low 
fevers. 



VERATRUM VIRIDE, American Hellebore,— is the 

rhizome and rootlets of Veratrum viride, or Indian Poke, Poke- 
root, Swamp Hellebore, an indigenous plant of the nat. ord. 
Melanthaceae, having a solid, round stem, furnished with bright 
green leaves, and terminating in a panicle of greenish-yellow 
flowers. The root is perennial, upright, externally blackish-gray, 
internally grayish-white, 2 to 3 inches long, with numerous, 
shrivelled rootlets, inodorous but sternutatory when powdered, 
taste bitter and very acrid. It contains several alkaloids, Jer- 
vine, C^H^NO^ Pseudojervine, C 29 H 43 N0 7 , Cevadine, C 32 H 49 N0 9 , 
a very little Rubijervine, C 26 H 43 N0 2 , and traces of Veratrine, 
C 37 H 53 NO n , and Veratralbine, C 28 H 43 N0 5 . Veratroidine, formerly 
regarded as one of its alkaloids, is now thought to be Rubijervine 
and Resin. Veratrum Viride also contains Gallic Acid and 
Sugar. 

Allied Plants. 

Veratrum Album, White Hellebore, — is a native of the moun- 
tainous regions of continental Europe, and so closely resembles 
V. Viride in appearance -and characteristics that it may be con- 
sidered a variety of the same plant. The rhizome was official in 
the U. S. P. 1870. It contains the alkaloids Jervine, Pseudo- 
jervine, Rubijervine, traces of Cevadine, and another powerful 
alkaloid Veratralbine, C^H^NOg. 

Veratrum Sabadilla, Cevadilla, Asagrsea officinalis, — is a 
bulbous plant of the nat. ord. Melanthaceae, indigenous in Mexico 
and Central America. It contains the alkaloids Cevadine (formerly 
called Veratrine), Cevadilline and Veratrine, with Veratric and 
Sabadillic or Cevadic Acids. It is the source of the official Vera- 
trine (see below). The seeds are official in the Br. Phar. under 
the title Sabadilla. 

Preparations. 

Extractum Veratri Viridis Fluidum, — Dose, Tiij-iv. 

Tinctura Veratri Viridis, — 50 per cent. Dose, iUij-x. 

Veratrina, Veratrine, — is an alkaloid or mixture of alkaloids prepared 
from the seeds of Asagrcea officinalis (see above). A white, or grayish-white, 
amorphous powder, highly irritant to the nostrils, of very acrid taste, pro- 
ducing tingling and numbness of the tongue and constriction of the fauces; 
slightly soluble in cold water, soluble in 3 of alcohol at 59 F., in 6 of ether, 
2 of chloroform, 96 of glycerin and in 56 of olive oil. Dose, gr. -£$-\§> 



388 VERATRUM VIRIDE. 

Unguentum Veratrine,— Veratrine 4, Alcohol 6, Benzoinated Lard 96 
parts. For local use. 

Oleatum Veratrine, — Veratrine 2, Oleic Acid 98 parts. For local use. 

Physiological Action. 

Veratrum Viride is a powerful depressant to the heart and a 
paralyzant of the spinal cord, acting similarly to Aconite in this 
respect, but differing therefrom in affecting respiration to a much 
less extent, in being a systemic emeto-cathartic (due to its Rubi- 
jervine), in paralyzing the motor nervous system centrally, im- 
pairing the reflexes but not sensation, and in having little or no 
action as a diaphoretic or diuretic. It produces great depression, 
but is seldom fatal in its results ; when it causes death it does so 
by paralyzing the heart. 

In small doses it reduces the force of the pulse without at first 
affecting the rate, which afterwards however becomes very slow 
and the pulse soft and compressible, rising on the least exertion 
to be very rapid and feeble. Muscular weakness and frequently 
nausea and vomiting accompany the depression of the circulation. 
By large doses these symptoms are very much increased, the 
pulse becomes extremely rapid and almost imperceptible, the skin 
cold and clammy, constant vomiting, great weakness, giddiness, 
lost vision and partial unconsciousness ensue. 

Jervine represents in part the depressant action of the plant 
on the circulation and the central nervous system. It has no 
action on the vagus, and but little on the voluntary muscles or on 
the motor nerves, but it irritates the motor centres in the brain, 
causing convulsions, and slows the heart by direct action on the 
cardiac muscle or its motor ganglia. It kills by asphyxia, respi- 
ration ceasing before the heart stops. 

Veratroidine, which is probably Rubijervine plus a poisonous 
resin, also slows the respiration and the pulse, but differs from 
Jervine in always causing emeto-catharsis, and in producing less 
violent convulsions. It stimulates the vagus centre and paralyses 
the vagus terminations, also increasing the excitability of the 
vaso-motor centre. 

Veratrine is an intensely acrid and irritant powder, consist- 
ing probably of several alkaloids. It causes violent sneezing, 
a burning sensation in the respiratory passages and free salivation. 
It affects the heart and circulation similarly to the other Veratriae, 
and seems in addition to be a direct poison to muscular tissue, 
causing violent convulsions before the muscular paralysis sets in. 

Veratrum Album contains a very powerful alkaloid Veratral- 
bine, and perhaps also an irritant poisonous resin. Its general 



VERBASCUM. 389 

action is similar to that of the official plant, but it is much more 
irritant to the gastro-intestinal mucous membrane, causing violent 
vomiting and purging, intense abdominal and oesophageal pain, 
greatly reduced pulse and temperature, collapse and death from 
cardiac and respiratory paralysis. 

Antagonists and Incompatibles. 

Alcohol, Opium, Belladonna and Ammonia counteract the cardiac depres- 
sion. Morphine and Atropine should be administered hypodermically, or 
Laudanum internally with alcoholic stimulants, the recumbent position should 
be enforced, and dry heat applied to the body. Caustic alkalies are incom- 
patible, as they decompose the alkaloids. 

Therapeutics. 

Veratrum Viride is inferior to Aconite in most of the fevers 
and inflammations, by reason of its lacking power over excretion. 
It renders good service, however, in the early stages of many 
parenchymatous and serous inflammations when occurring in 
sthenic subjects, especially in pneumonia. It is highly esteemed 
in puerperal fever and in many cardiac disorders, as simple hy- 
pertrophy, irritable heart, etc. It has been used with remarkably 
good results in many cases of acute mania and puerperal convul- 
sions, and it is of service in aneurism to depress the circulation 
to the lowest point, but in this case the recumbent position must 
be strictly observed in order to secure safety. It should always 
be administered in small doses and its effects carefully watched. 

Veratrum Album is the "Hellebore" of the ancient physi- 
cians, and was much used by them as a derivative in insanity. 
It is rarely used at present except by the homceopathists, who 
give it in the cold stage of cholera, in colic, in the vomiting and 
purging of summer diarrhoea, in whooping-cough and asthma. 

Veratrine is chiefly used externally. The ointment or oleate 
may be used with benefit in many cases of superficial neuralgia, 
myalgia and headaches, a small quantity being rubbed in over 
the seat of the pain. It may be absorbed through an abrasion 
of the cuticle and give rise to dangerous symptoms. Internally 
it has been employed as a cardiac sedative in fevers and inflam- 
mation, also in acute articular rheumatism, dropsies, dysmenor- 
rhea and various nervous affections, but its uncertainty of action 
and the dangerous depression which it may produce have caused 
it to lose favor as an internal remedy. 



VERBASCUM, Mullein (Unofficial),— the leaves of Ver- 
bascum Thaspus, the Mullein-weed, a common plant of the nat. 



390 VIBURNUM. 

ord. Scrophulariaceae, having large woolly leaves and yellow 
flowers in dense spikes. Its chief constituent is mucilage, though 
the flowers contain an essential oil in very small proportion. An 
infusion of §iv of fresh leaves to the pint of milk is the form in 
which it has generally been given ; this quantity to be taken 
thrice daily. 

Physiological Action and Therapeutics. 

Mullein is emollient and demulcent, perhaps also slightly ano- 
dyne. It has long been a popular Irish remedy in pulmonary 
affections, as under its use the weight steadily increases in phthisis 
and other wasting disorders, while expectoration is rendered more 
easy, cough is palliated and the general condition improved. It 
is also recommended in cystitis, irritable bladder, and diarrhoea, 
and is employed as an enema in dysentery and as a poultice 
for. hemorrhoids. The dried leaves may be smoked with benefit 
in aphonia from laryngeal irritation. 



VIBURNUM, Black Haw, — is the bark of Viburnum pru- 
nifolium, an indigenous shrub or small tree of the nat. ord. Cnpri- 
foliacese, having sharply serrulate leaves, and small, white flowers 
in terminal cymes. The bark occurs in glossy, purplish-brown, 
thin pieces or quills covered with scattered warts and minute 
black dots ; inner surface whitish and smooth, inodorous, some- 
what astringent and bitter. It contains tannic, oxalic, citric and 
malic acids, sulphates and chlorides ; also two resins, one of 
which is named Viburnin, and Viburnic Acid, which is identical 
with Valerianic Acid. 

Preparation. 

Extractum Viburni Flutdum, — Dose, 3SS-1J. 

Physiological Action and Therapeutics, 

Viburnum is considered to possess nervine, antispasmodic, 
astringent, diuretic and tonic properties, and to be especially 
useful in preventing abortion in the nervous diseases of preg- 
nancy, and in dysmenorrhoea. It may be administered with 
cannabis indica, morphine, nerve-sedatives or simple aromatics. 
No exact observations have been made regarding its action, and 
its therapeutical claims are denied by many who have used it. 
It often excites nausea and vomiting. 

Viburnum Opulus, Cramp- bark, Cranberry-tree ', — another 
shrub of the same genus, is highly valued by many practitioners 
as a remedy in uterine and other abdominal pains, but is not 



VIOLA TRICOLOR — VISCUM. 39 1 

official. The so-called " Viburnum Compound of Dr. Hay den" 
is stated by its manufacturers to consist of " the active principles 
of the Viburnum Opulus, Dioscorea Villosa, Scutellaria Lateri- 
flora, and a combination of aromatics, prepared by a process 
peculiar to ourselves.' ' This they call publishing the formula of 
the preparation. 



VIOLA TRICOLOR, Pansy,— is the wild-grown, flower- 
ing herb of Viola tricolor, the Heart's-ease Pansy, a plant of the 
nat. ord. Violaceae, native in Europe, but naturalized in the 
southern U. S. It has an angular and nearly smooth stem; leaves 
alternate, petiolate, ovate or oblong and crenate ; flowers with an 
obtuse spur and variegated petals, inodorous, taste somewhat 
bitter and acrid. It contains an active alkaloid Violine, allied in 
many respects to Emetine, and poisonous. There are no official 
preparations. Dose, gr. x~3j, in decoction. 

Physiological Action and Therapeutics. 

Viola is mucilaginous, emollient, expectorant and slightly laxa- 
tive. Its active principle is emeto- cathartic, but exists in very 
small quantity in the plant. A decoction of the fresh herb in 
milk, with a poultice of the same was formerly highly recom- 
mended in crusta lactea and impetigo. It is used with benefit in 
some forms of eczema, especially in that of the head and face, 
and has had some reputation in bronchitis and constitutional 
syphilis. 



VISCUM, Mistletoe (Unofficial), — occurs in two species 
(1) Viscum album, the European Mistletoe, a small, parasitic, 
evergreen shrub, of the nat. ord. Loranthacege, growing chiefly 
on deciduous-leaved trees, and (2) Viscum flavescens, the Ameri- 
can species, growing on oaks, elms, etc. They contain mucilage, 
starch, fixed oil, resin, salts, etc., and Viscin, or Bird-lime, which 
occurs also in Ilex aquifolium, Gentiana lutea and other plants. 
Dose, gr. x~3j in decoction, or mv-xxxof a ten percent, tincture. 

Physiological Action and Therapeutics. 

The berries of the mistletoes have produced emeto-catharsis, 

with great thirst, tenesmus, bloody stools, convulsions and even 

death in young children. The leaves and twigs have been used 

in epilepsy, hysteria, chorea, asthma and other nervous affections. 



392 VITELLUS — XANTHOXYLUM. 

The American plant is asserted to possess qualities similar to those 
of Digitalis, and to incite uterine contractions. It has been used 
in cardiac affections, dropsies, uterine hemorrhages and amenor- 
rhcea, also as an abortifacient. 



VITELLUS, Yolk of Egg,— is the yolk of the egg of the 
domestic fowl, Gallus Bankiva, var. domesticus. It is a viscid, 
reddish-yellow, opaque liquid, of bland taste, alkaline reaction, 
odorless, and may be regarded as a dense emulsion of oil sus- 
pended in water by means of albumen. It is coagulated by heat 
or by alcohol and contains Vitellin, which is a proteid related 
to casein, Cholesterin and Albumin, besides fat, inorganic salts, 
sugar, etc. 

Preparation. 

Glyceritum Vitelli, Glycerite of Yolk of Egg, Glyconin, — consists of 
Vitellus 45, Glycerin 55 parts rubbed together until thoroughly mixed. 

Physiological Action and Therapeutics. 

Yolk of Egg is highly nutritive and forms a useful article of 
diet in exhausted conditions of the system, but its chief use in 
medicine is for emulsionizing oils and camphors. The Glycer- 
ite has the consistence of honey and forms an opaque emulsion 
with water. It is a very good vehicle for cod-liver oil (see ante, 
page 265), and an excellent protective application for burns, ery- 
sipelas, fissure of the nipples and many cutaneous disorders. It 
is also used as a cosmetic, and may be employed as an aliment. 



XANTHOXYLUM, Prickly Ash,— is the bark of Xan- 
thoxylum fraxineum, the northern species, and of Xanthoxylum 
carolinianum, the southern species of an indigenous shrub of the 
nat. ord. Rutaceae, having small, greenish flowers, alternate un- 
equally pinnate leaves, leaflets punctate with pellucid dots, stems 
and leafstalks armed with prickles. The bark of both species 
comes in curved or quilled fragments, of a brownish-gray color 
externally with whitish patches, and minute black dots, faintly 
furrowed, inodorous, bitter and pungent. That of X. fraxineum 
is about ^ inch thick, has several two-edged spines each y^ inch 
long, the bark of X. carolinianum is twice as thick as the other 
and is marked by many conical, corky projections, and by stout 
brown spines, arising from corky bases. It contains a volatile 
oil, a fixed oil, resin, gum, coloring matter and an alkaloid, 



ZEA MAYS. 393 

Xanthoxyline, which is identical with Berberine (see ante, page 
ioo.) Dose, of the powdered bark, gr. x-xxx. 

Preparations. 

Extk actum Xanthoxyli Fluidum,— Dose, gss-j. 

Decoctum Xanthoxyli (Unofficial),— gj to the quart. Dose, a pint dur- 
ing 24 hours in divided doses. 

Physiological Action. 

Xanthoxylum is a stimulant and aromatic bitter, a local and 
systemic sialogogue, diaphoretic, diuretic and emmenagogue. 
Its taste is aromatic, soon becoming acrid and bitter and causing 
profuse salivation, tingling in the tongue and increased secretion 
from stomach, intestines, liver and pancreas. It also increases 
the cardiac action and raises the arterial tension, and is classed 
among the vegetable alteratives, with Mezereum, Guaiac, Stillin- 
gia, etc. 

Therapeutics. 

Xanthoxylum has a high reputation in chronic rheumatism, 
myalgia, lumbago and similar disorders, also in jaundice from 
catarrh of the bile- ducts, in dropsies, chronic pharyngitis and 
constitutional syphilis. In old cases of pharyngitis, the mucous 
membrane being glazed and dry, the decoction should be used 
as a gargle and ^Ix-xxx of the fluid extract taken internally 
thrice daily. The bark, used as a masticatory, is a popular rem- 
edy for toothache, and has been frequently successful in paraly- 
sis of the tongue. 



ZEA MAYS, Maize, Indian Corn. — This well-known 
species of the nat. ord. Graminaceae, though itself unofficial, is 
the source of two drugs one of which is official, viz. — 

Ustilago, Corn Smut, — Ustilago Maydis, nat. ord. Fungi, 
grown upon the stems, the pistils and the male inflorescence 
(tassel) of Zea Mays. It occurs in irregular, globular masses, 
sometimes 6 inches thick, and consisting of a blackish membrane, 
inclosing numerous globular, minute spores, their surfaces covered 
with echinulate warts. Its odor and taste are unpleasant, and it 
contains fixed oil, resin, pectin, gluten, sugar, an acid resembling 
the Sclerotic Acid of Ergot, and a volatile principle called 
Secaline, which is supposed to be identical with Trimethylamine. 

Preparation. 

Extractum Ustilagtnis Fluidum (Unofficial), — may be made according 
to the general rule. Dose, lUxv-gj. 

33 



394 zincum. 

Stigmata Maydis, Stigmata of Maize, Corn Silk (Unoffi- 
cial), — should be gathered when the tassel has well shed its 
pollen. Its active principle is said to be Maizenic Acid. 

. Preparation. 

Extr actum StigMatarum Maydis Fluidum (Unofficial), — made by the 
general rule for fluid extracts. Dose, £j-ij. 

Physiological Action and Therapeutics. 

The properties of Ustilago, so far as examined, resemble 
those of Ergot and Nux-vomica combined. It is a spinal excitant, 
exalts sensibility and reflex action, producing tonic convulsions 
on the least irritation of the skin. It slows the heart by stimu- 
lation of the pneumogastric, dilates the pupil, causes muscular 
paresis, and death by tetanus of the respiratory muscles or by 
exhaustion. Experiments on its reputed oxytocic action have 
not substantiated the claims made for it in this respect, though 
it is said to have produced abortion in cows and other animals, 
after they had eaten the diseased grain. As a therapeutic agent 
Ustilago has been very little used, and when employed it has been 
as a substitute for Ergot. 

Stigmata Maydis is a certain but mild diuretic when given in 
full doses at short intervals. It is by some observers considered 
demulcent and anodyne, and is generally believed to have a 
specific or alterative influence over many disorders of the genito- 
urinary passages and the urinary bladder. It has been used with 
considerable success in incontinence of urine, uric and phos- 
phatic gravel, gout, rheumatism, urethritis, pyelitis, acute and 
chronic cystitis, cardiac dropsy and obstructive valvular disease 
of the heart. 



ZINCUM, Zinc, Zn, — is metallic Zinc, in the form of thin 
sheets, or irregular, granulated pieces, and is a bluish-white metal, 
having the sp. gr. 6.9. It occurs native as a Sulphide {Blende), as 
a Carbonate and a Silicate .(Calamine), as a Red Oxide (Zincite), 
and as a mixture of Zinc Oxide with Oxide of Iron and Manga- 
nese (Franklinite) . Zinc is soluble in the weakest acids, and 
therefore should never be used for culinary vessels. Its salts are 
all more or less active poisons. Metallic Zinc is not employed 
as a medicine. 

Zinc Compounds and their Preparations. 

Zinci Acetas, Acetate of Zinc, Zn(C 2 H 32 0) 2 .3H 2 0, — soft, white, mica- 
ceous or pearly, six-sided tablets or scales, somewhat efflorescent in dry air, 



zincum. 395 

of faintly acetous odor, sharp metallic taste and a slightly acid reaction ; 
soluble in 3 of water and in 30 of alcohol at 59 F., in 1^ of boiling water 
and in 3 of boiling alcohol. Used locally as an astringent in solution of gr. 
j or ij to 3j, or internally in doses of gr. j£-ij. 

ZlNCl Carbonas Pr^cipitatus, Precipitated Carbonate of Zinc, (ZnC0 3 ) 3 .- 
3Zn(HO) 2 , — a white, impalpable powder, permanent in the air, odorless and 
tasteless, insoluble in water or alcohol, but soluble in acids with copious effer- 
vescence. When strongly heated it loses water and carbonic acid gas, leaving 
a residue of oxide of zinc. Used locally as a protective. 

Zinci Chloridum, Chloride of Zinc, ZnCl 2 , — a white, crystalline powder, 
deliquescent, odorless, of caustic, saline, and metallic taste and acid reaction, 
very soluble in water and in alcohol, forming a clear or only faintly opalescent 
solution. Tonic and escharotic. For internal use a solution in Spirit of Ether 
is the most convenient form, of the strength of gss-^iij, of which from 4 to 8 
drops may be given twice daily. Strength of injections and collyria, gr. j-ij 
adgj. 

Liquor Zinci Chloridi, — an aqueous solution of Zinc Chloride containing 
about 50 per cent, of the salt. A clear, colorless, odorless liquid, of a very 
astringent, sweetish taste and an acid reaction. A powerful disinfectant for 
sinks, drains, etc. Used also as an injection in gonorrhoea, leucorrhcea, etc., 
in dilute solution, ^ to I per cent. Burnett's Disinfecting Fluid is similar 
to the above but slightly stronger. 

Zinci Iodidum, Iodide of Zinc, Znl 2 , — a white, granular powder, very 
deliquescent, odorless, of sharp, saline and metallic taste and acid reaction, 
very soluble in water and in alcohol. Dose, gr. ss-ij in syrup. 

Zinci Oxidum, Oxide of Zinc, ZnO, — a soft, pale-yellowish powder, per- 
manent in the air, odorless and tasteless, insoluble in water or alcohol, but 
soluble in acids without effervescence. Dose, gr. j-x, in pill. 

Unguentum Zinci Oxidi, — strength 20 per cent., made with Benzoinated 
Lard, thoroughly mixed. 

Zinci Sulphas, Sulphate of Zinc, ZnSO^.yH^O, — small colorless prisms or 
acicular needles, slowly efflorescing in dry air, odorless, of sharp, saline, nau- 
seous and metallic taste and acid reaction, soluble in 0.6 of water, insoluble 
in alcohol. Dose, as emetic, gr. x-xxx, — as a tonic and astringent, gr. T V-ij> 
in pill. For Vitiate' s Solution, see ante, page 169. 

Zinci Valerianas, Valerianate of Zinc, Zn(C 5 H 9 2 ) 2 .H 2 0, — soft, white, 
pearly scales, of sweet and styptic taste and acid reaction; soluble in 100 of 
water and in 40 of alcohol at 59 F. Dose, gr. ^-ij, in pill. 

[The Bromide of Zinc is described under Bromum, see page 103, and the 
Phosphide under Phosphorus, on page 289.] 

Physiological Action and Therapeutics. 

Zinc Salts are astringents, but milder ones than the salts of 
Lead. Its soluble compounds (the Chloride, Iodide, Sulphate 
and Acetate) are corrosive poisons, causing violent gastro- 
enteritis, and in some cases profound nervous depression. The 
Chloride is a very powerful and painful escharotic or rather 
mummifier of the tissues, having great affinity for water, coagu- 
lating albumen and shrivelling the vessels. It is a very active 
disinfectant. The Sulphate is also escharotic and a specific 



396 ZINCUM. 

emetic, acting promptly by direct irritation of the stomach, and 
without much depression or after-nausea. In small doses it is 
tonic and astringent, in larger it would be a severe irritant but for 
its causing prompt emesis. The Acetate resembles the sulphate 
in action. The Oxide used externally is a mild, soothing astrin- 
gent; used internally it enters the blood as a lactate or chloride, 
and acts as a mild astringent and as a nervous sedative. Being 
almost insoluble in the stomach, it has but feeble diffusive power 
and consequently but slight activity. The Carbonate resembles 
the Oxide in action. The Iodide locally is a powerful escharotic 
and has been supposed to possess some alterative powers when 
given internally in addition to its astringent qualities as a zinc 
salt. The Valerianate acts as a nervous sedative, but its prop- 
erties are in all probability due to its base and not to the acid 
combined with it. 

Continued use of zinc salts produces symptoms similar to those 
of chronic lead-poisoning, but of much less gravity. They 
manifest much less tendency to accumulate in the system than 
other metallic salts, and are excreted much more rapidly. Elimi- 
nation takes place chiefly by the liver and intestinal glands. 

[The actions of the Bromide and Phosphide are described 
respectively on pages 105 and 290.] 

Antidotes and Incompatibles. 

Lime-water, mucilaginous drinks, soap, tannic acid, milk, Potassium and 
Sodium Carbonates if given early, are the antidotes in poisoning by the salts 
of zinc. Incompatibles are — lime-water, alkalies and their carbonates, nitrate 
of silver, and vegetable astringents. Acetate of Lead produces double de- 
composition with zinc salts, but it is often used in solution with the sulphate 
as an injection. 

Therapeutics. 

Zinc salts are chiefly employed in weak solution as mild astrin- 
gent applications in catarrhs of mucous membranes, such as con- 
junctivitis, gonorrhoea, etc., and as unguents and lotions in skin- 
diseases, particularly eczema, impetigo, herpes and erythema. 
The Chloride is made into a paste with flour and glycerin for 
the destruction of lupus, epithelioma and other morbid growths, 
and for opening abscesses in locations where puncture or incision 
might be dangerous. The cuticle, if unbroken, should be re- 
moved by strong water of ammonia before the paste is applied, 
as it will not act through the epidermic tissue. It is a commonly 
used disinfectant and deodorant, and in weak solution (mjij-v of 
the Liquor to 3j of water) makes a good lotion for putrid ulcers, 
and still weaker (gr. j-ij to the pint), is an excellent injection 



ZINGIBER. 397 

for gonorrhoea. The Iodide is not employed as an escharotic, 
nor has it ever been a favorite remedy for internal use. It is 
chiefly employed in solution as an application to enlarged tonsils, 
and as an ointment (i part to 8 of lard) for the reduction of 
glandular enlargements. The Sulphate is used locally as an 
astringent to mucous surfaces generally, internally as an emetic 
in narcotic poisoning and croup, and in small doses as a tonic 
and antispasmodic in convulsive diseases, as chorea, hysteria, 
epilepsy, angina pectoris, asthma, etc. In diarrhoeas and dysen- 
tery it is a good astringent, and is frequently combined with 
Opium and Ipecac. The Acetate is used for the same purposes 
as the Sulphate, but is usually preferred for collyria. The Oxide 
may be used as a dusting powder in intertrigo, and as an oint- 
ment in eczema and excoriated surfaces generally. In combina- 
tion with Bismuth and Pepsin it is an excellent remedy for the 
summer diarrhoea of children, and with Aromatic Powder and 
Morphine it is very efficient in gastralgia. It is a good remedy 
in 3-grain doses for the night-sweats of phthisis, and has been 
successfully employed in epilepsy and neuralgia, in whooping- 
cough, hysteria, nervous headache and in bronchorrhcea to check 
the profuse secretion. It is much employed as an ingredient of 
cosmetics. The Carbonate is by some preferred to the oxide 
for local use in skin diseases. Calamine Ointment, which is a mix- 
ture of the impure carbonate (calamine) with the oxide and an 
unguent basis, was until recently a favorite application as a sooth- 
ing protective to abrasions and inflammations of the integument. 
The Valerianate has been used in chorea, epilepsy, neuralgia 
and various anomalous nervous affections, such as the nervous 
headache of hysterical women, nervous coughs and aphonia due 
to uterine and ovarian irritation. 

[The Bromide and Phosphide are used entirely with reference 
to their respective non-metallic bases, under which titles their 
therapeutics are described.] 



ZINGIBER, Ginger, — is the rhizome of Zingiber officinale, 
a plant of the nat. ord. Zingiberaceae, having dingy-yellow 
flowers on a leafless flower-stalk, and long, lanceolate leaves on a 
separate stem. The plant is a native of Hindostan, but is culti- 
vated in Jamaica, Sierra Leone, etc. The rhizome is about J- 
inch broad, flattish, on one side lobed or clavately branched, of 
a pale-buff color, striate, agreeably aromatic and of a warm, pun- 
gent taste. It breaks with a mealy, fibrous fracture showing 



39^ ZINGIBER, 

numerous small resin-cells and fibro-vascular bundles. It con- 
tains an aromatic volatile oil and a resin. 

Preparations. 
EXTRACTUM ZlNGIBERIS FLUIDUM, — Dose, ™lx-gSS. 

Tinctura Zingiberis, — 20 per cent. Dose, Titxx-^ij. 

Syrupus Zingiberis, — has of the fluid extract 2 per cent, in sugar and 
water. Dose, £ss-ij. 

Trochisci Zingiberis, — each troche contains of the tincture 2 grains, with 
Tragacanth, Sugar and Syrup of Ginger. 

Oleoresina Zingiberis, — contains all the virtues of the root, and is ex- 
tracted by ether. Dose, rrv^-j, well diluted. 

Ginger is also a constituent of Pulvis Aromaticus, Pulvis Rhei Compositus 
and Vinum Aloes. 

Physiological Action and Therapeutics. 

Ginger is sialogogue when chewed, sternutatory when inhaled, 
and externally a rubefacient. Internally it is a grateful stimulant 
and carminative, produces a sensation of warmth at the epigas- 
trium and promotes the expulsion of flatus. It is employed as a 
carminative in colic, as a masticatory to increase the secretion of 
saliva and in relaxed conditions of the throat, also internally in 
atonic dyspepsia, to relieve flatulence, and as an adjunct to pur- 
gative agents to correct their griping properties. The syrup is 
in common use as a flavoring and adjuvant in prescriptions. 



CLASSIFICATION OF MEDICINES. 



In the present state of knowledge respecting the actions and 
uses of medicinal agents, no really scientific classification of 
these substances is possible. Some writers have adopted a system 
based on the natural relations of the various articles to each 
other, while many classify them according to their effects on 
the human system, and others make no attempt at arrangement 
but treat of them in alphabetical order. The latter method has 
been followed in this work, from a conviction that every medi- 
cine should first be studied as an individual, both with respect to 
its physiological actions and its therapeutical applications. When 
the student has thus made himself familiar with the characteristic 
features of each article of the Materia Medica, he may begin, by 
comparing one with another, to seek acquaintance with their more 
delicate lights and shades. Some system of classification then 
becomes imperative as an aid to the memory, and as the titles of 
the groups to which the various agents belong in any physiological 
classification are also used to express their actions and uses, the 
following synopsis is inserted as an appropriate addendum to the 
section on Materia Medica and Therapeutics. 



Stimulants and Sedatives. 

These are general terms employed in various classifications with 
very little discrimination. 

Stimulant (stimulus, a. goad), — is a term which is used 
in various senses as applied to medicinal agents. Alcoholic 
preparations, which are true narcotics, are commonly termed 
" stimulants," and the same expression is employed to designate 
any agent which excites the organic action of a part of the 
economy. 

Diffusible Stimulants are those which have a prompt but transient effect, 
such as Alcohol, Ammonia, Camphor, etc. Spinal Stimulants exalt the func- 
tions of the cord, as Strychnine, Picrotoxin, Ergot, Atropine, Phosphorus. 



400 AGENTS ACTING ON THE NERVOUS SYSTEM. 

Cardiac Stimulants increase the action of the heart, as Alcohol, Atropine and 
Morphine in small doses, Strychnine, etc., also Squill, Convallaria, Cimi- 
cifuga and Digitalis, which slow but strengthen the cardiac action. Vaso-motor 
Stimulants, as Alcohol, Chloroform, Ether, Ammonia, Strychnine, Digitalis 
and Squill, acting on the vaso-motor centre ; and the Nitrites, Belladonna, 
Electricity, Volatile Oils, etc., acting as local dilators of the vascular system. 
Cerebral Stimulants as Alcohol, Opium, Belladonna, Caffeine, Cocaine, 
Theine, Cannabis, Chloroform, Ether, Tobacco, etc. Renal Stimulants, as 
the diuretic group. Sto?nachic Stimulants, as the Aromatics, Volatile Oils, 
Vegetable Bitters, Mineral Acids, Nux Vomica, Mustard, Capsicum, etc. 
Hepatic Stimulants, as Nitro-muriatic and Nitric Acids, and the cholagogue 
purgatives Podophyllum, Jalap, Leptandra, Euonymin, Iridin, etc. Intestinal 
Stimulants, as Mercurials, Elaterium, Colocynth, Jalap, Scammony, Podo- 
phyllum, etc., which affect the glandular apparatus, — and Belladonna, Phy- 
sostigma, Nux Vomica, Rhubarb, Senna, Aloes, Frangula, Cascara, etc., which 
chiefly affect the muscular fibres and the intestinal nerves. Cutaneous Stimu- 
lants, as the diaphoretic group, and the rubefacients Mustard, Capsicum, Tur- 
pentine, Ammonia, etc. All stimulation reacts into depression, and most of 
the agents which stimulate the nerve centres at first soon depress and finally 
paralyze them. 

Sedatives (sedo, to allay), — are agents which exert a soothing 
influence on the system by lessening functional activity, depressing 
motility and diminishing pain. 

General Sedatives include the narcotics and anaesthetics. Local Sedatives 
include Aconite, Opium, Ice, etc. Pulmonary Sedatives, as Hydrocyanic 
Acid, Veratrine, and the nauseants and emetics. Spinal Sedatives, as Phy- 
sostigma, Gelsemium, Potassium Bromide. Stomachic Sedatives include Ar- 
senic, Bismuth, Nitrate of Silver, Bicarbonate of Sodium. Vascular Seda- 
tives, as Digitalis, Tobacco, Aconite, Veratrum, and the emetics. Nervous 
Sedatives, among which are Potassium Bromide, Tobacco, Lobelia, and the 
group of spinal depressants. 



Agents Acting Chiefly on the Nervous System. 

Motor-Excitants are agents which increase the functional 
activity of the spinal cord and the motor apparatus, producing 
disturbances of motility, heightened reflex excitability, and 
tetanic convulsions when given in large doses, their ultimate 
effect being motor paralysis from over-stimulation. 

The most important members of this class are Nux Vomica and Ignatia, 
with their alkaloids Strychnine and Brucine, also Thebaine, the tetanizing 
alkaloid of Opium. It also includes Morphine and Atropine, which, though 
at first sedative, when given in large doses produce convulsions. The respi- 
ratory centre in the medulla is stimulated by Strychnine, Atropine, Ammonia, 
and small doses of Alcohol, Ether and Chloroform. The motor convolutions 
in the brain are stimulated by Alcohol in moderate doses, as also for a brief 
period by Ether and Chloroform. 



AGENTS ACTING ON THE NERVOUS SYSTEM. 



401 



The end-organs of the motor nerves are stimulated by the local use of 
Electricity, Strychnine and friction ; and are irritated by the internal admin- 
istration of Aconitine, Nicotine, Camphor, Pilocarpine and Pyridine. Other 
members of this class are embraced in the following list. 

Nux Vomica. 



Ignatia. 

Strychnine. 

Brucine. 

Thebaine. 

Morphine.* 

Atropine.* 



Alcohol. I 

Ether.f 

Chloroform.-)- 

Ammonia. 

Absinthe. 

Buxine. 

Calabarine. 



Ergot. 

Ustilago. 

Gossypium. 

Picrotoxin. 

Aconitine. 

Nicotine. 

Camphor. 



Digitalis. 

Convallaria. 

Cimicifuga. 

Pilocarpine. 

Pyridine. 

Rhus Toxicoden. 

Electricity. 



Motor-Depressants lower the functional activity of the 
spinal cord and motor apparatus, and in large doses paralyze 
them. Some act indirectly by reducing the spinal circulation, as 
Digitalis, Aconite and large doses of Quinine; others by a 
directly paralyzant action on the centres. The principal mem- 
bers of this class may be enumerated as follows, viz. — 

Amyl Nitrite. 
Sodium Nitrite. 
Methyl Strychnine. 
Ethyl Strychnine. 
Methyl Thebaine. 
Methyl Veratrine. 
Methyl Conine. 
Other Methyl Compounds. 
Ammonium Cyanide. 
Ammonium Iodide. 
Ethyl Ammonium Chloride. 
Amyl Ammonium Chloride. 
Amyl Ammonium Iodide. 
Amyl Ammonium Sulphate. 
• Other Compound Ammonias. 
Galvanism. 



Opium, Morphine. 

Gelsemium. 

Muscarine. 

Pulsatilla. 

Grindelia. 

Phytolacca. 

Physostigma. 

Belladonna. 

Stramonium. 

Hyoscyamus. 

Pilocarpus. 

Quebracho. 

Camphor. 

Aconite. 

Tobacco. 

Lobelia. 



Curare. 

Conium. 

Chloral. 

Ergot (at last). 

Arnica. 

Ailanthus. 

Veratrum. 

Alcohol* 

Ether* 

Chloroform.* 

Bromides. 

Potassium. 

Lithium. 

Zinc. 

Prussic Acid. 

Potass. Cyanide. 



The motor centres in the medulla are powerfully depressed by Opium, Mor- 
phine, Aconite, Conium, Chloral, Physostigma, and large doses of Alcohol, 
Ether and Chloroform. The three last named are also paralyzers of the 
motor convolutions in the brain, arresting ail voluntary movements when 
administered in sufficient quantity. The anterior cornua of the cord are 
greatly depressed by Physostigma and other agents, and the motor nerves by 
Conium, Methyl-Strychnine, etc., both actions resulting in paralysis of the 
limbs. Curare^ even in small doses, paralyzes the end-organs of the motor 
nerves, and Belladonna, the compound Ammonias, Methyl compounds, etc., 
exercise a similar but less powerful influence. Galvanism is also an effective 
local depressant of motor activity. 

Local Stimulants increase common sensibility to the extent 
of producing pain, chiefly by direct action upon the end-organs 



* In large doses. 



•f In small doses. 



34 



402 AGENTS ACTING ON THE NERVOUS SYSTEM. 

of the sensory nerves in the skin, though some act probably by 
stimulating the local circulation, as in inflammation. The prin- 
cipal members of this group are — 



Faradism. 


Chloroform. 


Volatile Oils. 


Heat. 


Carbolic Acid. 


Acrid Essential Oi 


Cold. 


Creasote. 


Metallic Salts. 


Alcohol. 


Mineral Acids. 


Veratrine (at first) 


Ether. 


Ammonia. 


Cantharis (at first), 



Local Anaesthetics and Anodynes (av, without, afodTjaf:, 
perception, ddbv-q, pain), — reduce the functions of the sensory 
nerves until they lose the power of receiving or conducting sen- 
sations. Some act by direct depression of the end-organs in the 
skin, etc., others by impairing the conductivity of the sensory 
nerves, while some act indirectly by reducing the local circula- 
tion. The Anodynes diminish, and the Anaesthetics destroy, for 
a time, the sensibility of the skin or mucous membrane. The 
chief agents of this class are — 

Local Anodynes, Local Anaesthetics. 

Aconite, Aconitine. Extreme Cold, Ice. 

Belladonna, Atropine. Ether Spray. 

Opium, Morphine. Carbolic Acid. 

Carbolic Acid. Erythroxylon. 
Chloroform. Cocaine. 

Chloral. Hydrocyanic Acid. 

Veratrum, Veratrine. Creasote. 

Volatile Oils. Oil of Turpentine. 

Galvanism. Iodoform. 

Cerebral Excitants, — are remedies which increase the func- 
tional activity of the cerebrum, without producing any subsequent 
depression, or any suspension of the cerebral functions. They 
act partly by increasing the action of the heart and consequently 
the rapidity of the circulation, partly by a direct action upon the 
gray matter of the brain. The chief members of this group are — 

Alcohol (at first). Coffee, Caffeine. 

Ammoniac. Tea, Theine. 

Asafetida. Guarana, Guaranine. 

Camphor. Erythroxylon, Cocaine. 

Cannabis. Tobacco. 

Valerian. Strychnine. 

Ammonia (inhaled). Acetic Acid (inhaled). 

Deliriants excite the functions of the higher brain to such a 
degree as to disorder the mental faculties, producing intellectual 
confusion, loss of will-power, delirium and even convulsions. 



AGENTS ACTING ON THE NERVOUS SYSTEM. 403 

They are all narcotics (though all narcotics are not deliriants), 
and may be listed as follows, viz. — 

Alcohol. Cannabis Indica. 

Belladonna. Chloral. 

Stramonium. Lupulus (at first). 

Hyoscyamus. Opium (at first). 

Cerebral Depressants lower or suspend the functions of the 
higher cerebrum after a preliminary stage of excitement. Under 
this head may be included the Narcotics, General Anaesthetics, 
and several of the Antispasmodics, all acting on the cells of the 
convolutions, at first stimulating the brain-functions, they produce 
after a time stupor, coma and insensibility. 

The most useful of this class are the Bromides, Zinc and Caffeine, as they 
also diminish reflex excitability and thus secure rest of the nervous system. 
Some of them are decidedly dangerous, as they may paralyze the heart or the 
medulla and its centres of organic life before the consciousness is much dis- 
turbed ; such being Chloroform, Aconite, Opium, and the irritant poisons. 

Narcotics (ydpxij, stupor), — are agents which, at first excitant 
to the higher brain, produce profound sleep, characterized by 
stupor, and if the dose be sufficient coma, insensibility and death 
by paralysis of the medullary centres governing respiration and 
other functions of organic life. They are closely related to stimu- 
lants, Opium and Alcohol being good illustrations, in the different 
stages of their action, of both stimulant and narcotic effects. 
They give us the power of lowering perception, inducing sleep 
and soothing the vital functions by rest, all of which are means 
of great therapeutical value. The chief narcotics are — 

Alcohol. Cannabis Indica. 

Opium, Morphine. Humulus. 

. Belladonna, Atropine. Chloroform, Ether, etc. 

• Hyoscyamus. Chloral-hydrate. 

Stramonium. Croton-chloral. 

Hypnotics (vnvoq, sleep), — are remedies which produce sleep, 
and in this wide sense of the term the class would include the 
Narcotics and the Anaesthetics, as well as those agents which 
may be termed Pure Hypnotics, which induce sleep by bringing 
the brain into a favorable condition therefor rather than by direct 
soporific action. In this sense the purest hypnotics are the 
Bromides, but artificial sleep may be produced by many other 
agents. The principal members of this class are the following: — 



/ 

404 AGENTS ACTING ON THE NERVOUS SYSTEM. 

Opium, Morphine, Narceine. Sodium Bromide. 

Chloral-hydrate. Calcium Bromide. 

Croton-chloral. Lithium Bromide. • 

Cannabis. Zinc Bromide. 

Cannabin Tannate. Potassium Bromide. 

Hyoscyamus. . Monobromated Camphor. 

Paraldehyde. Lettuce. 

Hops. Lactic Acid. 
General Anaesthetics. 

Analgesics (av, without, SXyoz, pain), or Anodynes (&v, 
without, 6duv7), pain), — are remedies which relieve pain, either 
by direct depression of the centres of perception and sensation 
in the cerebrum, or by impairing the conductivity of the 
sensory nerve fibres. Opium is the most efficient of all anal- 
gesics, because it arrests the afferent impressions at every step of 
their track — at their formation, along the course of their conduc- 
tion, and at the point where they impinge on the sensorium. 
The Local Anodynes have been described {ante, page 402), and 
the list of General Anodynes includes the following-named 
agents, viz. — 

Opium, Morphine. Aconite. 

Belladonna, Atropine. Chloroform, Ether, etc. 

Cannabis Indica. Conium. 

Stramonium. Chloral-hydrate. 

Hyoscyamus. Croton-chloral. 

Gelsemium. Lupulus. 

Anaesthetics (<&, without, aiad-qai<z, perception), — are agents 
which destroy sensation. Local Anesthetics have been described 
(ante, page 402.) General Ancesthetics are certain volatile sub- 
stances, mostly belonging to the class of alcohols and 'ethers, 
which when inhaled produce complete unconsciousness and loss 
of sensation (anaesthesia), with lessened motor power. 

Narcotics also produce anaesthesia, but the term is usually restricted to the 
effects of the volatile agents referred to, a full list of which may be found on 
pages 45 and 140. The principal members of this group are — 

Ether (Oxide of Ethyl). Nitrous Oxide. 

Chloroform. Bromide of Ethyl. 

Bichloride of Methylene. Bichloride of Ethylene. 

Antispasmodics (&vt(, against, Gnaaiioq, a spasm), — are agents 
which prevent or allay spasm of voluntary or involuntary muscles 
in any portion of the organism. Some of the agents belonging 
to this class act by stimulation of the higher nervous centres, the 



AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 405 

coordinating power, and the circulation, as Alcohol and Ether in 
small doses, Camphor, Musk, Valerian, etc. \ others by a depres- 
sant influence on the motor centres, as the Bromides ; and still 
others by paralysis of the end-organs of the vaso-motor nerves, as 
Amyl Nitrite, A few depress all the vital functions, as Aconite, 
Tobacco, Lobelia, Hellebore, and Prussic Acid ; and a long list 
stimulate the bowels to expel gaseous accumulations, namely, 
Asafetida, Cajuput, Valerian, Musk, Aromatic Oils, etc. They 
are used in convulsive affections, especially asthma and other 
spasmodic diseases of the respiratory organs, hysteria, chorea, 
angina pectoris, epilepsy, etc. The principal antispasmodics are 
as follows, viz. — 



Alcohol. 


Aconite. 


Ammoniac. 


Ether. 


Lobelia. 


Castor. 


Chloroform. 


Tobacco. 


Musk. 


Amyl Nitrite. 


Hellebore. 


Galbanum. 


Nitrites. 


Opium. 


Sumbul. 


Bromides. 


Belladonna. 


Ipecac. 


Potassium Iodide. 


Stramonium. 


Senega. 


Potassium Nitrate. 


Hyoscyamus. 


Silver Salts. 


Arsenic. 


Prussic Acid. 


Zinc Salts. 


Valerian. 


Physostigma. 


Copper Salts, 


Conium. 


Curare. 


Asafetida. 



The Cerebellum is affected by a few drugs, their action upon 
its several lobes producing various disturbances of equilibrium. 

Alcohol is the principal agent acting upon this portion of the brain, and dif- 
ferent products of the still seem to affect different portions of the cerebellum. 
For instance, intoxication by wine or beer is said to cause lateral falling, that 
by whiskey an inclination to fall face downwards, cider a backward tendency 
(Brunton). Apomorphine in large doses produces a tendency to move in a circle, 
and therefore probably affects the cerebellum or the corpora quadrigemina. 



Agents Acting on the Organs of Special Sense. 

Mydriatics (fiudo~, moisture), — are agents which produce dila- 
tation of the pupil of the eye (mydriasis). Some act locally, 
others when given internally, and the principal ones (Atropine 
and its congeners) act both locally and internally, producing at 
the same time paralysis of the ciliary muscle resulting in tempo- 
rary loss of accommodation, the e'ye remaining focussed for 
distant objects, and the intra-ocular tension being increased. 

The dilating action of Atropine and its congeners is due to stimulation of 
the end-organs of the sympathetic nerve, increasing the power of the radiating 
muscular fibres of the iris, and also to paralysis of the end organs of the motor 



406 AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 

oculi (3d cranial) nerve, lessening the power of the circular fibres or 
sphincter iridis (see ante, page 96). When administered internally the drug 
is carried by the circulation to the eye, acting thereon locally as if instilled 
directly upon the conjunctiva. The principal mydriatics are those named in 
the following list, viz., — 

Belladonna, Atropine. Belladonnine (internally only). 

Hyoscyamus, Hyoscyamine. Homatropine. 

Stramonium, Daturine, Gelsemine (locally only). 

Duboisia, Duboisine. Anaesthetics (at last). 

Atropine, Duboisine and Homatropine are the mydriatics used by ophthal- 
mologists. 

Myotics (fi6a> 9 to close), — are agents which produce contrac- 
tion of the pupil. The alkaloid of Physostigma, Eserine, is the 
chief local myotic, and the only one used in ophthalmic practice. 
It acts by stimulating the circular muscular fibres of the iris, at 
the same time contracting the ciliary muscle so that the eye is 
accommodated for near objects only, and diminishes intra-ocular 
tension. , 

Muscarine, Pilocarpine and Nicotine are also local myotics, acting upon 
the'end-organs of the oculo-motor nerve. Anaesthetics in the early stage of 
their action cause contraction of the pupil by lessening reflex action ; later, 
when they begin to paralyze respiration the accumulation of venous blood 
irritates the centres and produces dilatation, which is a sign of failing respira- 
tory power during anaesthesia. The myotic action of Opium is of central 
origin, probably the paralysis of the local reflex excitability. The chief my- 
otics are as follows : 

Physostigma, Eserine. Gelsemine (internally). 

Opium, Morphine. Lobeline (internally). 

Pilocarpus, Pilocarpine, Nicotine (locally). 

Muscarine. Anaesthetics (at first). 

The Sensibility of the Eye is increased by Strychnine, the 
field of vision becoming extended, and the vision rendered more 
acute. If the drug be administered hypodermically the improve- 
ment will be more marked in the eye corresponding to the side 
of the body where the injection was made. 

The sensibility for color is affected by drugs, Strychnine increasing the field 
for blue, Eserine diminishing it for red and green, and Santonin causing ob- 
jects to appear at first of a violet and afterwards of a greenish-yellow color. 

Visions are produced by several drugs, their action being 
probably on the cerebral sight-centres (angular gyrus and occipital 
lobes) rather than on the eye. Alcoholic delirium is a familiar in- 
stance, while Cannabis Indica often causes pleasant visions, and 



AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 407 

Sodium Salicylate in some persons produces very disagreeable ones. 
Digitalis may produce subjective sensations of the continued 
presence of light. 

Amblyopia, or impairment of vision from nerve-changes, is 
produced temporarily by Quinine, and may be permanently in- 
duced by Tobacco, Alcohol, Lead and Urea. 

The Ear is affected by several drugs. Strychnine and Opium 
increase the excitability of the auditory nerve or of the centre 
for hearing (superior temporo-sphenoidal convolution), and make 
that faculty much more acute. Quinine and Salicylates produce 
hyperaemia of the auditory apparatus, causing subjective noises, 
as humming, buzzing or ringing, which are very unpleasant. 
Hydrobromic Acid and the Bromides, also Ergot, will diminish 
the congestion and to a great extent will neutralize or prevent 
these noises. 

Quinine in large doses is believed by some to have produced permanent 
injury of the sight and the hearing, but authentic cases of such action are 
extremely rare, if indeed they can be found at all. Temporary deafness is 
often caused by Quinine, but it usually disappears soon after the administra- 
tion of the drug is stopped. 

The Sense of Smell is also increased by Strychnine, and de- 
creased by all cerebral depressants and by those which produce 
changes in the nasal mucous membrane, e.g., Potassium Iodide. 

The cerebral centre for this faculty is situated at the tip of the temporo- 
sphenoidal lobe, and the terminal branches of the olfactory nerve are distrib- 
uted upon the mucous lining of the upper portion of the nasal fossae. Strych- 
nine probably stimulates the former, and all drugs acting upon the latter region 
would have more or less effect upon the power of distinguishing smells. 

The Taste is not much affected by drugs except as each 
makes its peculiar impression on the nerves of taste, and may 
overcome that of another agent. Smell has much to do with 
taste in many instances, the expedient of holding the nose while 
swallowing Castor Oil being familiar to everyone. 

The " after-taste " of drugs is often different to their original taste; thus Bitters 
are said to leave a sweet after-taste, and the same is claimed for Quinine if given 
in acid solution so as to be entirely dissolved, and if washed out of the mouth 
with water immediately after swallowing. Substances which are excreted 
from the system in the saliva (as Iodides) leave a very persistent after-taste. 



408 AGENTS ACTING ON RESPIRATION. 



Agents Acting on Respiration. 

The Respiratory Centre is situated in the medulla oblongata, 
close to the termination of the calamus scriptorius. It probably 
consists of thoracic and diaphragmatic Inspiratory centres, the 
act of expiration being considered normally a passive one, due to 
the natural contraction of the walls of the air-vesicles, and the 
return of the diaphragm and thoracic walls to the position from 
which they were moved by the inspiratory effort. An Expiratory 
Centre must also exist for the initiation of forced expiration, as 
in the production of voice, cough, sneezing, etc. The chief In- 
spiratory Nerves are the pulmonary branches of the vagus. The 
Expiratory Nerves are the nasal branches of the fifth, the superior 
and inferior laryngeal, and the cutaneous nerves of the chest and 
abdomen. 

Respiratory Stimulants increase the activity of the re- 
spiratory centre, quickening and deepening the respirations. 
Such agents are — 



Heat. 


Brucine. 


Digitalis. 


Quebracho. 


Strychnine. 


Thebaine. 


Zinc salts. 


Tobacco (briefly) 


Atropine. 


Apomorphine. 


Copper salts. 


Alcohol (briefly) 


Duboisine. 


Emetine. 


Ammonia. 


Ether (briefly). 



Strychnine also stimulates the vagus tract. Electricity applied to the nerve- 
trunks or to the inspiratory muscles, is a direct respiratory stimulant. Vera- 
trine, Eserine and Muscarine stimulate the vagus terminations, quickening 
the respiration, but afterwards slow it by depressing the respiratory centre. 
Aconite stimulates the end-organs of the vagus when given in small doses. 

Respiratory Depressants lower the activity of the respira- 
tory centre, rendering the respirations slow and shallow. The 
chief agents of this class are — 



Cold. 


Gelsemium. 


Alcohol. 


Caffeine. 


Opium. 


Aconite. 


Ether. 


Colchicine. 


Physostigma. 


Veratrine. 


Chloroform. 


Nicotine. 


Muscarine. 


Prussic Acid. 


Chloral. 


Quinine. 


Lobeline. 


Conium. 


Saponine. 


Camphor. 



The last ten named first excite the centre for a brief period and then de- 
press it. 

Errhines and Sternutatories (&>, in, ^v, the nose; sternuto, 
to sneeze), — are agents which produce increased nasal secretion 
and sneezing, when locally applied to the mucous membrane of 
the nose. The first term is usually applied to substances which 



AGENTS ACTING ON RESPIRATION. 4O9 

cause increase of the mucus without sneezing, the latter to those 
which invariably produce sneezing. The drugs should be in 
powder for application. The stimulus produced by these agents 
is transmitted by the nasal branches of the fifth nerve to the 
respiratory centre, exciting the sudden and forcible expiratory 
effort called sneezing ; also to the vaso-motor centre, contracting 
the smaller vessels throughout the body and producing a general 
rise in the blood-pressure. The principal agents of this class 
are — 



Tobacco, as snuff. 


Euphorbium. 


Capsicum. 


Ipecacuanha. 


Sassy Bark. 


Hellebore, 


Sanguinaria. 


Saponine. 


Ammonia. 


Veratrum Album. 


Ginger. 


Cubebs. 



The last two named may be used as simple Errhines, as the vapor of dilute 
Ammonia-water or the smoke of burning Cubebs do not excite sneezing gen- 
erally. 

Pulmonary Sedatives diminish cough and dyspnoea by les- 
sening the irritability of the respiratory centre or the nerves of 
respiration. Some act by directly depressing the respiratory 
centre, as those enumerated under the preceding head ; others by 
removing some irritant from the passages, or by lessening local 
congestion, as the expectorant group ; and others by lowering 
the excitability of the vagus end-organs in the lungs, and that of 
the other afferent nerve filaments in the respiratory tract. 

Opium has the most powerful influence as a sedative to the respiratory 
centre, and mucilaginous or saccharine substances soothe the local irritation, 
hence the latter are so frequently used as vehicles for the former in cough- 
mixtures. Hydrocyanic Acid has a similar sedative action, hence the use in 
coughs of Prunus Virginiana and other substances containing it. Belladonna 
stimulates the respiratory centre, but at the same lessens the excitability of the 
vagus terminations in the lungs, and completely arrests secretion from the 
bronchi. Stramonium acts similarly. The principal pulmonary sedatives may 
be enumerated as follows, viz. — 

Opium. Prussic Acid. Turpentine. 

Belladonna. Amyl Nitrite. Ethyl Iodide. 

Stramonium. Quebracho. Conium. 

Hyoscyamus. Cannabis. Tobacco. 

Expectorants (ex, out of, pectus, the breast), — are remedies 
which modify the secretion of the broncho-pulmonary mucous 
membrane, and promote its expulsion. They may be divided 
into — 

Nauseating Expectorants, — in large doses act mechanically by 
expelling the mucus in the act of vomiting, iri small doses by 



4IO AGENTS ACTING ON THE CIRCULATION. 

increasing osmosis from the inflamed mucous membrane. The 
members of this subdivision generally increase secretion and tend 
to lower the blood-pressure. The chief of them are the following 
named : — 

Antimony, Tartar Emetic. Apomorphine. 

Ipecacuanha, Emetine. Quebracho. 

Lobelia, Lobeline. Potassium Iodide. 

Pilocarpus (Jaborandi). Alkalies. 

Stimulant Expectorants, — are eliminated by the* bronchial 
mucous membrane which they stimulate, altering the secretion 
and facilitating expectoration. These remedies generally diminish 
secretion and increase blood-pressure. They are- 
Acids. Squill. 

Ammonium Chloride. Garlic. 

Ammoniac. Onion. 

Benzoin and Benzoic Acid. Nux Vomica, Strychnine. 

Balsams of Peru and Tolu. Senega, Saponin. 

Wood Tar, and Tar. Sulphur. 

Oleum Pini Sylvestris. Liquorice. 

Turpentine. Saccharine Substances. 

Besides the above many other remedies may act as expectorants, some by 
relieving bronchial spasm, as Opium, Stramonium and Tobacco, — others by 
soothing the irritable respiratory centre, as Opium and Chloral, — and the 
ciliary excitants by reflex action through their impression on the nerves of the 
mouth. 

Ciliary Excitants, — promote the expectoration of bronchial 
mucus by reflex excitation of the tracheal and bronchial cilia, 
when dissolved in the mouth. Gum Acacia, Ammonium Chlo- 
ride, Potassium Chlorate, and native Chloride of Sodium 
have this action. 



Agents Acting on the Circulation. 

Cardiac Stimulants rapidly increase the force and frequency 
of the pulse in depressed conditions of the cardiac apparatus. 
One of the most useful agents of this class is Alcohol in some form, 
its action being largely due to a reflex influence excited through 
the nerves of the mouth and stomach. It should therefore be 
given in but slightly diluted form, and in small quantities fre- 
quently. Ether is next in value and still more rapid in action, 
and Heat is one of the most powerful and available of the class. 
Ammonia has an energetic action as a stimulant to the vaso-motor 
centre, as well as a reflex one upon the heart similar to that of 



AGENTS ACTING ON THE CIRCULATION. 4II 

Alcohol. The list of cardiac stimulants includes the following, 
viz. — 

Alcohol. Ether. Camphor. 

Ammonia. Chloroform. Aromatic Oils,- 

Atropine. Heat. Turpentine. 

Counter-irritation. Continuous Galvanic Current. 

Cardiac Tonics, when given in moderate doses, stimulate 
the cardiac muscle, slowing and strengthening its contractions. 
In large doses they are apt to produce irregular action of the 
heart, and some of them have more or less of a tendency to cause 
sudden death by syncope if pushed to any great extent. The 
most important of these agents are — 

Digitalis. Squill. Strychnine. 

Convallaria. Erythrophlceum. Helleborem. 

Cimicifuga. Caffeine. Adonis vernalis. 

Digitalis acts partly by stimulation of the vagus end-organs in the heart, 
thus increasing cardiac inhibition, and partly by direct stimulation of the car- 
diac centre in the medulla, as well as by a direct influence on the heart muscle 
itself. Convallaria, Erythrophlceum, Squill and Cimicifuga act similarly but 
less powerfully, and are correspondingly safer. 

Cardiac Sedatives lessen the force and the frequency of the 
heart's action and are used to control palpitation of that organ, 
and to slow the pulse in febrile conditions in sthenic subjects, 
especially when local inflammation is the exciting cause. The 
chief cardiac sedatives are — 

Aconite. Digitalis. 

Antimony. Senega, Saponin. 

Veratrum Viride. Prussic Acid. 

\ Muscarine. Potassium Salts. 

Pilocarpine. Cold. 

Aconite, Veratrum, Muscarine, Pilocarpine, Saponin and Prussic Acid 
are direct cardiac poisons, depressing the heart muscle and the cardiac motor 
ganglia ; Muscarine and Pilocarpine also stimulate the inhibitory ganglia ; 
Digitalis stimulates the vagus centre and the cardiac muscle, and acts as a 
sedative in many cases by slowing the rate and giving it a regular rhythm. 
Aconite is said by some authorities to relax inhibition, by others to stimulate 
the vagus centre. Antimony depresses the motor ganglia, Potassium the 
cardiac muscle. 

Vascular Stimulants produce dilatation of the peripheral 
vessels, and increase the rapidity of the circulation, thus equal- 
izing the blood-pressure and preventing internal congestions. 



412 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

The most useful are Alcohol and Ether, as they stimulate the 
action of the heart simultaneously with the vascular dilatation. 
The chief members of this group are — 

Alcohol. Amyl Nitrite. 

Ether. Liq. Ammonii Acetatis. 

Nitrous Ether. Opium, as Dover's Powder. 

Nitro-glycerin. Heat, as Poultices, etc. 

The dilating action of Amyl Nitrite and other Nitrites is due to weakening 
either of the muscular walls of the arterioles or to paralysis of the vaso- 
motor ganglia in them. Alcohol, Ether and Opium probably depress the vaso- 
motor centre. 

Vascular Tonics produce increased contraction of the 
arterioles and consequently increased blood-pressure. The most 
important are — 

Digitalis. Iron. Strychnine. 

Squill. Ergot. Lead and Silver. 

These agents act upon the local vaso-motor mechanism in the walls of the 
vessels, which are also directly stimulated by cold produced in any way, as 
by Ether spray, or evaporating lotions of Alcohol, Vinegar or Ammonium 
Chloride. 

Vascular Sedatives increase the contraction of the vessels 
and lessen the circulation through them. They are employed 
to check hemorrhage and to cut short a local inflammation. The 
chief agents belonging to this group are — 

Cold. Hamamelis. Opium. 

Ergot. Digitalis. Acetate of Lead. 



Agents Acting on the Digestive System. 

Dentifrices {dens, a tooth, frico, to rub), — are medicated 
powders or pastes employed to cleanse the teeth and gums. Chalk 
is the basis generally used for its mechanical action and its al- 
kaline quality. Antiseptics, as Borax, Quinine, Carbolic Acid, 
etc., should also be employed so as to prevent the acid fermenta- 
tion of food products between the teeth and the consequent decay 
of the dentine. Tincture of Myrrh is an excellent ingredient, 
being an aromatic local stimulant and disinfectant. 

Many drugs affect the teeth injuriously, such being the Mineral Acids, Per- 
salts of Iron and Alum. The first two should be taken through a glass tube, 
and the mouth should be afterwards rinsed with a weak alkaline wash. Opium, 
Carbolic Acid, Creasote, Chlorate of Potassium and Aconite are the agents 
used as local anodynes in toothache from caries exposing a nerve filament. 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 413 

Sialogogues (eiaAov, saliva, ayco, to carry off), — are agents 
which increase the secretion and flow of saliva and buccal mucus, 
either by reflex action from the local irritation produced when 
anything is taken into the mouth, or by stimulating the glands 
during their elimination. The principal sialogogues are divided 
into two classes, the first (topical) acting by reflex stimulation, 
the second (general) acting through their systemic influence on 
the glands or their secretory nerves. They are as follows : — 

Topical Sialogogues. General Sialogogues. 

Acids and Alkalies. Pilocarpus (Jaborandi). 

Ether, Chloroform, etc. Muscarine. 

Mustard, Ginger. Physostigma. 

Pyrethrum, Mezereon. Mercurials. 

Tobacco, Cubebs. Iodides, and Ipecac. 

Capsicum, Rhubarb. Antimonials. 

Antisialics (dvrt, against, trialov, saliva), — are remedies which 
diminish the secretions of the salivary glands. Atropine is the 
principal agent of this group, acting by paralyzing the termina- 
tions of the nerves of secretion. Physostigma counteracts this 
paralysis, but in large doses acts as an antisialic by lessening the 
blood supply to the glands. Opium diminishes the reflex excita- 
bility of the reflex centre and also diminishes the secretion. 
Others acting locally are — 

Borax. Soda. Lithia. 

Potassium Chlorate. Lime. Magnesia. 

Insipid or nauseous articles of food or medicine. 

Refrigerants {refrigero, to cool), — are remedies which allay 
thirst and impart a sensation of coolness. They include the 
Vegetable Acids, the Mineral Acids (greatly diluted), Ice, Water, 
Effervescing drinks, Fruit juices, and many diaphoretics. 

Gastric Tonics or Stomachics, — are agents which increase 
the appetite and promote gastric digestion. They include a num- 
ber of substances, dietetic and medicinal, some acting by stim- 
ulation of the production of gastric juice, others by stimulating 
the local circulation, and several by exciting the activity of the 
nervo-muscular apparatus of the stomach. 

The first indication is met by the use of dilute alkaline solutions before 
meals, — the second by administering any of the pungent carminatives, as the 
Aromatic Oils, Pepper, Mustard, etc., or by Alcohol and Ether in small doses, 
or by the Aromatic Bitters, as Gentian, Orange, etc., or the simple bitters, as 
Calumba ; —while the third desideratum is secured by the use of such agents 
as Nux Vomica, Hydrastis, Arsenic, the dilute Mineral Acids, and the Volatile 



414 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

Oils. Adjuvants to gastric digestion are the various digestion-ferments, 
Pepsin, Ingluvin and dilute HC1 Acid, which may be used to supplement the 
gastric juice when deficient in quantity or quality. 

Acids, — considered therapeutically and physiologically, are 
medicines which in concentrated form act usually as caustics, and 
when given in medicinal doses internally check the secretions of 
organs producing acid secretions with which they come in con- 
tact, and increase those of organs producing alkaline secretions. 
Thus a dilute acid given before meals will check the production 
of the acid gastric juice, but will stimulate that of the alkaline, 
pancreatic juice. 

The chief members of this group are the following, which should be given 
in very dilute form ; — 

Acidum Aceticum. Acidum Nitricum. 

Acidum Citricum. Acidum Phosphoricum. 

Acidum Benzoicum. Acidum Sulphuricum. 

Acidum Hydrochloricum. Acidum Nitro-hydrochloricum. 

Ant-acids or Alkalies, — from the same stand-point, are 
remedies which neutralize acids, check alkaline secretions and 
stimulate acid secretions, when in contact with the ducts of the 
organs producing them. Thus a dilute alkali given before meals 
will stimulate the production of the acid gastric juice, and if 
applied to the mouth of the pancreatic duct will check the secre- 
tion of the alkaline pancreatic juice. The principal articles which 
belong to this group are the following, which should always be 
administered in dilute solution : — 

Liquor Potassse, Liquor Sodae. Potassium Acetate. 

Carbonates and Bicarbonates of Potassium, Potassium Citrate. 

Sodium, Lithium, Magnesium and Am- Potassium Tartrate. 

monium. Potassium Bitartrate. 

Calcined Magnesia (Magnesia). Sodium Acetate. 

Lime-water, Chalk. Sodium Citrate. 

Aromatic Spirit of Ammonia. Lithium Citrate. 

The substances in the first list are direct antacids, lessening the acidity in 
the stomach, and many of them also acting as remote antacids, lessening the 
acidity of the urine, as Potash and Soda, and their Carbonates and Bicarbo- 
nates. Ammonia and its Carbonates after absorption are eliminated as urea, 
and do not lessen the acidity of the urine. The salts in the second list are 
remote antacids, do not lessen acidity in the stomach, but do that of the urine, 
being oxidized in the blood and excreted as Carbonates. 

Emetics (£fi£a>, to vomit), — are agents which produce vomit- 
ing. They maybe subdivided into two groups, (i) Local Emetics, 
or those which act by irritating the end-organs of the gastric, 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 



415 



pharyngeal or oesophageal nerves, and (2) General or Systemic 
Emetics, which act through the medium of the circulation. Both 
these classes produce the emetic action by irritation of the vom- 
iting centre in the medulla, the first by reflex, the second by 
direct stimulation. The principal emetics are the following 
named : — 

Local Emetics. General Emetics. 

Alum, Mustard, Salt. Ipecacuanha. 
Ammonium Carbonate. Emetine. 

Zinc and Copper Sulphates. Apomorphine. 

Subsulphate of Mercury. Tartar Emetic. 

Tepid Water, in quantity. Veratrine. 

Vegetable Bitters, as Quassia, Seneca. 

in strong infusions. Squill. 

Tartar Emetic, Ipecacuanha and probably Apomorphine, act locally as well 
as systemically, for if injected subcutaneously they are excreted by the 
stomach in part, thus irritating the gastric nerves as well as the vomiting 
centre. Piloca?pus is a local emetic, and Digitalis and its congeners, also 
Muscarine, are systemic emetic?, but none of these agents are used medicin- 
ally for that purpose. Opium, Morphine and Codeine usually produce emesis 
as one of their after-effects. 



Anti-emetics, — are agents which diminish nausea and vomit- 
ing, either through a local sedative action upon the end-organs 
of the gastric nerves, or by reducing the irritability of the vom- 
iting centre in the medulla. The most efficient of the local 
sedatives is Ice, swallowed in small pieces. Astringents are very 
useful when there is congestion of the gastric mucous membrane, 
as in the vomiting of alcoholism and phthisis, where Silver Nitrate 
and Alum are respectively effective. The most important anti- 
emetics are the following, viz. : — 

Local Gastric Sedatives. 
Alcohol. Creasote. 

Alum. Ether. 

Ice. 

Opium. 

Prussic Acid. 

Silver Nitrate. 

Calomel | small 

Ipecac J doses. 

Hot Water. 



Arsenic. 
Belladonna. 
Bismuth. 
Carbonic Acid. 
Cerium Oxalate. 
Chloroform. 
Carbolic Acid. 



General Sedatives. 
Opium. 

Morphine. 
Prussic Acid. 
Bromides. 
Chloral. # 
Nitroglycerin. 
Food. 
Alcohol. 
Amyl Nitrite. 



Vomiting being set up by irritation of many afferent nerves from various 
regions of the body, or by impulses from the brain excited through impres- 
sions on the nerves of special sense, the measures for combating it are very 
diversified. (Compare the title Vomiting in Part III.) 

Gastric Pain is best treated by such local sedatives as Bismuth, Hydrocy- 
anic Acid, or small doses of Morphine, Arsenic and Belladonna. 



41 6 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

Carminative s : rm£ma t to soothed, — aid the expulsion of gas 
from the stomach and intestines, by increasing peristalsis, stimu- 
lating the circulation, and relaxing the cardiac and pyloric 
orifices of the stomach. They also act as diffusible stimulants, 
both of the bodily and mental faculties. The principal carmina- 
tives belong to the aromatic oils, alcohols or ethers, and are 
embraced in the following list : — 



Asafetida. 


Mustard. 


Oil of Eucalyptus. 


Capsicum. 


Pepper. 


Oil of Fennel. 


Cardamom. 


Spirits. 


Oil of Peppermint. 


Chloroform. 


Oil of Anise. 


Oil of Spearmint. 


Ether. 


Oil of Cajuput. 


Oil of Xutmeg. 


el. 


Oil of Caraway. 


Oil of Pimento. 


~er. 


Oil of Cinnamon. 


Oil of Valerian. 


Horse-radish. 


Oil of Clove-. 


Camp hor. 




Oil of Coriander. 


Serpentaria. 



Cathartics or Purgatives (zada>pa) 9 purgo, to cleanse), — 
are agents which increase or hasten the intestinal evacuations. 
According to their respective degrees and direction of action they 
are subdivided into several groups, as follows : — 

Laxatives (laxo, to loosr . vr Aperients (aperio, to open), — 
include those which excite moderate peristalsis, and produce soft- 
ened motions without irritation. Sulphur is the typical laxative. 

Simple P . — increase peristalsis actively, and stimulate 

the secretions of the intestinal glands, producing one or more 
copious and semifluid motions with some irritation and griping. 
Senna is the type of this group. 

Dras: Spw, to act), — act still more intensely, 

producing violent peristalsis and watery stools, with much grip- 
ing pain, tenesmus and borborygmi. They irritate the intestinal 
mucous membrane, cause exosmosis of serum from its vessels, 
and in large dose set up inflammation and symptoms of irritant 
poisoning. Jalap is a typical drastic. 

Saline P* . — consist of the neutral salts of metals of the 

alkalies op alkaline earths. They stimulate the glands, increase 
peristalsis, promote osmosis and cause free watery evacuations. 
Magnesium Sulphate is a typical saline. 

Hydragogue Purgatives Itmp, water, ay to, to bring away), — 
include the most active of the drastic and saline groups, those 
which remove a large quantity of water from the vessels. Ela- 
terium is a typical hydragogue. 

Chohsgogue Purgath bile, ayco, to bring away), — are 

those agents which stimulate the flow of bile and produce free 



AGENTS ACTING ON THE DIGESTIVE SYSTIA'. 



-7 



purgation at the same time, the stools being green-colored, or 
" bilious," and liquid. Podophyllin is the type of this group. 
The principal Cathartics are the following named : — 



Laxatives. 


S:-:r'c F:>. "-/.::;': ■::. 


Drastics. 


SGy::.::. 


Senna. 


':.':;. 


V.-.^i-.eri.i. 


A . : r 5 . 


C: . : :y-".h. 


Cassia. 


Ah .::-::. 


El~:er:u~. 


V;.~r.i. 


Castor Oil. 


S ::.::".:" my- 


F:^>. 


R:.;.::".:.-? rrir.^A. 


G-~: : ~e. 


r : . r. e ? 


Cx-:-;:, 


Cr:::r. J A 


7:.:: :.r.z. :A. 


L-A:~:A. 




H rr.ev. 


Sn:.ll Ases :: :r:. ; :::?. 


sG.Ae 5 :r :h :'."^: ^ue = . 


OlireOil. 






C.--:.-.r:. .S.-gr;.;:!. 


Saline Purgatives. 


Hydragogues. 


Fr.y=;i-.:r— ;.. 


V- ;..,-■. ■:-.-. i-:.\ ?.:e. 


EG.:rrA:r.. 


Ergot 


■y^r . ^ .. - _. 


G;.:r.r :^e. 


Br.l" .: rr.r.:.. 


7 ::..ji;:z AAA-.-..:e. 


F -:;..?. I :::.r:r-:e. 


5::~::^ r_:.:~:. 


T - - ; - • .-.. _ - ." ^ 


Croton Oil. 


Ky: jcy.-.z:"-5. 


T - - ; ^ ~ • J 


SrGi"r5 in ;.:je Ases. 


5::.r. 


^ : •-"- A ■ — e. 




Almond Oil. 


5 - ": — - p ~ A- ~ -- e< 


lA. .'.:;.;:.:.' 


Taraxacum. 


Sodium Chloride. 


Mercurials. 


Glycerin. 


J ;: e: S: A.:~: 7:.::::.:., 


A '. ; e ; . 


0.--:~:e;.l. 


Manganesr :t. 


Rhubarb. 


Br:." I:-:-.:::. 




Euonymin. 


Brown Bread. 




1 : ArbyG:::. 
Iridin. 



Intestinal Astringents. ntract the walls of the intestinal 
vessels, diminishing the exudation therefrom, and lessening the 
fluidity of the faecal discharges. The more powerful members 
of this group have also a constringing action on the intestinal 
mucous membrane. The principal agents of this class are the 
following : — 



Astringents. 
losphoric Acid. "J 



Sulphuric Acid. 

A:r::.:e A I e:A 
A\:rate of Silver 






r a—a 



Gmstringents. 

Tannic Acid. 

V:;;-.: ;"_- A-:::: zer.:?, 

Alum. 

Oxide of Zinc. 

SGrh.v.e ;:" Avyer. 

Peisalts of Iron. 



Hepatic Stimulants and 



Cholagogues 



A 



bile, ayw 9 
to bring away), — are two groups of agents acting upon the biliary 
secretion, the first-named increasing the functional activity of 
the liver and the amount of bile formed, the second removing 
the bile from the duodenum and preventing its reabsorption into 
the portal circulation. Some hepatic stimulants are also chola- 
gogues, others are not, while cholagogues proper generally act as 

55 



4i8 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 



hepatic stimulants by carrying off the bile and so indirectly 
urging the liver to secrete more. The discovery of the entero- 
hepatic circulation of bile has cleared up many of the discrepan- 
cies formerly existing with regard to the action of drugs upon 
this gland and its secretion. The following list includes the 
principal drugs belonging to both groups : — 



Hepatic Stimulants. 



Aloes. 

Podophyllin. 
Mercuric Chloride. 
Sodium Benzoate. 

Phosphate. 

Salicylate. 
Nitro-hydrochloric Acid. 
Euonymin. 
Iridin. 
Phytolaccin. 
Sanguinarin. 
Antimony. 
Arsenic. 
Ipecacuanha. 
Colchicin. 
Colocynth. 
Rhubarb. 



Potassium Sulphate. 
Sodium Sulphate. 

Bicarbonate. 
Ammonium Benzoate. 
Chloride. 
Nitric Acid (dilute). 
Benzoic Acid. 
Baptisin. 
Hydrastin. 
Juglandin. 
Leptandrin. 
Jalapin. 
Scammony. 
Guaiac. 
Sarsaparilla. 
Physostigma. 
Rochelle Salt. 



Cholagogues. 
Aloes. 

Podophyllin. 
Mercurous Chloride. 
Pil. Hydrargyri. 
Mercury with Chalk. 
Sodium Phosphate. 

Sulphate. 
Potassium Sulphate. 
Colchicum. 
Colocynth. 
Rhubarb. 
Arsenic. 
Euonymin. 
Scammony. 
Baptisin. 
Jalapin. 
Iridin. 



Those in the first column are the most powerful of the stimulant group, the 
second column including the less efficient agents. To secure the best chola- 
gogue effect it is advisable to combine an hepatic stimulant with an intestinal 
stimulant which shall produce increased secretion from the intestinal mucous 
membrane and excite peristalsis. 

The Glycogenic Function of the liver, and the production of 
urea are stimulated by the following-named drugs: — 



Increasing Glycogen. 
Nitrite of Amyl. 
Sodium Bicarbonate. 
Nitro-hydrochloric Acid. 



Increasing Urea. 
Arsenic. Iron. 

Antimony. Phosphorus. 
Ammonium Chloride. 



Hepatic Depressants are agents which lower the functional 
activity of the liver, reducing the quantity of bile secreted, and 
lessening the production of glycogen and urea. They are as 
follows, viz. : — 



Lessening Bile. 
Opium. Morphine. 
Many Purgatives. 
Acetate of Lead. 
Quinine (?). 
Alcohol (?). 



Diminishing Glycogen. 
Opium. 

Morphine. Codeine. 
Phosphorus. 
Arsenic. 
Antimony. 



Lessening Urea. 
Opium. 
Morphine. 
Colchicum. 
Alcohol. 
Quinine. 



AGENTS ACTING ON METABOLISM. 419 

Many purgatives act as hepatic depressants and diminish the secretion of 
bile by lowering the blood-pressure in the liver, and by carrying off the ma- 
terials from which bile might be formed. 

Pancreatic Stimulation may be obtained by the adminis- 
tration of Ether, or by Galvanism of the gland itself. It is 
depressed by Atropine and by inducing nausea and vomiting. 

Anthelmintics (dvrt, against, iX/uvs, a worm), — are agents 
which destroy (vermicides) or cause the expulsion (vermifuges) 
of intestinal worms. The chief vermifuges are Castor Oil, Jalap 
and Scammony, while the vermicides may be enumerated as fol- 
lows, viz. :— - 

Thread Worms. Round Worms. Tapeworms. 

{Oxyuris Vermicular is.) (Ascaris Lumbricoides.) {Teenies ; etc.) 

Alum. Santonica. Filix Mas. 

Sulphate of Iron. Santonin. Kamala. 

Lime-water. Spigelia. Kousso. 

Quassia. Chenopodium. Gfanatum. 

Eucalyptol. Azedarach. Pelletierine. 

Sodium Chloride. Senna. \ with the Pepo. 

Tannin. Calomel. / above. Turpentine. 

Veg. Astringents. Chloroform. 

The substances enumerated in the first column are all used locally by 
enema. Adjuncts to these remedies are such agents as prevent the excessive 
secretion of intestinal mucus, which affords a nidus for the worms. Such are 
Bitter Tonics and preparations of Iron, also Ammonium Chloride and Sodium 
Chloride. 

Agents Acting on Metabolism. 

Restoratives,— are agents which promote constructive meta- 
morphosis, including the Foods, Haematics, and Tonics, as well 
as many agents called Stimulants in other classifications. 

Foods, — are substances which, when introduced into the body, 
supply material to renew some structure or to maintain some 
vital process ; being distinguished from medicines in that the 
latter modify some vital action but supply no material to sustain 
such. 

The food of man is derived from all three of the kingdoms of nature, viz., 
the mineral, vegetable and animal, and includes many substances treated of 
in the Materia Medica, as Oils and Fats, Sugar, Starch, Gum, Alcohol, Bev- 
erages like Coffee and Tea, Water, Phosphate of Lime, Chloride of Sodium, etc. 

Hamatics (alfia, the blood), — are medicines which augment 
the quantity of haematin in the blood, and thus restore the quality 



420 AGENTS ACTING ON METABOLISM. 

of that tissue by enriching its red corpuscles. They consist 
chiefly of Iron and Manganese and their compounds. 

Tonics (rows, tension), — are agents which improve the tone 
of the tissues on which they have specific action, restoring energy 
and strength to debilitated subjects, by a scarcely perceptible 
stimulation of all the vital functions, their effects being apparent 
in an increased vigor of the entire system. The chief tonics 
are enumerated in the foregoing lists under the heads of the 
organs or tissues particularly affected by them. (Compare the 
titles Stimulants, Respiratory Stimulants, Cardiac Tonics, 
Vascular Tonics, Gastric Tonics, etc.) 

The most typical medicinal agents which impart a general sense of tone 
and strength are Strychnine, Quinine, Iron, and Vegetable Bitters. Those 
especially acting upon the stomach are Arsenic, Bismuth, Cinchona, Hydrastis 
and Nux Vomica, — on the spinal cord and general circulation, Strychnine, — 
on the heart, Digitalis, Squill, Convallaria and Cimicifuga, — on the nervous 
system, Phosphorus, Quinine and the Valerianates, — on muscular tissue, Tan- 
nin, — on the blood, Iron, Manganese, Cod-liver Oil, and other fats. 

Alteratives, — are certain remedies which alter the course of 
morbid conditions in some way not yet understood, perhaps by 
promoting metabolism. They certainly modify the nutritive 
processes and thereby cure many diseases of chronic type. Mer- 
cury and Iodine are the most prominent agents of this class, the 
former being endowed with the power of breaking up newly de- 
posited fibrin, and disorganizing syphilitic deposits, while the 
latter acts energetically upon the lymphatic system and promotes 
absorption. Arsenic also is almost specific in many chronic skin 
affections, and has remarkable power over chronic pulmonary 
consolidations, probably producing fatty degeneration and soft- 
ening of the effusion, so that it maybe absorbed or expectorated. 
The principal alteratives are : — 



Arsenic. 


Mercury. 


Iodine. 


Antimony. 


Colchicum. 


Iodides. 


Aurum. 


Guaiacum. 


Stillingia. 


Mezereum. 


Sanguinaria. 


Sarsaparilla. 


Sulphur. 


Xanthoxylum. 


Cod-liver Oil, 


Sulphides. 


Calcium Chloride. 


Phosphorus. 



Certain therapeutists of laboratory type have, of late years, seen fit to de- 
nounce the term Alterative as " a cloak for ignorance," but have never been 
able to present a better designation for a class of agents whose effects are 
among the most thoroughly established of chemical facts. 

Resolvents or Discutients {resolvo, to unbind, discutio, to 
dissipate), — are agents which promote the absorption of inflam- 
matory products or other materials of morbid origin, apparently 



AGENTS ACTING ON METABOLISM. 



42 [ 



by stimulation of the lymphatic system. They include Mercury, 
Arsenic, Iodine and Cadmium, as well as such local measures as 
Poulticing and Counter-irritation. 

The Destructive Metamorphosis of the body is promoted 
by a number of agents, most of which are classed as Alteratives 
or Astringents, and the most important of which are the follow- 
ing-named : — 

Alkalies. Sulphides and Iodides. 

Vegetable Acids. Sarsaparilla. 

Metals and their salts. Stillingia. 

Colchicum. Xanthoxylum. 

Tannic and Gallic Acids, and substances containing them. 

On the other hand, Metabolism may be diminished by many 
substances, the following-named being the chief ones, — 
Alcohol. Salicin. Resorcm. 

Glycerin. Salicylates. Chinoline. 

Oils and Fats. Quinine. Kairine. 



Antipyretics (am, against, Kuperds, fever), — are agents or 

measures which reduce the body-temperature when abnormally 

high. This may be done by two principal methods, and the 

agents doing either accomplish the result by different actions, as 

follows, viz. — 

D T **. r* j _*■ j? tt l f I- Diminishing tissue-change. 

By Lessening the Production of Heat, by < . f> & 

J -* \ 2. Reducing the circulation. 

[ 3. Dilating cutaneous vessels, and producing 

increased radiation. 

4. Producing perspiration, and its evaporation. 

I 5. Abstracting heat from the body. 

The following list contains nearly all the antipyretics, the 
number following each referring to its proper method of action, 
as enumerated above : — 



or by 
Promoting the Loss of Heat, by 



Quinine. 1 
Quinidine. 1 
Cinchonine. 1 
Cinchonidine. 1 
Berberine. 1 
Benzoic Acid. 1 
Carbolic Acid. 1 
Picric Acid. 1 
Salicin. 1 
Salicylic Acid. 1 
Sodium Salicylate.1, 4 
Quinine Salicylate. 1 
Methyl Salicylate. 1 

; Oil of Gaultheria.) 
Trimethylamine. 2 



Chinoline. 1 

Resorcm. 1 

Kairine. 1 , 4 

Kairoline. *,* 

Antipyrine. l ,i 

Hvdroquinone. 1 

Thallm.y 

Pyrocatechin. 1 

Pheno-resorcin. 1 

Camphor. 1 

Eucalyptol. 1 

Thymol. 1 

Other Essential Oils. 1 

Alcohol i, 3 

Digitalis. 2 



Aconite. 2 
Antimonials. 2 , 4 
Veratrine. 2 
Colchicum. 2 
Leeching. 2 
Cupping. 2 
Blistering. 2 
Poulticing. 2 
Nitrous Ether, 3 , 4 
Dover's Powder. 4 
Cold Bath.* 
Cold Drinks. * 
Ice to Surface. 5 
Cold Sponging. 5 
Wet Packing. 5 



422 AGENTS ACTING UPON EXCRETION 

Purgation and Venesection produce antipyretic results, but their mode of 
action is doubtful (Brunton). For the action of some unofficial antipyretics, 
see page 151. 

Antiphlogistics (dvri, against, (pXeya), to burn), — are measures 
and medicines which are supposed to have some specific power 
in reducing inflammation. The term is becoming obsolete, but 
frequent references are seen yet to the influence of Mercury and 
Opium in inflammations of serous membranes, Antimony and 
Aconite in inflammations of the respiratory tract and organs, 
and to the power of Veratrum Viride over puerperal metritis. 
The chief antiphlogistics are the following: — 

Aconite. Digitalis. Venesection. 

Veratrum Viride. Ergot. Local Depletion. 

Tartar Emetic. Ipecacuanha. Purgation. 

Mercury. Potassium Nitrate. Counter-irritation. 

Opium. Rest, recumbent position. Cold. 

Antiperiodics are remedies which affect certain periodical 
febrile diseases, lessening the severity of their paroxysms or pre- 
venting their return. They act probably by arresting the devel- 
opment in the blood of successive crops of pathogenic organisms, 
upon which the disorders are supposed to depend. The principal 
antiperiodics are : 

Cinchona Bark and its Alkaloids. Arsenic. 

Bebeeru Bark and its Alkaloid. EucalyptoL 

Salicin, Salicylic Acid, Salicylates. Iodine. 



Agents Acting upon Excretion. 

Diuretics {dwopriat^, urination), — are remedies which increase 
the renal secretion. They may act in several ways, namely: — 

1. By raising the general blood-pressure by contraction of efferent vessels 

or vessels in other regions of the body. 

2. By dilating the renal arteries and increasing the renal blood-supply, 

raising the pressure in the glomeruli. 

3. By stimulating the secreting nerves or cells of the kidney. 

4. By simply washing out the kidneys, as by Water in quantity. 

The following list contains the most important agents of this 
class, which are usually subdivided into the two groups indicated 
by the sub-titles. The numbers refer to the action of the drug 
in the # above synopsis: 



AGENTS ACTING UPON EXCRETION. 



423 



Refrigerant Diuretics. 
Potassium Acetate. 3 
Potassium Bitartrate. 3 
Potassium Citrate. 3 
Potassium Chlorate. 3 
Potassium Nitrate. 3 
Sodium Acetate. 3 
Sodium Chloride. 3 
Digitalis. 1 , 2 
Ery throphlceum . 1 
Caffeine. 3 
Broom. 3 
Squill.1, 2 
Nitrites. 2 
Colchicum. 3 
Strychnine. 1 
Stigmata Maidis. 1 , 2 



Stimulant Diuretics. 



Alcohol. 2 

Cantharides. 3 

Turpentine. 3 

Juniper. 3 

Savine. 3 

Copaiba. 3 

Cubebs. 3 

Pepper.3 

Matico. 3 • 

Kava. 3 

Guaiac. 3 

Parsley. 3 

Taraxacum. 3 

Jaborandi. 3 

Dulcamara. 3 

Bryonia. 3 



Gin. 2 

Carrot. 3 

Fennel. 3 

Mustard. 3 

Asparagus. 3 

Uva Ursi. 3 

Buchu. 3 

Sarsaparilla. 3 

Pareira. 3 

Chimaphila. 3 

Santonica. 3 

Lobelia. 3 

Aconite. 3 

Tobacco. 1 , 3 

Volatile Oils. 3 

Oleo-resins. 3 



Diuretics are employed for the following purposes, namely, 
(1) to remove the excess of fluid in dropsies, — (2) to hasten the 
elimination of waste products and other poisonous substances 
from the blood, — (3) to dilute the urine. In — 

Cardiac Dropsy, — or other dropsies due to venous congestion, the best 
diuretics are those which act on the general vascular system, as Digitalis, 
Squill, etc. 

Dropsy from Renal Disease, — Broom, Nitrous Ether, Oil of Juniper, Digi- 
talis and Squill are the most reliable diuretics in the order named. 

Hepatic Dropsy, — Copaiba is considered especially suitable. In this and 
the previous form a little Pil. Hydrargyri occasionally often aids the diuretic 
action of other agents. 

To Eliminate Solids, — Potassium Nitrate and Bitartrate, Turpentine, Ju- 
niper, Caffeine, etc., are the most efficient. [Compare Antilithics.] 

To Dilute the Urine, — Water is the best diuretic, and the most efficient 
form is Distilled Water acidified with Carbonic Acid Gas. 



Renal Depressants, — are such agents as directly diminish 
the activity of the renal cells and lessen or suspend the secretion 
of urine. Morphine, Quinine and Ergot act in this way through 
the circulation, and Digitalis, instead of acting as a diuretic, may 
arrest the renal circulation by stimulating the vaso-motor centre 
and thus contracting the vessels stopping the secretion altogether 
(Brunton). 

Alkalinizers of the Urine, — are agents which produce an 
alkaline reaction to the urine when taken internally. They in- 
clude the alkalies, particularly Potassium and Lithium salts, but 
excepting Ammonia, which is broken up in the organism. Sodium 
salts, being excreted partly by the bile and the bronchial mucus, 
and partly locked up in the system as the neutral chloride, while 
the Urate of Sodium is insoluble, are not as efficient in this re- 



424 AGENTS ACTING UPON EXCRETION. 

gard as are other alkalies. Fruits, milk and fish also act in the 
same manner by means of the salts which they convey into the 
economy. 

Acidifiers of the Urine, — are Benzoic and Salicylic 
Acids, and Vegetable Acids in excess, also excess of proteids, 
sugar and starch in the food, and certain wines and spirits. The 
Mineral Acids have little or no influence on the acidity of the 
urine, being excreted as neutral sulphates, chlorides, phosphates, 
etc. 

Vesical Sedatives, — are substances which lessen irritability 
of the bladder, relieving pain and decreasing the desire to mic- 
turate. Opium, Belladonna, Hyoscyamus, Stigmata Maidis, 
Cannabis, etc., lessen the irritability of the nerves, Carbonate of 
Lime that due to the presence of calculi, — and mucilaginous 
drinks, such as Barley-water or Linseed tea, also astringents like 
Buchu, Uva Ursi, Pareira, etc., diminish the irritation due to 
chronic cystitis, and antiseptics as Copaiba and Cubebs, also act 
in like manner. 

Vesical Tonics, — increase the contractile power of the mus- 
cular fibres in the wall of the bladder. Cantharides, Potassium 
Bromide, Strychnine and Belladonna are the most prominent 
members of this class. 

Urinary Sedatives and Astringents, — act upon the whole 
extent of the genito-urinary mucous membrane through the con- 
tact of the urine charged with them when administered internally. 
Some of the members of this class may be administered locally, 
as to the urethral and vesical mucous membranes, which are acces- 
sible to local medication. 

Instances of the application of these agents are in the use of Potassium 
and Lithium Salts to diminish the acidity of the secretion, — Cubebs, Copaiba 
and Sandal-wood Oil as antiseptics and astringents, — and urethral injections 
of Alum, Acetates of Zinc and Lead, Boracic Acid, Chloral and Zinc Chlo- 
rides, etc., for a similar purpose. Copaiba is one of the most efficient agents 
for rendering the urine antiseptic, and should be more employed in cystitis 
and urethritis than it is. Oil of Eucalyptus is nearly as efficient, and Stigmata 
Maidis (Corn Silk), in tincture, is beginning to be well thought of for a gen- 
eral alterative influence on the urinary tract. 

Antilithics or Lithontriptics (oyri, against, Xt&os, a stone, 
rpi l 3o) ) to wear down), — are agents supposed to prevent the forma- 



AGENTS ACTING UPON EXCRETION. 425 

tion of concretions in the excretory passages (antilithics), or to 
dissolve them when formed (lithontriptics). The terms are gen- 
erally restricted to remedies affecting the urinary calculi, but 
those directed against the biliary form are included in this ar- 
rangement for the sake of consistent classification. The chief 
agents coming under this title are — 

Biliary Calculi. Uric Acid or Urates. 

Ether and Turpentine. Distilled Water. 

(Durande's Solvent.) Alkalies, Potash or Lithia. 

Sodium Bicarbonate. Potassium Salts. 

Sodium Salicylate. Lithium Salts. 

Sodium Phosphate. Potassium Tartraborate. 

Castile Soap. Magnesium Citroborate. 
Alkaline Waters, especially Vichy. 

Oxalate of Calcium. Phosphatic Calculi. 

Dilute Nitro-Hydrochloric Acid. Ammonium Benzoate. 

Benzoic Acid. 
Dilute Nitric Acid. 

There is probably little or no solvent value to the agents recommended for 
biliary calculi. In the case of Uric Acid the administration of Potash or 
Lithia is based on their combining with the acid forming the calculus, and 
forming Urate of Potassium or Lithium, which salts are more soluble than the 
Uric Acid itself. 

Diluents (diluo, to dilute), — are agents which dilute the ex- 
cretory fluids after their absorption and enable the latter to hold 
more solid material in suspension. Water is the one true diluent, 
whatever form it may be disguised in, as teas, weak fluid foods, 
acid drinks, etc. 

Diaphoretics and Sudorifics (dlayopiu), to carry through ; 
sudor, sweat, facto, to make), — are remedies which increase the 
action of the skin and promote the secretion of sweat. When 
they act energetically, so that the perspiration stands in beads 
upon the surface they are known as Sudorifics. They may be 
subdivided into the following groups, viz. — 

1. Simple Diaphoretics, which enter the circulation and are eliminated by 
the sudoriferous glands, which they stimulate to increased action. 

2. Nauseating Diaphoretics, which produce relaxation and the dilatation 
of the superficial capillaries. 

3. Refrigerant Diaphoretics , which reduce the circulation, at the same time 
acting directly on the sweat centres in the spinal cord and medulla. 

The principal diaphoretics are enumerated as follows, the figures 
referring to their supposed mode of action as indicated above, viz. 

36 



426 



AGENTS ACTING ON THE GENERATIVE SYSTEM. 



Jaborandi. 1 , 8 

Pilocarpine. 1 , 3 

Salicylic Acid. 1 

Salicylates. 1 

Ipecacuanha. 2 

Tartar Emetic. 2 

Sulphur.i 

Opium. 2 ,? 

Camphor. 1 

Tobacco. 2 , 3 



Ether. 2 , 3 
Alcohol. 2 , 3 
Nitrous Ether. 2 , 3 
Ammonium Acetate. 1 
Ammonium Citrate. 1 
Dover's Powder. 2 
Aconite. 3 
Veratrum Viride. 3 
Potassium Salts. 3 
Mezereon. 1 



Lobelia. 2 , 3 
Sarsaparilla. 1 
Guaiacum. 1 
Serpentaria. 1 
Sassafras. 1 
Senega. 1 
Vapor Bath. 2 
Turkish Bath. 2 
Wet Pack. 2 * 
Warm Drinks. 2 



Anhidrotics (&>, without, idpws, sweat), — are agents which 
check perspiration. They may act — 

1. By depressing the action of the sweat-glands. 

2. By depressing the excitability of the sweat-centres. 

3. By reducing the circulation in the skin. 

The most important agents of this class are the following- 
named, the figures indicating their mode of action as above ar- 
ranged, viz. : — 

Belladonna. 1 

Atropine. 1 

Hyoscyamus. 1 

Stramonium. 1 

Muscarine. 2 

Agaricus Albus. 2 

Strychnine, Atropine, Dover's Powder, Jaborandi, Picrotoxin and Zinc 
Salts, are all respiratory stimulants, and very efficient against the sweating of 
phthisis, though most of them are classed as diaphoretics. This is explained 
on the theory of accumulation of Carbonic Acid in the blood by depressed 
respiration caused by severe coughing, this stimulating the sweat centres, and 
being opposed by agents which stimulate the respiratory centre. 



Acids, locally. 3 

Jaborandi. 

Pilocarpine. 

Nux Vomica. 

Strychnine. 

Ergot. 3 



Quinine ? 
Picrotoxin. 
Dover's Powder. 
Opium. 2 
Zinc Salts.3 
Local Cold. 3 



Agents Acting on the Generative System. 



Aphrodisiacs (^Acppodirr), Venus), — are medicines which 
stimulate the sexual appetite and power. They act by reflex or 
central action upon either the cerebral or the spinal genital centre. 
Tonics are indirectly aphrodisiac, as are all measures which pro- 
mote the general bodily nutrition. The chief agents used as 
direct aphrodisiacs may be enumerated as follows, viz. : — 



Nux Vomica. 


Cimicifuga. 


Ergot. 


Strychnine. 


Serpentaria. 


Iron. 


Cannabis. 


Sanguinaria. 


Alcohol. 


Cantharis. 


Opium (at first). 


Bitter Tonics, 


Phosphorus. 


Camphor (at first). 


Flagellation. 


Aurum. 


Damiana (?). 


Meat Diet. 



AGENTS ACTING ON THE GENERATIVE SYSTEM. 



427 



Strychnine acts by increasing general nutrition and exalting the reflex ex- 
citability of the genital centres. Hemp probably only causes a mild delirium 
which may or may not take a sexual direction. Cantharides acts by direct 
irritation of the mucous lining of the urethra, and is dangerous in aphrodisiac 
doses. Alcoholin small doses excites the genital centre in the brain ; so, also, 
Opium and Camphor, the latter being decidedly anaphrodisiac after a time. 
The power of Damiana is doubtful. Urtication and Flagellation of the nates 
produce priapism by irritation of the genital centre in the cord through the 
sensory nerves of the part. Ergot is considered useful by contracting the 
dorsal vein of the penis, preventing its emptying too rapidly. 



Anaphrodisiacs (&v, without, J A<ppodirq, Venus), — are medi- 
cines and measures which lower the sexual function and diminish 
the sexual appetite. They act by lessening the excitability of the 
nerves of the genital organs, by depressing the genital centres in 
the brain and cord, or by decreasing the local circulation. The 
principal anaphrodisiacs are enumerated as follows, viz. : — 



Potassium Bromide. 
Ammonium Bromide. 
Potassium Iodide. 
Camphor (at last). 
Opium (at last). 
Lupulin. 



Tobacco. 

Digitalis. 

Conium. 

Belladonna. 

Stramonium, 

Gelsemium. 



Nauseants. 
Purgation. 
Venesection. 
Ice, locally. 
Cold Baths. 
Vegetable Diet 



Emmenagogues (gpfajviu, the menses, ayw 9 to move), — are 
remedies which restore the menstrual function, either directly by 
stimulation of the uterine muscular fibre, or indirectly by im- 
proving the blood and toning up the nervous system. The direct 
emmenagogues are ecbolic in large doses. The principal members 
of this class are those enumerated in the following list, viz. : — 



Direct Emmenagogues. 



Ergot. 

Quinine. 

Savine. 


Rue. 

Apiol. 
Borax. 


Digitalis. 
Cantharis. 


Myrrh. 
Guaiacum. 


Pulsatilla. 
Asafetida. 
Alcohol. 


Polygonum Hydrop, 
Potass. Permang. 
Cimicifuga. 



Indirect Emmenagogues. 

Iron. Manganese. 

Cinnamon. Strychnine. 
Aloetic Purgatives. 
Cod-liver Oil. 
Hot Hip-baths. 
Leeching the genitals. 
Rubefacients to thighs. 
Tonic remedies. 



Oxytocics or Ecbolics (of 6c, quick, roxoq, childbirth ; 
ixftolrj, abortion), — are agents which stimulate the muscular fibres 
of the gravid uterus to contraction, and produce abortion. In 
small doses the same remedies are emmenagogue as a rule. Their 
mode of action has not been clearly made known, but it is gen- 
erally believed to be due in some cases to direct stimulation of 



428 AGENTS ACTING ON THE GENERATIVE SYSTEM. 

the uterine centre in the cord, in others to congestion of the 
uterus producing reflex stimulation. The principal oxytocics are 
those enumerated in the following list, viz. : — 

Ergot. Quinine. Oil of Rue. 

Ustilago. Borax. Pilocarpine. 

Savine. Cotton-root Bark. Viscum Flavescens. 

Any drastic purgative, or gastro-intestinal irritant, may produce abortion 
by reflex action. The Volatile Oils act in this manner, also Colocynth and 
many other agents used by women to produce abortion, as Tansy , Pennyroyal, 
etc., all of which are dangerous to life in doses sufficient to excite the action 
of the gravid uterus. 

Uterine Depressants lower the activity of the nervo-mus- 
cular apparatus which controls the uterine contractions. The 
most important of these agents are : — 



Opium. 


Chloral. 


Tobacco. 


Bromides. 


Chloroform. 


Sulphate of Copper. 


Cannabis. 


Tartar Emetic. 


Emetics. 



Uterine Tonics and Alteratives, — are medicines which 
are considered to have such specific influence over the uterus. 
Authorities differ very much regarding the value of these agents, 
but those enumerated in the following list are generally consid- 
ered to have considerable value in uterine therapeutics, viz. : — 

Uterine Tonics. Uterine Alteratives. 

Potassium Bromide. Iodine. 

Potassium Chlorate. Iodoform. 

Pulsatilla. Iodized Phenol. 

Helonias Dioica. Glycerin. 

Cimicifuga. Hydrastis. 

Savine. Silver Nitrate. 

Astringents (locally). Galvanism. 

Those in the first list, except Astringents, are used internally; those in 
the second column as topical applications to the uterine cavity or cervix. 

Galactagogues (jdka, milk, ayw, to bring away), — are medi- 
cines which increase the lacteal secretion, as Ricinus, Tea, Anise, 
Fennel, Potassium Chlorate, etc. The value of many so-called 
galactagogues is extremely doubtful, the best being the local ap- 
plication of the leaves of the Castor-oilplant (Ricinus communis), 
and a good black Tea internally, with Milk, Beer or Porter as a 
beverage. Pilocarpus comes the nearest to being a true galacta- 
gogue, but its influence is very transient. 



AGENTS ACTING ON THE CUTANEOUS SURFACE. 429 



Agents Acting on the Cutaneous Surface. 

Irritants are substances which, when applied to the skin, 
produce a greater or less degree of vascular excitement. When 
used to produce a reflex influence on a part remote from their 
site, they are termed Counter-irritants, and may be subdi- 
vided into the following groups, viz. — 

Rubefacients (rubefacio, to make red), — produce temporary 
redness and congestion of the skin, unless left too long in contact 
with the surface, when they may cause exudation between the 
cuticle and the true skin (vesicants), or may destroy the tissue 
and form a slough (escharotics). 

Vesicants, Epispastics or Blisters, — produce decided inflamma- 
tion of the skin, and outpouring of serum between the epidermis 
and derma. Cantharides is the agent generally used for this 
purpose. 

Pustulants, — affect isolated parts of the skin, as the orifices of 
the sudoriferous glands, giving rise to pustules. 

The following list embraces the principal agents and measures 
belonging to these groups, viz. — 

Rubefacients. Vesicants. 

Mustard. Cantharides. 

Capsicum. Euphorbium. 

Camphor. Mezereon. 

Ammonia. Iodine. 

Mezereon. Rhus Toxicodendron. 

Arnica. Ammonia (the confined vapor). 

Alcohol. Glacial Acetic Acid. 

Ether. Volatile Oil of Mustard. 

Chloroform. Heati Boiling Water. 

Iodine. \ Corrigan's Hammer. 
Menthol. 

Oil of Cajuput. Pustulants. 

Oil of Turpentine. Croton Oil. 

Volatile Oils. Tartar Emetic. 

Pitch. Ipecacuanha. 

Friction. Silver Nitrate. 
Hot Water. 

Escharotics or Caustics (k<T%dpa, a slough or scab ; xa\w, to 
burn), — are agents which destroy a tissue to which they are 
applied, and produce a slough. They act usually in one of three 
modes, viz. — 

1 . By abstracting the water of the tissue. 

2. By combining with the albumen of the part. 

3. By corrosive oxidation. 



430 



AGENTS ACTING ON THE CUTANEOUS SURFACE. 



The principal escharotics are enumerated in the following list, 
the numbers affixed to each pointing out its mode of action as 
stated above. 



Mineral Acids. 1 
Glacial Acetic Acid. 1 
Carbolic Acid. 1 
Chromic Acid. 3 
Arsenious Acid. 1 
Antimony Chloride. 1 



Caustic Potash. 1 
Caustic Soda. 1 
Lime. 1 

Dried Alum. 2 
Silver Nitrate. 2 
Copper Sulphate. 



Mercuric Chloride. 2 
Mercuric Oxide. 2 
Mercuric Nitrate. 2 
Zinc Sulphate. 2 
Zinc Chloride. 2 
Bromine. 3 



Astringents {ad, to, stringa, to bind), — are agents which 
produce contraction of muscular fibre and condensation of other 
tissues, the first probably by direct irritation, the second by pre- 
cipitating its albumen and gelatin. They also lessen secretion 
from mucous membranes. The principal astringents may be 
enumerated as follows, viz. : — 



Acids. 


Tannic Acid. 


Bismuth Subnitrate, etc, 


Alcohol. 


Gallic Acid. 


Cadmium Sulphate. 


Alum. 


Catechu. 


Copper Sulphate. 


Chalk. 


Galls. 


Ferric Chloride. 


Lime. 


Kino. 


Lead Acetate. 


Creasote. 


Oak-bark. 


Silver Nitrate. 


Carbolic Acid, 


Uva-Ursi. 


Zinc Sulphate. 



Gallic Acid and Acetate of Lead are examples of Remote Astringents, acting 
on internal organs through the blood. Those which affect the part to which 
they are applied are Local Astringents, and include most of those enumerated 
above. 



Styptics or Hemostatics {<ttu<p(o., to contract \ al/ia, blood, 
azdatq, a standing), — are agents which arrest hemorrhage, Styptics 
being those which are applied locally, and Hemostatics those 
which are administered internally. Some of the former act 
mechanically, by promoting the formation of a clot in the 
mouths of the bleeding vessels ; others cause the vessels them- 
selves to contract, checking the flow of blood. The principal 
members of this class are the following-named : — 



Styptics. 



Acids. 
Alum. 
Cautery. 
Collodion. 
Ferric Chloride. 
Ferric Sulphate. 
Silver Nitrate. 



Cold. 
Matico. 
Spider's-web. 
Tannic Acid. 
Lead Acetate. 
Zinc Sulphate. 
Vegetable Astringents. 



Hemostatics, 

Ergot. 

Digitalis. 

Gallic Acid. 

Lead Acetate. 

Dilute Mineral Acids, 

Ipecacuanha. 

Hamamelis. 

Oil of Turpentine. 



AGENTS ACTING ON MICROBES, FERMENTS, ETC. 43 1 

Emollients (emollio, to soften), — are substances which soften 
and relax the tissues to which they are applied. They relieve 
tension, dilate vessels, diminish pressure on the nerves, and pro- 
tect inflamed surfaces from the air and from friction. The prin- 
cipal articles which may be classed under this heading are the 
following: — 

Hot Fomentations. Linseed Oil. Petrolatum. 

Poultices. Olive Oil. Soap Liniment. 

Glycerin. Spermaceti. Starch. 

Lard. Almond Oil. Cacao Butter. 

Demulcents (demulceo, to soothe), — are substances generally 
of a mucilaginous nature, which soothe and protect the parts to 
which they are applied. This term is generally used for substances 
employed for mucous membranes, and the term Emollients for 
similar agents used on the skin. The chief agents belonging to 
this class are — 



Acacia. 


Starch. 


Honey. 


Olive Oil. 


Cetraria. 


Glycerin. 


Marsh-mallow. 


Isinglass. 


Barley. 


Flaxseed. 


White of Egg. 


Tragacanth 


Liquorice. 


Gelatin. 


Almond Oil. 


Bland Oils. 



Protectives, — are agents of a mechanical nature, employed 
to cover and protect an injured part from the air, water, etc. 
Collodion and Gutta-percha are those in general use, but certain 
plasters, as the Adhesive, the Lead or the Soap Plaster, may be 
employed for this purpose, also Cotton Wool. 



Agents Acting on Microbes, Ferments, etc. 

Antizymotics (&vt\, against, £ui±u)Giq y fermentation), — are 
agents which arrest fermentative processes, which may depend 
upon the action of organic ferments (enzymes), as diastase, ptya- 
lin, pepsin, etc., or upon that of organized ferments, as the yeast- 
plant, bacteria, etc. The Antizymotics may be subdivided into 
two groups, Antiseptics and Disinfectants. 

Antiseptics {avri, against, <7^r:xo?, putrefaction), — prevent or 
retard septic decomposition, by destroying the bacilli which 
produce it, or by arresting their development. The chief anti- 
septics are — 



432 AGENTS ACTING ON MICROBES, FERMENTS, ETC. 

Mercuric Chloride. Carbolic Acid. 

Mercuric Iodide. Creasote. 

Mercuric Oxide. Alcohol. 

Potassium Permanganate. Eucalyptol. 

Sulphurous Acid. Quinine. 

Sulphites and Hyposulphites. Salicin. 

Sulpho-carbolates. Thymol. 

Potassium Chlorate. Borax. 

Zinc Chloride. Chlorine. 

Disinfectants, destroy the specific germs of communicable 
diseases, many of which belong to the microbe class, hence many 
antiseptics are also disinfectants. They act in several modes, 
some as oxidizants, others by combining with albumen, others by 
chemical combination forming substitution-compounds, others by 
arresting molecular changes, and still others by altering the reac- 
tion of the media containing the germs. The principal disinfect- 
ants are — 

Heat, 230°-250° F. Aluminium Chloride. Iodine. 

Sulphurous Acid Gas. Zinc Chloride. Bromine. 

Nitrous Acid Gas. Carbolic Acid. Lime. 

Chloride of Lime. Potass. Bichromate. Ferrous Sulphate. 

Mercuric Chloride. Potass. Permanganate. Zinc Sulphate. 

Condy's Fluid is an aqueous Solution of Potassium Permanganate, 2 parts 
in ioo, or gr. 176 in §xx. Burnetfs Fluid is a solution of Zinc Chloride, 
containing about 50 per cent, of the salt, and equivalent to the official Liquor 
Zinci Chloridi. Labarraque's Solution is the official Liquor Sodae Chloratae. 

Deodorants, — are agents which destroy foul odors. The Vol- 
atile Deodorants are chiefly oxidizing and deoxidizing substances, 
acting chemically on the obnoxious gases ; while the Non-volatile 
ones are mainly absorbents, which condense and decompose the 
effluvia. The deodorants in general use are the following- 
named: — 

Chlorine Gas. Ozone. 

Sulphurous Acid Gas. Charcoal. 

Nitrous Acid Gas. Earth. 

Peroxide of Hydrogen. Lime. 

Potassium Permanganate. Ferrous Sulphate. 

Parasiticides (jzapafTiroq, a parasite, ccedo, to kill), — are agents 
which destroy the animal and vegetable parasites found upon the 
human body. They are generally applied in the form of lotions, 
ointments or oleates, and include the following substances, viz. — 

Sulphur. Mercury. Carbolic Acid. 

Sulphides. Ammoniated Mercury. Petroleum. 

Sulphurous Acid. Mercuric Chloride. Storax. 

Iodide of Sulphur. Mercuric Nitrate. Staphisagria. 

Iodine. Mercuric Oxide. Balsam of Peru. 



AGENTS ACTING UPON EACH OTHER. 433 



Agents Acting upon Each Other. 

Antidotes and Antagonists are terms frequently con- 
founded with each other, and rarely defined with sufficient lucid- 
ity to enable a clear distinction to be drawn between them. An 
Antidote is a substance which affects a poison either physically or 
chemically, or both, and in such a manner as to remove the poison 
from the body or to form with it an insoluble salt or an inert 
compound, with the object of preventing its toxic action upon the 
organism. 

Thus, Tannic Acid is an antidote to Digitalis, as it forms therewith a com- 
pound (tannate), which is soluble with difficulty and therefore comparatively 
innocuous. But as this tannate is not wholly inert, another antidotal measure 
must be employed, viz. — evacuation of the stomach, which may be accom- 
plished by the administration of Zinc Sulphate or any other emetic, or by the 
use of a stomach-pump. 

Antagonists, on the other hand, are agents which directly 
oppose each other in some or all of their physiological actions, 
and may be used against each other to counteract their effects on 
the system. Antidotal action takes place in the alimentary canal, 
and is applicable to vegetable as well as mineral poisons. 
Antagonism takes place in the blood and tissues, and so far as 
antagonistic drugs are concerned, is applicable almost wholly to 
vegetable poisons, as these produce their effects after absorption. 
The heart and respiratory apparatus are the principal objective 
points for the antagonism of drugs, but the spinal cord, the cere- 
brum, muscular tissue and the glandular system are also affected 
by most of them. 

Antagonistic Measures are such proceedings as may tend to 
antagonize certain effects of poisons, and include Artificial Respi- 
ration, — Faradism of the respiratory muscles, — Constant motion, 
— Douching, — Rest, etc. 

Thus, to refer to the case of Digitalis again, Saponin and Senegin are its 
most complete physiological antagonists, their counteraction extending through- 
out the whole range of its effects. Aconite and Morphine antagonize its cardiac 
action, the former being considered the best antagonist to the effects of large 
doses, and the latter to those of its long-continued use. Alcohol is also indi- 
cated in Digitalis-poisoning, and absolute Rest in the recumbent posture is an 
antagonistic measure of great importance, by reason of the liability of the heart 
to cease its action on assuming the erect position, when much lowered by the 
drug. 

In the treatment of poisoning, whether from mineral or vege- 
table substances, the first indication is to administer the appro- 
priate chemical antidote, so as to render the poison harmless or 



434 AGENTS ACTING UPON EACH OTHER, 
i 

comparatively so. Next, the stomach should be emptied and 
washed out, lest the newly-formed compound be absorbed after a 
time, and to remove any of the poison which may have escaped 
the action of the antidote. Next, the antagonist should be 
administered, in order to counteract the effects of such portion of 
the poison as may have been absorbed. Lastly, the appropriate 
antagonistic measures should be employed to sustain the action of 
any organic function which may show signs of failure. In most 
cases of alkaloidal poisoning absorption has proceeded so far 
before assistance is obtained that antidotes are of no value, and 
reliance can only be placed upon the physiological antagonist and 
such supporting measures as will tend to maintain vitality until 
the poison has been eliminated by the natural channels. 

In the previous pages the antidotes and antagonists for each 
poisonous substance in the Materia Medica are enumerated under 
their proper titles, and in the Appendix the same agents are tabu- 
lated in a suitable form for reference. A few examples are 
appended below, to illustrate the principles above stated, and to 
point out some of the most prominent instances of physiological 
antagonism at present known. 

Atropine, Belladonna, etc. 

Antidotes, — Tannic Acid, to form an insoluble tannate. Zinc Sulphate, as 
an emetic, or Apomorphine hypodermically, or the stomach-pump. Purga- 
tion. Antagonists, — Muscarine (see page 49). Physostigmine. Pilocarpine, 
Morphine. Quinine. Aconite (see page 96). Antagonistic Measures, — Artifi- 
cial respiration. Faradism of respiratory muscles. 

Strychnine, Nux Vomica and Ignatia. 

Antidotes, — Animal Charcoal suspended in water. Emesis, as above-men- 
tioned. AntagQMistsJ&QniQraX, or Chloroform, to muscular relaxation (see 
page 138). CurareV^5ytrit?oi"Amyl. Bromide of Potassium. Antagonistic 
Measures, — Artificial Respiration. Perfect quiet. 

Morphine and Opium, 
Antidotes, — Emesis or stomach-pump. Antagonists, — Atropine (see page 
281). Black Coffee. Caffeine. Ammonia, inhaled. Amyl Nitrite. Antagonistic 
Measures, — Cold douche. Artificial respiration. Continued movement. 

Potassium Cyanide. 
Antidotes, — Sulphate of Iron, to form Prussian Blue. Emesis. Antago- 
nists, — Atropine. Ammonia. Alcohol. Antagonistic Measures, — Artificial 
respiration. Faradism. 

Arsenic and its Compounds. 

Antidotes, — Hydrated Oxide of Iron (see pages 87 and 191). Dialyzed 
Iron. Magnesia. Chalk. Lime-water. Emetics, or stomach-pump. Oil or 
Mucilage to protect the mucous membranes. Diluents. Iodide of Potassium, 
to promote elimination. Antagonists, — none. 



PART II. 



PHARMACY AND PRESCRIPTION WRITING. 



Pharmacy (<pdpi±axov, a medicament), — may be defined as the 
art of selecting and preserving medicines, and preparing them 
for administration. It may be divided into — 

Official or Galenical Pharmacy, — dealing with the processes 
and preparations of the Pharmacopoeia ; and — 

Extemporaneous or Magistral Pharmacy, — which includes the 
operations of compounding and dispensing remedies as directed 
by the prescriptions of physicians. 

Pharmacopoeias and Dispensatories. 

A Pharmacopoeia is an official list of the drugs and their 
preparations recognized by the medical profession of a certain 
country. In foreign countries the Pharmacopoeias are published 
under government auspices and have the force of a legal standard ; 
in the United States its publication is left to the medical and 
pharmaceutical professions and is revised every ten years by a 
convention called for that purpose. The principal official Phar- 
macopoeias, with their dates of latest revision or additions, are the 
following, viz. — 

Pharmacopoeia of the United States of America, 1882. 

British Pharmacopoeia, 1885. 

Pharmacopcea Germanica, 1882. 

Codex Medic amentarius (Pharmacopee Fran false), 1884. 

Besides the above there are the Russian (P. Rossica, 1880) ; the Austrian 
(P. Austriaca, 1869); the Swedish (P. Suecica, 1869); the Norwegian (P. 
Norvegica, 1879; the Danish (P. Danica, 1868, 1874, 1876); the Belgian 
(P. Belgica, 1881) ; the Swiss • (P. Helvetica, 1872, 1876); the Spanish (F. 
Espafiola, 1865); the (Portuguese P. Portugueza, 1876); the Hungarian (P. 
Hungarica, 1871); the Netherlands' (P. Neerlandica, 1 871) ; the Roumanian 
(P. Romana, 1862); the Finnish (P. Fennica, 1863); the Greek (P. Hel- 
lanica, 1868); the Mexican (Nueva Farmacopea Mexicana, 1884); and the 



43^ THE CONSTITUENTS OF VEGETABLE DRUGS. 

Pharmacopoeia of India, 1868, 1869. Italy, Chili and Japan are each about to 
issue a national pharmacopoeia. 

A Dispensatory is a commentary on one or more pharma- 
copoeias, giving in extenso the physical and medicinal history of 
the drugs and preparations, together with their doses, physiologi- 
cal action and therapeutics, and includes similar information 
about many drugs which are not official in any pharmacopoeia, 
but are of occasional use or general interest. A dispensatory is 
a private publication, of authority according to the reputation of 
its author. The principal Dispensatories published in the English 
language are the two following, viz. — 

United States Dispensatory, 15th edition, edited by Wood, 
Remington and Stadtler. J. B. Lippincott & Co., Philadelphia. 

National Dispensatory, 3d edition, edited by Stille and Maisch. 
Lea Bros. & Co., Philadelphia. 

American Dispensatory, King & Lloyd, Cincinnati, is the organ of the 
" Eclectic" school of physicians. 

Companion to the U. S. Pharmacopoeia, Oldberg and Wall, William Wood 
& Co., New York, is an excellent commentary on official and unofficial drugs. 



THE CONSTITUENTS OF VEGETABLE DRUGS. 

The constituents of vegetable drugs may be classified as soluble 
and insoluble, the first group containing those ingredients which 
may be extracted by suitable menstrua, the second such as resist 
the action of all ordinary solvents. 

The Soluble Constituents comprise both inert and active 
principles, the inert being chiefly starch, gum and pectin, which 
may be readily separated by water. The active principles are 
alkaloids, acids, salts, glucosides and other neutral principles, 
volatile oils, resins, etc. Some few of these may be extracted by 
Water alone {e. g. Morphine), and in some cases the addition of 
acids or alkalies to the water will effect the chemical solution of 
many ingredients which are insoluble in water alone. As a rule, 
however, Alcohol is the most generally applicable of all simple 
solvents, but from its hardening the cell-membranes instead of 
softening them it prevents the osmosis of their contents. Drugs 
subjected to alcoholic or ethereal menstrua should have their 
cells thoroughly broken or torn, so that the solvent may be 
brought into actual contact with the principles contained in 
them. The degree of disintegration required depends upon the 
size of the cells, ducts, tubes, intercellular spaces, etc., in which 



OFFICIAL OPERATIONS. 437 

the active principles are enclosed. A very finely powdered state 
is however open to objection from the packing of the particles 
together into an almost impenetrable mass when treated by the 
solvent. The average size of vegetable cells is about -^-$ of an inch, 
while resin cells and other cavities are larger, averaging perhaps 
about T i-jj inch. The Pharmacopoeia prescribes in each instance the 
degree of fineness of the powdered drug employed in making 
certain of its preparations, or its bruising, slicing, etc., when 
such operations will answer. [Compare the article on Comminu- 
tion in the following section.] 

The Insoluble Constituents are cellulose, lignin and scler- 
ogen, which make up the cell- walls of vegetable substances, and 
are extremely intractable. 



OFFICIAL PHARMACY. 

OFFICIAL OPERATIONS. 

The official operations are those processes which are directed 
in the pharmacopoeia to be used in the preparation of medicines. 
Many of them are processes which are common to both chemistry 
and pharmacy, as precipitation and crystallization, — while others 
are peculiar to pharmacy, as percolation, trituration, etc. The 
most important of the pharmaceutical operations are briefly de- 
scribed below ; for full details of the various apparatus used the 
student is referred to the more exhaustive treatises on Pharmacy. 

Vaporization includes the various operations by which vola- 
tile matters are separated from fixed substances or from other 
matters which are less volatile, heat at varying temperatures being 
the agent used. The operations under this head are — Evapora- 
tion, Distillation, Desiccation, and Sublimation. 

Evaporation in Pharmacy is the process by which the more 
volatile constituents of a liquid are driven off by heat for the 
purpose of reducing its volume or of purifying it, as in the prep- 
aration of extracts and fluid extracts, the crystallization of salts, 
etc. The vessels used should be shallow so as to expose a large 
surface of the liquid to the atmosphere. The heat used may be 
regulated by a water-bath, a steam-bath or sand-bath, and ordi- 
narily should be kept below but near to the boiling point of the 
liquid treated. As organic substances are usually injured b'y long 
heating, small portions only of vegetable preparations should be 



43^ OFFICIAL OPERATIONS. 

subjected to this process, and the liquid should be frequently- 
stirred in order to hasten the operation. In large laboratories 
vacuum-pans are employed to remove the atmospheric pressure, 
enabling the evaporation to be accomplished at a much less de- 
gree of heat than if the liquid were exposed to the air. Ebulli- 
tion or Boiling is a form of evaporation. 

Spontaneous Evaporation is the evaporation of a liquid without the 
direct application of strong heat, but at the temperature of the room or closet 
used for the purpose. It is especially applicable to cases in which the residue 
is liable to injury or loss from much heat, or to secure finer crystals than can 
be obtained by quick evaporation of their solution. 

Distillation consists of two processes, (i) the evaporation of 
a liquid, (2) the condensation of the vapor into a liquid in a 
separate vessel. The agent used in the first part of the operation 
is heat, in the second part cold. Its object is to separate mixed 
volatile and fixed substances, or to combine volatile substances 
which cannot otherwise be mixed, as in the preparation of some 
of the official Waters. The apparatus used is of great variety, 
from the simple retort and receiver to the elaborate and costly 
stills. 

Destructive or Dry Distillation is a process of decomposing an 
organic substance by heat into volatile products which are collected in a sep- 
arate vessel, the residue being said to be carbonized. It is only employed by 
large manufacturers, for the preparation of Acetic and Succinic Acids, Oil of 
Amber, Wood-tar, etc. 

Fractional Distillation is the separation by distillation of substances 
which are volatile at different temperatures, each being separately driven over 
and received in a vessel by itself. Different degrees of heat are successively 
employed in accordance with the volatilizing points of the substances to be 
obtained. 

Sublimation is the distillation of a volatile solid, the product 
being termed a sublimate. Its objects are to purify volatile solids 
from impurities, and to collect such as result from chemical ac- 
tion at high temperatures. The operation is carried on in iron, 
glass or stoneware retorts, and results in cake sublimates ox powder 
sublimates according as the temperature of the condensing surface 
is high or low. 

Desiccation is the process of removing moisture from solids, 
and has for its object either the preservation of the substance, 
the reduction of its bulk or the facilitation of its comminution. 
The operation should be conducted at as low a temperature as 
possible. Roots, leaves and seeds are generally dried by being 
placed in trays of wire net-work and exposed to a uniform tem- 
perature in a room heated by steam. A better method is to 



OFFICIAL OPERATIONS. 439 

suspend organic substances from the ceiling of an attic during 
warm weather ; a slow process, but one which does not result in 
much loss of the active volatile principles. Crystals and precipi- 
tates require a higher temperature and are usually dried on a 
water-bath. When the water of crystallization is to be expelled, 
as in desiccating Alum and Sulphate of Iron, a temperature of 
about 400 F. is required. In absorbing water from alcohol 
Carbonate of Potassium and slaked Lime heated are employed, 
and in several instances Sulphuric Acid is the active desiccator 
used. 

Fusion is the process of liquefying solids by the application 
of high heat without the use of a solvent. It is employed in 
making ointments, plasters, etc., in purifying resins, and for the 
purpose of decomposition. The degree of heat required varies 
from a temperature of 90 F., sufficient to melt lard in an open 
vessel, to one of 8oo° F., employed in fusing Zinc in an earthen 
crucible ; and may be regulated by the aid of the water-, steam- 
or sand-bath. The two former appliances limit the degree of 
heat applied, while the sand-bath prevents sudden changes in the 
temperature. Oil-baths and glycerin-baths are employed in frac- 
tional distillation on a large scale. 

Exsiccation or Calcination is the process of depriving a 
solid of its moisture or other volatile constituents by the appli- 
cation of heat without fusion. The term Exsiccation is usually 
applied to the vaporization of the water of crystallization from 
a crystalline body, Calcination, to such operations as the expul- 
sion of carbonic acid and water from carbonates, as in the manu- 
facture of Lime, Magnesia, etc. 

Carbonization is the heating of organic substances without 
exposure to the air until the volatile constituents are driven off, 
and the residue assumes the characteristic appearance of carbon. 

Incineration is the heating of organic substances with access 
of air until the carbon is consumed, the ash remaining being the 
product desired. 

Ignition in pharmacy means the process of strongly heating 
solids or semi-solid substances, the residue left being the product 
desired. It is used in the official quantitative tests for Phosphoric 
Acid, Phosphate of Ammonium and purified Sulphide of Anti- 
mony. 

Deflagration is the heating of an inorganic substance with 
another which yields oxygen (usually a nitrate or a chlorate), the 



44-0 OFFICIAL OPERATIONS. 

result being the decomposition of the body, with violent and 
sudden combustion. 

Torrefaction or Roasting is the application of heat, in a 
less degree than for carbonization, to an organic substance for 
the purpose of modifying some of its constituents, as in the 
roasting of coffee and rhubarb. The latter substance when sub- 
jected to this process, loses its cathartic properties but retains its 
astringency, and is known as Torrefied Rhubarb. 

Comminution is the process by which the aggregation of the 
particles of a solid body is overcome, and the body is reduced to 
pieces of varying sizes. Its object is to increase the surface ex- 
posed to the action of solvents, and it includes the mechanical 
operations of cutting, rasping, grating, crushing, stamping, grind- 
ing, pulverizing, triturating, levigating, elutriating, granulating, 
etc. Apparatus of various kinds, as cutters, mortars and pestles, 
mills, etc., are used for the comminution, while spatulas are 
employed to loosen the particles, and sieves to sift the coarser 
from the finer. These last-named contrivances are of five sizes, 
designated by the number of their meshes to the inch, 80, 50, 
60, 40 and 20, respectively permitting the passage of powders 
termed very fine, fine, moderately fine, moderately coarse and 
coarse. 

Trituration is the comminution of a solid to an extremely 
fine powder by continued rubbing in a wedgwood mortar with an 
inert and gritty powder, Sugar of Milk being the substance di- 
rected to be used. The product is called a Trituration (see that 
title under Official Preparations). The surfaces of the mortar 
and pestle-head should coincide closely, and the thorough commi- 
nution of the trituration is best accomplished by a circular motion 
of the pestle in gradually increasing circles, until the side of the 
mortar is reached, then reversing the motion, and gradually 
lessening the circles until the pestle reaches the centre again. 
The process is greatly facilitated by having the pestle attached to 
a long handle playing in an opening made in a piece of wood 
which is nailed at a convenient height. A weight may be fixed 
on top of the handle if a greater degree of friction be desired. 

Pulverization by Intervention is only another name for trituration 
when performed in a mortar and with solid bodies, the foreign substance used 
being subsequently removed. Potassium Sulphate may be employed as the 
medium for the pulverization of Gold, and is then dissolved out with water. 
Alcohol or Chloroform may be added to Camphor to aid its pulverization, 
and then removed by evaporation. Phosphorus may be pulverized by placing 



OFFICIAL OPERATIONS. 44I 

it in water, gently heating the latter until the phosphorus is melted, and agi- 
tating the whole while cooling. 

Levigation is trituration of a substance made into a paste with water or 
some other liquid, and resembles the old process of grinding oil-paints by- 
hand on a slab of stone. This process is used for coarse materials, as chalk, 
etc., where the refuse is rejected, or for such substances as Red Oxide of Mer- 
cury, Oxide of Zinc, etc. When performed with a porphyry slab and muller 
it is termed Porphyrization. 

Elutriation is a water-sifting process for separating the coarser particles 
of insoluble substances from the finer. The substance is mixed with water 
and after the larger particles have fallen to the bottom, the liquid is decanted 
into another vessel, in which the light and powdery particles are collected. 

Solution is the dissolving of a solid or a gaseous substance in 
a liquid, and may be simple when the substance undergoes no 
alteration, being recovered unchanged on evaporation, or chem- 
ical, when the dissolved body is chemically altered by the solvent 
or some other substance present, and cannot be recovered on 
evaporation. Simple Syrup is an instance of simple solution, the 
Syrup of Lime one of chemical solution. The liquid employed 
is termed a solvent before the substance is added to it, after the 
operation is completed the combined preparation is called a solu- 
tion. If fully charged with the dissolved substance so that it will 
retain no more, it is known as a saturated solution. One liquid 
may be dissolved in another, or a gas may be dissolved in a 
liquid. The solution of solids is greatly facilitated by pulveriza- 
tion and by stirring the menstruum. Heat generally aids solu- 
tion, most substances being more soluble in hot liquids than in 
cold ones. A saturated solution of one substance may still be 
capable of dissolving others. Rapid solution of solids without 
chemical change causes reduction of temperature, while chemical 
solution produces elevated temperature. Circulatory Solution is 
performed by suspending the substance to be dissolved near the 
surface of the solvent in a gauze bag or on a porous shelf. The 
portion first acted on descends and produces a circulatory move- 
ment in the fluid, facilitating the solution of the whole. 

Solvents employed are chiefly Water, Alcohol, Glycerin, Acids and Oils. 
Others less frequently used are Ether, Chloroform, Benzin and Carbon Disul- 
phide. 

Washing is a simple mechanical process for separating soluble 
from insoluble matter, by pouring upon it a liquid which will 
dissolve the soluble portion. Various methods of doing this are 
in vogue and are often dignified with very high-sounding terms, 
as Lotion, Affusion, Ablution, etc. An ordinary wash-bottle, 
with the two glass tubes perforating the cork, is a convenient 
implement for directing a continuous stream upon a precipitate, 

37 



442 OFFICIAL OPERATIONS. 

while for continuous washing a combination of bottles with a 
funnel may be used. 

Decantation is the pouring or drawing off a supernatant 
liquid into another vessel. If done by pouring, a guiding-rod for 
the liquid to run on is an effective adjuvant ; if by drawing, the 
siphon in some form is usually employed. 

Colation, or Straining is another very simple operation, so 
familiar to every one of ordinary experience as to be scarcely 
worth describing. The strainers are made of cotton flannel, fine 
muslin, gauze, woollen felt and other fabrics. 

Filtration is a process of straining through a medium so fine 
as to deliver the filtrate in transparent condition. The filters are 
made of paper usually, though charcoal, asbestos, sand and other 
articles are sometimes employed, and are supported in a funnel 
of glass or other material held by the ring of a retort-stand. 
The best filtering-paper is made in Sweden by Munktell, and 
is white; but a good paper for ordinary use is the " Prat 
Dumas White," which should always be employed for filter- 
ing alkaline or alkaloidal solutions. The gray French papers 
answer well enough for fluid extracts, tinctures or colored 
liquids, but should never be used for solutions containing free 
alkali. 

Filtering-paper is folded by doubling a sheet upon itself, and then folding 
it again directly in the middle. When opened four distinct sections appear, 
one of which is separated from the other three, and the filter thus formed is 
placed in a funnel. This arrangement is known as a plain filter, which by 
repeated creasing is converted into the plaited filter ; the latter being the form 
generally used in pharmaceutical operations of small extent. In large labo- 
ratories special processes of filtration are employed, with apparatus of more or 
less complexity for hot filtration, rapid filtration, etc. 

Clarification is the separation from liquids of solid matter, 
which prevents their being transparent, without using filters or 
strainers. It may be effected by heat (as in the case of Mel 
Despumatum), by adding a lighter liquid, by adding albumen, 
gelatin, milk, or paper-pulp, by fermentation, or by subsidence 
of the particles in the form of a sediment through long standing. 

Decoloration, or the removal of coloring-matter from liquids 
or from solids in solution, is effected by the use of animal char- 
coal, which in small operations may be arranged in a funnel or a 
percolator, and the liquid placed thereon. It should not be 
forgotten that charcoal absorbs many other principles besides 
coloring-matter, especially alkaloids, bitters, and astringents, so 



OFFICIAL OPERATIONS. 443 

that the process of decoloration may be one of serious injury to 
the efficiency of the preparation. 

Separation of liquids which do not mix with each other is a 
simple mechanical process performed with pipettes of various 
forms, or with funnels having stop-cocks in their necks. Special 
forms of receivers are used for the separation of volatile oils from 
the water which may accompany them during distillation. 

Precipitation is the process of separating solids from their 
solutions, and is usually effected by chemical reaction, though it 
may be accomplished by other methods, as by adding a second 
liquid in which the substance is insoluble, by heating albuminous 
solutions, or by exposing solutions of silver salts to the action of 
light. The most familiar example of chemical precipitation is the 
addition of a solution of Mercuric Chloride to one of Potassium 
Iodide, the result being a double decomposition of the salts and 
the formation of Mercuric Iodide, which falls to the bottom of the 
vessel as a brilliant, red, insoluble and crystalline powder. The 
precipitate is the separated substance, which is usually thrown 
down, but it remains suspended in some cases, and in others it 
rises to the top. The precipitant is the substance which is added 
to produce the precipitation. A magma is a thick, tenacious 
precipitant remaining behind after the supernatant liquid is 
removed by decantation or otherwise. Precipitates are termed 
flocculent, gelatinous, curdy, granular, crystalline, etc., according 
to the forms assumed. In small operations they are usually col- 
lected on plain filters, and washed by the repeated addition of 
water. 

Crystallization is the process which bodies undergo in 
passing from the liquid or the gaseous state to the geometrical 
forms called crystals. Six systems of crystals are recognized by 
crystallography, which has assumed the dignity of a separate 
science. Bodies which are not capable of crystallization are 
termed amorphous. Every crystallizable body assumes its own 
peculiar form, or some other form directly derived from or related 
to it. The process of crystallization is effected (i)by fusion and 
partial cooling, as in the cases of some metals and Sulphur; (2) 
by sublimation, as Benzoic Acid, Mercuric Chloride, etc. ; (3) 
by deposition from hot saturated solutions while cooling; (4) by 
deposition from a solution during evaporation ; (5) by deposition 
caused by passing a galvanic current through the solution ; (6) by 
precipitation, as in the case of the Mercuric Iodide; (7) by the 
addition to the solution of a substance having a strong affinity for 



444 OFFICIAL OPERATIONS. 

water, as in the adding of Calcium Chloride to an aqueous solu- 
tion of Sodium Chloride, or Alcohol to a solution of Potassium 
Nitrate, or to an aqueous syrup. In a few cases amorphous solids 
may crystallize without undergoing liquefaction, as Sulphur, 
Barley-sugar, Iron or Brass wire. The methods most frequently 
employed are those by deposition from supersaturated solutions, 
and by deposition during evaporation. The more slowly the 
process is carried on the larger and more regular will be the 
crystals. The process is facilitated by use of foreign bodies as 
nuclei around which the crystals are deposited ; a familiar 
instance being the thread in the centre of a mass of rock- 
candy. 

The Water of Crystallization is the H 2 with which most substances com- 
bine in the act of crystallization, and the number of molecules thereof differs 
for each body and for the same body frequently under different conditions. 
Exsiccation is the driving off of this combined water by heat, the crystals 
assuming thereby the form of a dry powder. Efflorescence is a similar process 
occurring spontaneously on exposure of the crystals to the air, the effloresced 
portion appearing as a dry powder on the surface of the crystals. Deliquescence, 
on the other hand, is the act of absorbing water from the atmosphere, a prop- 
erty possessed by some substances which are therefore said to be hygroscopic. 

Granulation is a process of reducing a coarsely crystalline 
substance to a granular powder by dissolving it in water and 
evaporating the solution with constant stirring until the product 
becomes perfectly dry. Many salts are thus treated for conve- 
nience in dispensing, as the Bromide, the Iodide, the Car- 
bonate and the Citrate of Potassium. Sulphate of Iron, though 
generally dispensed in the exsiccated powder, may be granu- 
lated into minute crystals by filtering an aqueous solution of it 
into alcohol. 

Dialysis is a process by which crystallizable substances are 
separated from non-crystallizable ones, by suspending a solution 
containing both upon a porous diaphragm having its under sur- 
face in contact with water. The crystalloids pass through the 
diaphragm, while the non-crystalline remain above it, and are 
termed colloids. Examples of the latter class are gelatin, gum, 
glue, starch, dextrin, albumen and extractive matters, which are 
generally the inert and valueless constituents of vegetable drugs. 
Parchment-paper and bladders are used for the diaphragm; the 
whole apparatus being termed the dialyzer, while the water into 
which the crystalloids pass is called the diffusate. 

The unofficial preparation known as Dialyzed Iron or Fermm Dialysatum 
is a colloidal substance obtained by treating Ferric Chloride in solution with 



OFFICIAL OPERATIONS. 445 

Ammonia whereby Ferric Hydrate is precipitated and then dissolved by 
agitation. The mixture being placed on a dialyzer, the crystalloids formed 
(Ammonium Chloride and Ferric Chloride), together with any free acid 
present, pass into the diffusa te, leaving the neutral colloidal liquid (solution of 
Ferric Oxychloride) above on the septum. 

Maceration is one of the processes of extracting the soluble 
principles from drugs, and consists in steeping or soaking the 
comminuted substance in a suitable liquid called the menstruum, 
generally alcohol, for a period varying from 2 to 14 days, during 
which it is occasionally agitated. The liquid is then poured off, 
the residue is expressed, and the mixed liquors are filtered. Sev- 
eral of the official tinctures are prepared by this method, and in 
many others are subjected to maceration first and percolation 
afterwards. 

Expression is the forcible separation of liquids from solids, 
by subjecting them to pressure. Hand-pressure through strain- 
ing-cloths may be employed, but mechanical presses are more 
efficient and are coming into general use. Oils obtained in this 
manner are called expressed ox fixed oils, to distinguish them from 
the volatile oils obtained by distillation. 

Percolation or Displacement is a process of obtaining the 
soluble constituents of a substance in powder by the descent of a 
solvent through it. Though an ancient process for the making 
of lye from wood-ashes (lixiviation), it has only within the last 
forty years been adopted as an official process in pharmacy, and 
it is gradually taking the place of maceration as a means of 
extracting the soluble principles of drugs. The vessel used to 
hold the powdered drug is called the percolator, of which there 
are many forms employed by the manufacturers. The liquid 
used as a solvent is called the menstruum, and when coming 
from the percolator it is termed the percolate. The U. S. 
Pharmacopoeia gives the following directions concerning this 
process : — 

" The process of percolation, or displacement, directed in this Pharmaco- 
poeia, consists in subjecting a substance, or substances, in powder, contained in 
a vessel called a percolator, to the solvent action of successive portions of 
menstruum in such a manner that the liquid, as it traverses the powder in its 
descent to the recipient, shall be charged with the soluble portion of it, and 
pass from the percolator free from insoluble matter. 

" When the process is successfully conducted, the first portion of the liquid, 
or percolate, passing through the percolator will be nearly saturated with the 
soluble constituents of the substance treated ; and if the quantity of menstruum 
be sufficient for its exhaustion, the last portion of the percolate will be desti- 
tute of color, odor, and taste, other than that possessed by the menstruum 
itself. 



446 OFFICIAL OPERATIONS. 

" The percolator most suitable for the quantities contemplated by this 
Pharmacopoeia should be nearly cylindrical, or slightly conical, with a funnel- 
shaped termination at the smaller end. The neck of this funnel-end should 
be rather short, and should gradually and regularly become narrower toward 
the orifice, so that a perforated cork, bearing a short glass tube, may be tightly 
wedged into it from within until the end of the cork is flush with its outer 
edge. The glass tube, which must not protrude above the inner surface of 
the cork, should extend from one and one-eighth to one and one-half inch (3 
to 4 centimeters) beyond the outer surface of the cork, and should be provided 
with a closely fitting rubber tube, at least one-fourth longer than the percolator 
itself, and ending in another short glass tube, whereby the rubber tube may be 
so suspended that its orifice shall be above the surface of the menstruum in 
the percolator, a rubber band holding it in position. 

" The dimensions of such a percolator, conveniently holding five hundred 
grammes of powdered material, are preferably the following : Length of body, 
fourteen inches (36 centimeters) ; length of neck, two inches (5 centimeters) ; 
internal diameter at top, four inches (10 centimeters) ; internal diameter at 
beginning of funnel-shaped end, two and one-half inches (6.5 centimeters) ; 
internal diameter of the neck, one-half inch (12 millimeters), gradually 
reduced at the end to two-fifths of an inch (10 millimeters). It is best con- 
structed of glass, but, unless so directed, may be constructed of a different 
material. 

" The percolator is prepared for percolation by gently pressing a small tuft 
of cotton into the space of the neck above the cork, and a small layer of clean 
and dry sand is then poured upon the surface of the cotton to hold it in 
place. 

" The powdered substance to be percolated (which must be uniformly of 
the fineness directed in the formula, and should be perfectly air-dry before it 
is weighed) is put into a basin, the specified quantity of menstruum is poured 
on, and it is thoroughly stirred with a spatula, or other suitable instrument, 
until it appears uniformly moistened. The moist powder is then passed 
through a coarse sieve — No. 40 powders, and those which are finer, requiring a 
No. 20 sieve, whilst No. 30 powders require a No. 15 sieve for this purpose. 
Powders of a less degree of fineness usually do not require this additional 
treatment after the moistening. The moist powder is now transferred to a 
sheet of thick paper and the whole quantity poured from it into the percolator. 
It is then shaken down lightly and allowed to remain in that condition for a 
period varying from fifteen minutes to several hours, unless otherwise directed ; 
after which the powder is pressed, by the aid of a plunger of suitable dimen- 
sions, more or less firmly, in proportion to the character of the powdered 
substance and the alcoholic strength of the menstruum ; strongly alcoholic 
menstrua, as a rule, permitting firmer packing of the powder than the weaker. 
The percolator is now placed in position for percolation, and the rubber tube 
having been fastened at a suitable height, the surface of the powder is covered 
by an accurately fitting disk of filtering paper, or other suitable material, and a 
sufficient quantity of menstruum poured on through a funnel reaching nearly 
to the surface of the paper. If these conditions are accurately observed, the 
menstruum will penetrate the powder equally until it has passed into the 
rubber tube and has reached, in this, the height corresponding to its level in 
the percolator, which is now closely covered to prevent evaporation, and the 
apparatus allowed to stand at rest for the time specified in the formula. 

"To begin percolation, the rubber tube is lowered and its glass end intro- 
duced into the neck of a bottle previously marked for the quantity of liquid 



OFFICIAL OPERATIONS. 447 

to be percolated, if the percolate is to be measured, or of a tared bottle, if the 
percolate is to be weighed; and by raising or lowering this recipient, the 
rapidity of percolation may be increased or lessened as may be desirable, 
observing, however, that the rate of percolation, unless the quantity of material 
taken in operation is largely in excess of the pharmacopoeial quantities, shall 
not exceed the limit of ten to thirty drops in a minute. A layer of menstruum 
must constantly be maintained above the powder, so as to prevent the access 
of air to its interstices, until all has been added, or the requisite quantity of 
percolate obtained. This is conveniently accomplished, if the space above the 
powder will admit of it, by inverting a bottle containing the entire quantity of 
menstruum over the percolator in such a manner that its mouth may dip beneath 
the surface of the liquid, the bottle being of such shape that its shoulder will 
serve as a cover for the percolator. 

" When the dregs of a tincture, or similar preparation, are to be subjected to 
percolation, after maceration with all or with the greater portion of the men- 
struum, the liquid portion should be drained off as completely as possible, the 
solid portion packed in a percolator, as before described, and the liquid poured 
on, until all has passed from the surface, when immediately a sufficient quantity 
of the original menstruum should be poured on to displace the absorbed liquid, 
until the prescribed quantity has been obtained." 

Modification of the above Process. 

" Authority is given to employ, in the case of Fluid Extracts, where it may 
be applicable, the process of Repercolation, without change of the original 
menstruum. " 

Testing is directed by the Pharmacopoeia in convenient cases, 
for the purpose of ascertaining the identity and purity of its prep- 
arations; and a List of Reagents used is given at the end of the 
book, which is divided into three parts, — (t) Articles used in 
Testing, (2) Test-solutions, (3) Volumetric Solutions, The analysis 
directed under the title of each preparation is frequently Quali- 
tative, but often Quantitative, and of the latter both the Gravi- 
metric and the Volumetric methods are used. Pharmacopoeial 
testing and volumetric analysis are necessary to the work of the 
practical pharmacist, and as the apparatus used is simple and the 
operations are those in the line of his daily work, he should be 
familiar therewith. On the other hand the proximate analysis of 
organic substances for their principles, and the ultimate analysis 
of the same bodies for their elements require a high degree of 
skill and long experience, and should be left to the professional 
chemist. 

The apparatus used in testing consists of graduated flasks and 
jars, burettes, pipettes, funnels, beakers, test-tubes, capsules, 
crucibles, reagent-bottles, etc. The metric system is directed 
for all analytical work, and the apparatus employed should be 
graduated accordingly* 



448 OFFICIAL PREPARATIONS. 



OFFICIAL PREPARATIONS. 

The pharmacopoeial preparations may be presented under 
various methods of classification, one of the simplest being that 
which divides them into liquids and solids, the former being 
subdivided into groups named after their principal bases, viz. : — 

Liquid Preparations. 

Aqueous, — Waters, Solutions, Infusions, Decoctions, Syrups, Honeys, Mu- 
cilages, Mixtures; the last four containing sweet or viscid substances. 
Alcoholic, — Fluid Extracts, Tinctures, Wines, Spirits, Elixirs. 
Ethereal, — Oleoresins, Collodions. 
Oleaginous, — Liniments, Oleates. 
Acetous, — Vinegars. Glycerines, — Glycerites. 

Solid Preparations. 



Extracts. 


Troches. 


Ointments, 


Abstracts. 


Confections. 


Cerates. 


Resins. 


Powders. 


Plasters. 


Masses. 


Triturations. 


Papers. 


Pills. 


Suppositories. 





In the following descriptions of the pharmacopoeial groups the 
composition and dosage of the various preparations are omitted, 
as they are fully detailed in the section on Materia Medica, under 
the title in each case of the principal constituent. 

Aqueous Preparations. 

Aquae, Waters, — are aqueous solutions of volatile substances, 
which may be either solids, liquids, or gases, dissolved either by- 
solution in cold or hot water, by filtration through an absorbent 
powder, by percolation through cotton saturated with the sub- 
stance, or by distillation. The official waters number 15, includ- 
ing the two forms of Aqua itself, as follows, viz. — 

Aqua. Aqua Chlori. 

Aqua Destillata. Aqua Cinnamomi. 

Aqua Ammoniae. Aqua Creasoti. 

Aqua Ammoniae Fortior. Aqua Foeniculi. 

Aqua Amygdalae Amarae. Aqua Menthae Piperitae. 

Aqua Anisi. Aqua Menthae Viridis. 

Aqua Aurantii Florum. Aqua Rosae. 
Aqua Camphorae. 

Of the above-named two are made by simple solution (A. 
Amygdalae Amarae and A. Creasoti), three are made by passing 
gases through water (A. Ammoniae, A. Ammoniae Fortior, and 
A. Chlori), three are made by distillation (A. Aurantii Florum, 



OFFICIAL PREPARATIONS. 449 

A. Destillata and A. Rosae), and the other six are made by per- 
colation through cotton impregnated with the substance. All 
waters deteriorate when long kept, microscopic plants being 
propagated in them from spores from the atmosphere. They 
should be prepared only in such quantities as are needed for use 
within a reasonable time. 

Liquores, Solutions, — comprise all aqueous solutions of non- 
volatile substances except the syrups, infusions and decoctions, 
which naturally form distinctive classes. Included among the 
Liquores is the Solution of Gutta-percha, the solvent of which 
is Chloroform ; all the others being made with water. There 
are 28 official solutions, as follows, — the first 11 being simple 
aqueous solutions : the next 16 being chemical aqueous solutions, 
in which the properties of the dissolved substance are altered by 
chemical action ; and the last-named being a solution in Chloro- 
form. 

Liquor Acidi Arsenici. Liquor Ferri Citratis. 

Liquor Arsenii et Hydrargyri Iodidi. Liquor Ferri Nitratis. 

Liquor Calcis. Liquor Ferri Subsulphatis. 

Liquor Ferri et Quininae Citratis. Liquor Ferri Tersulphatis. 

Liquor Iodi Compositus. Liquor Hydrargyri Nitratis. 

Liquor Pepsini. Liquor Magnesii Citratis. 

Liquor Plumbi Subacetatis Dilutus. Liquor Plumbi Subacetatis. 

Liquor Potassae. Liquor Potassae. 

Liquor Sodae. Liquor Potassii Citratis. 

Liquor Sodii Arseniatis. Liquor Potassii Arsenitis. 

Liquor Sodii Silicatis. Liquor Sodae. 

Liquor Ammonii Acetatis. Liquor Sodae Chloratae. 

Liquor Ferri Acetatis. Liquor Zinci Chloridi. 

Liquor Ferri Chloridi. Liquor Gutta-Perchae. 

Syrupi, Syrups, — are concentrated solutions of Sugar in Water 
or in aqueous liquids. They sometimes contain Acetic Acid, and oc- 
casionally Alcohol; and are termed simple, medicated ox flavored, 
according as they are simple solutions of sugar in water alone, or 
contain soluble medicinal substances, or flavoring ingredients. The 
Sugar used should be very dry, and its official description corre- 
sponds with the granulated sugar of commerce. The permanency 
of these preparations chiefly depends on their possessing the proper 
relative proportions of sugar and water. They are prepared 
either by solution with heat, by agitation without heat, by adding 
a medicated liquid to simple syrup, by digestion or maceration, 
or by cold percolation \ these processes being all officially di- 
rected except the last. They are best preserved by being poured 
while hot into pint bottles, which should be corked securely while 

38 



450 OFFICIAL PREPARATIONS. 

full, and the tops dipped into melted sealing-wax. Fermented 
syrups are useless for dispensing purposes. The number of official 
syrups is 34, as follows, viz. — 

Syrupus. Syrupus Ipecacuanhas. 

Syrupus Acaciae. Syrupus Krameriae. 

Syrupus Acidi Citrici. Syrupus Lactucarii. 

Syrupus Acidi Hydriodici. Syrupus Limonis. 

Syrupus Allii. Syrupus Picis Liquidas. 

Syrupus Altheae. Syrupus Pruni Virginianas. 

Syrupus Amygdalae. Syrupus Rhei. 

Syrupus Aurantii. Syrupus Rhei Aromaticus. 

Syrupus Aurantii Florum. Syrupus Rosas. 

Syrupus Calcii Lactophosphatis. Syrupus Rubi. 

Syrupus Calcis. Syrupus Rubi Idaei. 

Syrupus Ferri Bromidi. Syrupus Sarsaparillae Compositus. 

Syrupus Ferri Iodidi. Syrupus Scillas. 

Syrupus Ferri Quininae et Strychninae Syrupus Scillae Compositus. 

Phosphatum. Syrupus Senegae. 

Syrupus Hypophosphitum. Syrupus Sennas. 

Syrupus Hypophosphitum cum Ferro. Syrupus Tolutanus. 

Syrupus Zingiberis. 

Mellita, Honeys, — differ from syrups merely in their being 
prepared with honey as a base. The Oxymel and Oxymel Scilloz 
of the B. P. are similar preparations, containing also Acetic Acid. 
There are 3 official Honeys, including two forms of honey 
itself, viz. — 

Mel. Mel Despumatum. Mel Rosae. 

Mucilagines, Mucilages, — are thick, viscid liquids, prepared 
by dissolving gum in water, or by extracting with water the 
mucilaginous principles from certain plants. They are easily 
spoiled and should be kept only in small quantities. The official 
Mucilages number 5, as follows, the three first-named being 
prepared without heat, the two last-named with heat, viz. — 

Mucilago Acaciae. Mucilago Sassafras Medullas. 

Mucilago Cydonii. Mucilago Tragacanthae. 

Mucilago Ulmi. 

Misturae, Mixtures, — in official pharmacy are aqueous pre- 
parations of insoluble substances held in suspension by a suitable 
vehicle. In extemporaneous pharmacy the term mixture has a 
wider signification, as explained under that head. They are 
generally prepared extemporaneously upon prescriptions, as few 
of them are of the stability necessary to insure their preservation 
beyond a few days. The official Mixtures number 11, of which 



OFFICIAL PREPARATIONS. 451 

one (Mistura Ferri et Ammonii Acetatis) is misnamed, and should 
be entitled a Solution, as it does not contain any insoluble sub- 
stance. Their names are as follows, viz. — 

Mistura Ammoniaci. Mistura Ferri Composita. 

Mistura Asafoetidae. Mistura Glycyrrhizae Composita. 

Mistura Amygdalae, Mistura Magnesii et Asafoetidae. 

Mistura Chloroformi. Mistura Ferri et Ammonii Acetatis. 

Mistura Cretae. Mistura Rhei et Sodae. 

Mistura Potassii Citratis. 

Of the above-named, the first two are simple gum-resin emul- 
sions, the third is a seed-emulsion, the fourth an egg-emulsion : 
the next four contain insoluble powders in suspension by the aid 
of gum arabic, sugar, etc., the next two do not contain insoluble 
powders in suspension, while the last is an effervescing mixture. 

Infusa, Infusions, — are prepared by treating vegetable sub- 
stances with hot or cold water without boiling. Cold water is 
preferred when the drug contains a desirable volatile principle, 
or when its active ingredient is injured by heat. The drug should 
be coarsely comminuted, sliced or bruised, and treated by mace- 
ration or percolation with the proper quantity of water, which in 
the absence of specific directions to the contrary should be 10 
parts by weight to i of the drug. These preparations should be 
freshly made when required, as they are very prone to decompo- 
sition. The number of official Infusions is 5, viz. — 

Infusum Brayerae. Infusum Digitalis. 

Infusum Cinchonae. Infusum Pruni Virginianae. 

Infusum Sennse Compositum. 

The proportions of drug to menstruum in the official infusions 
vary from 1 y 2 per cent, in the case of Digitalis to 4 per cent, in 
the case of Wild Cherry and 6 per cent, in the cases of the others. 
Alcohol is an ingredient of the Infusion of Digitalis to prevent 
decomposition. 

Many dispensing pharmaceutists are in the habit of making 
infusions from concentrated alcoholic tinctures or from fluid ex- 
tracts. It is a very reprehensible practice, especially in those 
cases where the active ingredients are of a resinous nature and 
therefore precipitated when the alcoholic solution is added to 
water. 

Decocta, Decoctions, — are made by boiling vegetable sub- 
stances with water. As very few drugs contain active ingredients 
which are not injured by heat, these preparations have never 



45 2 OFFICIAL PREPARATIONS. 

obtained favor with scientific physicians. There are only 2 official 
Decoctions, viz. — 

Decoctum Cetrariae. Decoctum Sarsaparillse Compositum. 

The general official formula prescribes that an ordinary decoc- 
tion, the strength of which is not directed by the physician, nor 
specified by the Pharmacopoeia, shall be prepared in the propor- 
tion of 1 part of the substance to 9 of water. Decoctum Ce- 
trariae is one-half the aforesaid strength, while the Compound 
Decoction of Sarsaparilla is of the full strength as to its chief 
ingredient. 

Alcoholic Preparations. 

Extracta Fluida, Fluid Extracts, — are liquid alcoholic so- 
lutions (concentrated tinctures) of uniformly definite strength if 
the crude drugs are so, a cubic centimeter (rn.16.23) in each case 
representing the medicinal powers of one gramme (gr. 15.43) of 
the drug, or approximately a minim of the finished preparation 
representing the active constituents of a grain of the drug. 
They are officially directed to be prepared by percolation and 
partial evaporation, the menstrua employed being usually Alco- 
hol, diluted Alcohol, or Alcohol and Water in various propor- 
tions, though a few are percolated with water, the alcohol being 
afterwards added. In several instances Glycerin in different pro- 
portions is added to the first menstruum, and in the menstruum 
used for the extraction of Aconite root Tartaric Acid is an ingre- 
dient. In the preparation of the fluid extract of Prunus Virgin- 
iana, the extraction is preceded by maceration with water and 
glycerin, in order to permit of the formation of Hydrocyanic 
Acid by the reaction of the amygdalin and emulsin of the bark 
upon each other, which takes place only in the presence of water. 
The glycerin aids to keep the dissolved matters in perfect solu- 
tion, and also to better retain the acid and volatile oil formed 
during the process. The fluid extract of Glycyrrhiza is prepared 
with a first menstruum containing Ammonia, and that of Lactu- 
carium is first treated with Ether and then put through an elabo- 
rate process in order to obtain a preparation which will make a 
clear mixture with water, syrup or glycerin. The menstruum 
directed to be used in each case is intended to be that which will 
thoroughly extract all the active constituents of the drug and at 
the same time will leave the inert soluble matters behind in the 
rejected portion, known as the marc. In manufacturing fluid 
extracts on a large scale, modifications of the official processes 
are necessary, and the methods used are generally percolation 



OFFICIAL PREPARATIONS. 



453 



and maceration with hydraulic pressure, vacuum maceration fol- 
lowed by percolation, percolation with incomplete exhaustion, 
or repercolation. The number of official Fluid Extracts is 79. 
They are named in the following list, the letters following each 
one in parentheses showing the character of its menstruum, and 
representing Alcohol, Diluted Alcohol, Alcohol and Water, or 
Glycerin, by their respective initials. 

(A). 



Extractum Aconiti Fluidum (A). 

Ext. Arnicae Radicis PI. (DA). 

Ext. Aromaticum Fl. (A). 

Ext. Aurantii Amari Fl. (AjWj). 

Ext. Belladonna? Fl. (A). 

Ext. Brayerse Fl. (A). 

Ext. Buchu Fl. (A^). 

Ext. Calami Fl. (A). 

Ext. Calumbse Fl. (DA). 

Ext. Cannabis Indicse Fl. (A). 

Ext. Capsici Fl. (A). 

Ext. Castanese Fl. (WA). 

Ext. Chimaphilae Fl. (DAgG^. 

Ext. Chiratae Fl. (DA^). 

Ext. Cimicifugge Fl. (A). 

Ext. Cinchona? Fl. (DjAgG^. 

Ext. Colchici Radicis Fl. (A 2 W X ). 

Ext. Colchici Seminis Fl. (A 2 W 1 ). 

Ext. Conii Fl. (DA). 

Ext. Cornus Fl. (DA 4 G X ). 

Ext. Cubebae Fl. (A). 

Ext. Cypripedii Fl. (A). 

Ext. Digitalis Fl. (AgWj). 

Ext. Dulcamara Fl. (DA). 

Ext. Ergotae Fl. (A 3 W 4 ). 

Ext. Erythroxyli Fl. (DA). 

Ext. Eucalypti Fl. (A). 

Ext. Eupatorii Fl. (DA). 

Ext. Frangulae Fl. (AjWg). 

Ext. Gelsemii Fl. (A). 

Ext. Gentianae Fl. (DA). 

Ext. Geranii Fl. (DA 9 Gj). 

Ext. Glycyrrhizae Fl. (DA). 

Ext. Gossypii Radicis Fl. (A 3 G 7 ). 

Ext. Grindeliae Fl. (AgWj. 

Ext. Guaranae Fl. (AgWj. 

Ext. Hamamelidis Fl. (A 1 W 2 ). 

Ext. Hydrastis Fl. (AgW^. 

Ext. Hyoscyami Fl. (AgW^). 



Extractum Ipecacuanha? Fl. 

Ext. Iridis Fl. (AgW x ). 

Ext. Krameriae Fl. (DA 4 G X ). 

Ext. Lactucarii Fl. (A^Vg). 

Ext. Leptandrae Fl. (DA 17 G 3 ). 

Ext. Lobeliae Fl. (DA). 

Ext. Lupulini Fl. (A). 

Ext. Matico Fl. (A 15 W 5 G 2 ). 

Ext. Mezerei Fl. (A). 

Ext. Nucis Vomicae Fl. (AgW^. 

Ext. Pareirae Fl. (DA^GJ. 

Ext. Pilocarpi Fl. (DA). 

Ext. Podophylli Fl. (AgW^. 

Ext. Pruni Virginianae Fl. (W^). 

Ext. Quassiae Fl. (DA). 

Ext. Rhei Fl. (AgW^. 

Ext. Rhois Glabrae Fl. (DA^). 

Ext. Rosae Fl. (DAgGj. 

Ext. Rubi Fl. (A 9 W 7 GJ. 

Ext. Rumicis Fl. (DAj. 

Ext. Sabinae Fl. (A). 

Ext. Sanguinariae Fl. (A). 

Ext. Sarsaparillae Co. Fl. ( A 5 W fij). 

Ext. Sarsaparillae Fl. (AgWgGj. 

Ext. Scillae Fl. (A). 

Ext. Scutellariae Fl. (A^). 

Ext. Senegae Fl. (A Wj). 

Ext. Sennae Fl. (A a W 4 ). 

Ext. Serpentariae Fl. (AgWj). 

Ext. Spigehae Fl. (DA). 

Ext. Stillingiae Fl. (DA^. 

Ext. Stramonii Fl. (AgW^. 

Ext. Taraxaci Fl. (A 2 W 3 ). 

Ext. Tritici Fl. (WA). 

Ext. Uva Ursi Fl. (DA 9 Gj). 

Ext. Valerianae Fl. (A^VJ. 

Ext. Veratri Viridis Fl. (A). 

Ext.Viburni Fl. (AjW^. 

Ext. Xanthoxyli Fl. (A). 



Extractum Zingiberis Fluidum (A), 

In nine instances only does the Pharmacopoeia direct the making 
of other preparations from corresponding fluid extracts, these 
nine being the Syrups of Krameria, Lactucarium, Rubus, Senega, 



454 OFFICIAL PREPARATIONS. 

and Ginger, the Extract of Ergot, the Liniment of Belladonna, 
the Ointment of Mezereum, and the Mixture of Rhubarb and 
Soda. Notwithstanding this fact it is a common practice for 
dispensing pharmaceutists to make tinctures, syrups, infusions, 
etc., from fluid extracts; and some manufacturers put a label on 
the bottles containing their fluid extracts, giving the formulae 
for so preparing other preparations. This practice is illegiti- 
mate, and tends to still further degrade the profession of phar- 
macy into a mere trade, so far as all dispensing is concerned. 

A large number of unofficial fluid extracts are manufactured and for sale, 
one house alone carrying over 400 such on their catalogue. Normal Liquids 
are a class of superior fluid extracts introduced by Parke, Davis & Co., which 
are claimed to be adjusted to a maximum strength by accurate assays for 
alkaloidal strength made at each stage of their manipulation, irrespective of 
the amount of material required, which in the case of official fluid extracts is 
prescribed by the Pharmacopoeia, regardless of the varying quality of drugs in 
the market. This firm prepares Normal Liquids of Aconite, Veratrum Viride, 
Belladonna (root or leaves), Cannabis Indica, Cinchona Calisaya, Cinchona 
Rubrum, Colchicum (root or seed), Conium, Ergot, Digitalis, Gelsemium, 
Hyoscyamus, Ipecacuanha, Podophyllum, Nux Vomica, Rhubarb, and Stramo- 
nium (seed or leaves). Of these preparations one cubic centimeter is equiva- 
lent to one gramme of the corresponding drug of standard alkaloidal strength. 
A fluid extract of Belladonna leaves may contain .25 or .45 per cent, of 
atropine, according to the quality of the drug employed ; a Normal Liquid will 
contain invariably .4 per cent, of the alkaloid, so that in a given dose it may 
be relied upon to produce a certain effect, 

Tincturse, Tinctures,— are alcoholic solutions of medicinal 
substances ; and with one official exception (Tincture of Iodine) 
are made from non-volatile bodies. They are prepared by percola- 
tion, maceration, solution or dilution ; the menstrua employed 
being chiefly Alcohol and diluted Alcohol of various strengths, 
though in a few cases the Aromatic Spirit of Ammonia, and mix- 
tures of Alcohol, Water and Glycerin are directed to be used. The 
Pharmacopoeia prescribes a general formula for Tinctures of 
Fresh Herbs, according to which, when not otherwise directed, 
these preparations are to be made by macerating 50 parts of the 
Fresh Herb, bruised or crushed, with 100 parts of Alcohol for 14 
days, then expressing the liquid and filtering. Of the 72 official 
Tinctures 2 are made with 5 per cent, of the ingredient, 20 with 
10 per cent., 9 with 15 per cent., 23 with 20 per cent., 1 with 35 
per cent., 1 (Aconite) with 40 per cent., 3 with 50 per cent., and 
1 (Soap) with 65 per cent. ; the others varying in strength from 
0.4 per cent, in the case of Paregoric to 26 per cent, in that of 
the Compound Tincture of Benzoin. Fifty-four are made by 
percolation, a few by solution or dilution, and the rest by mace- 
ration. The official Tinctures are as follows, the figures placed 



OFFICIAL PREPARATIONS. 



455 



after each giving the number 
in each fluid-drachm, viz. — 

Tinctura Aconiti, 19. 
Tinctura Aloes, 103/. 
Tinctura Aloes et Myrrhae, 10^. 
Tinctura Arnicae Florum, 10J4. 
Tinctura Arnicae Radicis, 5^. 
Tinctura Asafcetidae, io^f. 
Tinctura Aurantii Amari, 10*^. 
Tinctura Aurantii Dulcis, 10^. 
Tinctura Belladonnae, 8^. 
Tinctura Benzoini, ioj^. 
Tinctura Benzoini Composita, 13^. 
Tinctura Bryoniae, 4^. 
Tinctura Calendulae, 10^. 
Tinctura Calumbae, 5^. 
Tinctura Cannabis Indicae, 10^. 
Tinctura Cantharidis, 2^. 
Tinctura Capsici, 2^. 
Tinctura Cardamomi, 8^. 
Tinctura Cardamomi Composita, 2]/^ 
Tinctura Catechu Composita, 10^. 
Tinctura Chiratae, 5^. 
Tinctura Cimicifugae, 10^. 
Tinctura Cinchonae, ioj^. 
Tinctura Cinchonae Composita, ioj^ 
Tinctura Cinnamomi, 5^. 
Tinctura Colchici, 8^. 
Tinctura Conii, 8^. 
Tinctura Croci, 5^. 
Tinctura Cubebae, 5^. 
Tinctura Digitalis, 8J^. 
Tinctura Ferri Acetatis. 
Tinctura Ferri Chloridi. 
Tinctura Gallae, 10^. 
Tinctura Gelsemii, 7^. 
Tinctura Gentianae Composita, 7j^. 
Tinctura Guamci, ioj^. 



of grains of the active ingredients 

Tinctura Guaiaci Ammoniata, ioj^. 
Tinctura Humuli, ioj^. 
Tinctura Hydrastis, ioj^. 
Tinctura Hyoscyami, 8)4- 
Tinctura Ignatiae, gr. y 2 of Extract. 
Tinctura Iodi, 4. 

Tinctura Ipecacuanhae et Opii, 10^. 
Tinctura Kino, 5^. 
Tinctura Krameriae, 10^. 
Tinctura Lavendulae Composita, 2*^. 
Tinctura Lobeliae, 10^. 
Tinctura Matico, 5^. 
Tinctura Moschi, 51^. 
Tinctura Myrrhae, io^f. 
Tinctura Kucis Vomicae, 10^. 
Tinctura Opii, 5^. 
Tinctura Opii Camphorata, \. 
Tinctura Opii Deodorata, 5J^. 
, Tinctura Physostigmatis, 4^. 
Tinctura Pyrethri, \o%. 
Tinctura Quassiae, 5^. 
Tinctura Rhei, 7^. 
Tinctura Rhei Aromatica, i6j^. 
Tinctura Rhei Dulcis, 9. 
Tinctura Sanguinariae, 8*4. 
Tinctura Saponis Viridis, 36^. 
Tinctura Scillae, 8^. 
Tinctura Serpentariae, 5^. 
Tinctura Stramonii, 51^. 
Tinctura Sumbul, 4^. 
Tinctura Tolutana, 5 */£. 
Tinctura Valerianae, 10^. 
Tinctura Valerianae Ammoniata, 10^. 
Tinctura Vanillae, 5 */£. 
Tinctura Veratri Viridis, 24. 
Tinctura Zingiberis, ioj^. 



Vina, Wines, — when medicated are practically the same as 
Tinctures, White Wine brought to a definite alcoholic strength 
(Vinum Album Fortius), being the menstruum used. The official 
Wines number 14, of which 3 are not medicated, 4 are made by 
solution or admixture, 3 by maceration and 4 by percolation. 
They are as follows, viz. — 



Vinum Album, 10-12. 
Vinum Album Fortius, 20-25. 
Vinum Rubrum, 10-12. 
Vinum Aloes, 6. 
Vinum Antimonii, 0.4. 
Vinum Aromaticum, 6. 
Vinum Colchici Radicis, 40. 



Vinum Colchici Seminis, 
Vinum Ergotae, 15. 
Vinum Ferri Amari, 8. 
Vinum Ferri Citratis, 4. 
Vinum Ipecacuanhae, 7. 
Vinum Opii, 10. 
Vinum Rhei, 10. 



15. 



456 OFFICIAL PREPARATIONS. 

The figures placed after the first three show the percentage of 
absolute alcohol which is required in each ; those placed after 
the other members of the group show the quantity of the active 
ingredient used in preparing ioo parts of the Wine. 

Spiritus, Spirits, — are alcoholic solutions of volatile sub- 
stances which may be solids, liquids or gases. They are officially 
prepared either by simple solution, by solution with macera- 
tion, by gaseous solution, by chemical reaction, or by dis- 
tillation. The number of official Spirits is 22, as follows, 
viz. — 

Spiritus ^Etheris. Spiritus Lavandulae. 

Spiritus yEtheris Compositus. Spiritus Myrciae. 

Spiritus Ammoniae Aromaticus. Spiritus Myristicae. 

Spiritus Anisi. Spiritus Odoratus. 

Spiritus Aurantii. Spiritus Limonis. 

Spiritus Camphorae. Spiritus Menthae Piperitae. 

Spiritus Chloroformi. Spiritus Menthae Viridis. 

Spiritus Cinnamomi. Spiritus Ammoniae. 

Spiritus Gaultheriae. Spiritus ^Etheris Nitrosi. 

Spiritus Juniperi. Spiritus Frumenti. 

Spiritus Juniperi Compositus. Spiritus Vini Gallici. 

Of these, the first fifteen are prepared by simple solution, the 
next three by solution with maceration, the next one by gaseous 
solution, the next one by chemical reaction, and the last two by 
distillation. 

Elixiria, Elixirs, — are sweetened, aromatic, spirituous prep- 
arations containing active medicinal substances in small quanti- 
ties. There is but one official Elixir (Elixir Aurantii), which is 
intended as a type of the class of unofficial elixirs so largely 
employed in extemporaneous pharmacy. It is practically a 
flavored alcoholized syrup, designed for use as an excipient with 
extracts, salts and tinctures. 

Ethereal Preparations. 

Oleoresina, Oleoresins, — are liquid preparations consisting 
principally of natural oils and resins extracted from vegetable 
substances by percolation with Stronger Ether. They differ from 
fluid extracts in not bearing any uniform relation to the drug of 
gramme to cubic centimeter, in containing principles which 
though soluble in ether are not in alcohol, and in some instances 
being devoid of principles which are insoluble in ether but soluble 
in alcohol. They are the most concentrated liquid preparations 



OFFICIAL PREPARATIONS. 457 

of drugs which can be produced, and are prepared by perco- 
lating the powdered drug with Stronger Ether until exhausted, 
recovering the greater part of the ether by distillation, and 
exposing the residue in a capsule to spontaneous evaporation 
until the remaining ether has evaporated. There are 6 official 
Oleoresins, viz. — 

Oleoresina Aspidii (10-15). Oleoresina Lupulini (50). 

Oleoresina Capsici (5). Oleoresina Piperis (5). 

Oleoresina Cubebse (18-25). Oleoresina Zingiberis (6-8). 

The figures in parentheses show the percentage of oleoresin 
yielded by each drug. 

Collodia, Collodions, — are liquid preparations having for 
their base a solution of Pyroxylin in a mixture of Ether and 
Alcohol. They are intended for external use, being applied to 
the skin by means of a brush, and producing a film on the surface 
after the evaporation of the menstruum. There are 4 official 
Collodions, viz. — 

Collodium. Collodium Flexile. 

Collodium cum Cantharide. Collodium Stypticum. 

The Flexible Collodion contains 5 per cent, of Canada Turpen- 
tine, and 3 per cent, of Castor Oil. Styptic Collodion contains 
20 per cent, of Tannic Acid. 

Oleaginous Preparations. 

Linimenta, Liniments, — are very thin ointments for external 
application and intended to be applied with friction to the skin. 
They are solutions of various substances in oily liquids or in alco- 
holic liquids containing fatty oils. Of the following 10 official 
Liniments the first 4 have Cotton-seed Oil, the next 4 have Alcohol 
and the last 2 have Oil of Turpentine as their respective bases. 

Linimentum Ammonise. Linimentum Belladonna. 

Linimentum Calcis. Linimentum Chloroformi. 

Linimentum Camphorse. Linimentum Saponis. 

Linimentum Plumbi Subacetatis. Linimentum Sinapis Comp. 

Linimentum Cantharidis. 

Linimentum Terebinthinse. 

Oleata, Oleates, — are liquid solutions of metallic salts or 
alkaloids in Oleic Acid, intended for external administration. 
They are not definite chemical compounds, though the term is 
also employed in trade to designate certain solid preparations 
which are claimed to be chemical compounds of the same acid£ 



458 OFFICIAL PREPARATIONS. 

with various bases. [See under Acidum Olec|um, ante, page 
34.] There are 2 official Oleates, as follows, viz. — 

Oleatum Hydrargyri (10 per cent.). Oleatum Veratrinse (2 per cent). 

Acetous Preparations. 

Aceta, Vinegars, — are solutions of the active principles of 
certain drugs in Diluted Acetic Acid. They are made by per- 
colation and each contain the soluble principles from 10 per cent, 
of drug. Acidulous menstrua form soluble salts with the alka- 
loids and possess antiseptic qualities. The official Vinegars 
number 4, viz. — 

Acetum Lobelige. Acetum Sanguinariae. 

Acetum Opii. Acetum Scillae. 

Glycerin Preparations. 

Glycerita, Glycerites, — are mixtures of medicinal substances 
with Glycerin. In the U. S. Phar. of 1870 there were 5 official 
Glycerites, which were solutions of Carbolic, Gallic, and Tannic 
Acids, Tar, and Sodium Borate in Glycerin. They were very 
useful preparations for dispensing purposes, as they could be 
readily diluted with water or alcohol without precipitation. Only 
2 Glycerites are now official, viz. — 

Glyceritum Amyli. Glyceritum Vitelli. 

Solid Preparations. 

Extracta, Extracts, — are solid or semi-solid preparations 
obtained by evaporating solutions of vegetable principles. The 
drug is first powdered, then percolated with the appropriate men- 
struum to exhaustion. The first third of the percolate is reserved, 
the remainder is evaporated at a temperature not above 122 F. 
until its weight is ten per cent, of that of the drug used, then 
mixed with the reserved portion, and both are evaporated to a 
pilular consistence. The above is the general rule, but in several 
instances maceration is directed for 1 to 4 days before percola- 
tion ; and in . other cases, instead of reserving a portion of the 
percolate, the whole quantity is distilled until the alcohol is re- 
moved, and the residue is evaporated to a pilular consistence. 
The menstrua used are, — in 5 cases Alcohol, in 15 cases Diluted 
Alcohol of varying strength, in 8 Water, in 1 Water with 5 per 
cent, of Aqua Ammonise, and in 1 a diluted Acetic Acid. One 
extract is an inspissated juice (Ext. Taraxaci) ; one is made by 
evaporating a fluid extract (Ext. Ergotae), and one by mixing 



OFFICIAL PREPARATIONS. 459 

extracts with aromatics (Ext. Colocynthidis Comp.). Five per 
cent, of Glycerin is added to 10 to prevent their becoming hard. 
The official Extracts number 32, and are named as follows, the 
letters in parentheses showing the nature of the menstruum used 
in extraction in each case, viz. — 

Extractum Aconiti (A). Extractum Haematoxyli (W). 

Ext. Aloes Aquosum (W). Ext. Hyoscyami Alcoholicum (AgWjJ. 

Ext. Arnicae Radicis (DA). Ext. Iridis (AgWj). 

Ext. Belladonnae Alcoholicum (AgWJ. Ext. Juglandis (A). 

Ext. Cannabis Indicae (A). Ext. Krameriae (W). 

Ext. Cinchonae ^Wj). ' Ext. Leptandrae (AgWJ. 

Ext. Colchici Radicis (W). Ext. Malti (W). 

Ext. Colocynthidis (DA). Ext. Mezerei (A). 

Ext. Colocynthidis Compositum. Ext. Nucis Vomicae (AgWjJ. 

Ext. Conii Alcoholicum (DA). Ext. Opii (W). 

Ext. Digitalis (A 2 W X ). Ext. Physostigmatis (A). 

Ext. Ergotae (A 3 W 4 ). Ext. Podophylli (AgWJ. 

Ext. Euonymi (DA). Ext. Quassise (W). 

Ext. Gentianae (W). Ext. Rhei (AgW^. 

Ext. Glycyrrhizae (W). Ext. Stramonii (DA). 

Ext. Glycyrrhizae Purum (W). Ext. Taraxaci. 

The proximate principles which are generally present in ex- 
tracts, besides the peculiar principles of plants, are sugar, tannin, 
extractive, chlorophyll, coloring-matter, and salts. When an alco- 
holic solvent is used there are also present resins, fats and often 
volatile oil, and when the menstruum is not purely alcohol there 
is more or less gum and starch. One of these ingredients, named 
Extractive or Apotheme, is a deposit, soluble in water and alcohol, 
which has the singular property of passing into an insoluble sub- 
stance under the influence of the atmospheric air with heat. It 
also has a tendency, when precipitated from solutions, to unite 
with other principles carrying them down with it. It is frequently 
present in extracts, hence its name. 

Abstracta, Abstracts, — are solid, dry, powdered prepara- 
tions, containing the soluble principles of the drugs from which 
they are made, and each representing twice the strength of the 
corresponding drug or its fluid extract. They are prepared by 
spontaneous evaporation of an alcoholic tincture at a low tem- 
perature (not exceeding 122 F.), mixing with it enough dried 
Sugar of Milk to make the product weigh one-half the weight of 
the drug, and then reducing it to a fine and uniform powder. 
They are permanent and portable preparations, not subject to 
variation in strength, nor to become hard and brittle. They were 
first introduced into the U. S. Pharmacopoeia in the edition of 
1880, and are 11 in number, viz. — 



460 OFFICIAL PREPARATIONS. 

Abstractum Aconiti Abstractum Jalapae. 

Abstractum Belladonnae. Abstractum Podophylli. 

Abstractum Conii. Abstractum Senegae. 

Abstractum Digitalis. Abstractum Valerianae. 

Abstractum Hyoscyami. Abstractum Ignatiae. 

Abstractum Nucis Vomicae. 

The menstrua used for these are Alcohol 8 Water 1 for the 
two last-named, and Alcohol for the others ; but 2 per cent, of 
Tartaric Acid is added in the case of Aconite, and 6 per cent, 
of HC1 in the case of Conium. 

Resina^Resins, — are solid preparations obtained by precipi- 
tating the resinous principles of plants from their alcoholic solu- 
tion by the agency of water. They differ from alcoholic extracts 
in containing only those principles which are soluble in alcohol 
and insoluble in water, while the extracts contain all principles 
which are soluble in alcohol. There are 4 official Resins, viz. — 

Resina Copaibae. Resina Podophylli. 

R esina Jalapae. Resina Scammonii. 

Massae, Masses, — are Pill-masses prepared as described in the 
next paragraph. The official Masses number 3, viz. — 

Massa Copaibae. Mas^£erri Carbonatis. 

Massa Hydrargyri. 

Pilulae, Pills, — are spherical masses composed of medicinal 
agents and intended to be swallowed whole. The " mass 11 con- 
sists of the active ingredients and the excipientox substance which 
gives the mass its adhesive and plastic qualities. In official phar- 
macy the excipients are specified both as to composition and quan- 
tity in each case, and those directed to be used in the preparation 
of the 3 official Masses and the 15 official Pills are as follows, viz. — 

5 are made with Soap and Water, viz. — Pil. Aloes, Pil. Aloes et Asafcetidae, 

Pil. Asafcetidae, Pil. Opii, Pil. Rhei. 
3 are made with Water alone, viz. — Pil. Aloes et Mastiches, Pil. Cathar- 

ticae Comp., Pil. Rhei Comp. 
3 are made with Syrup, viz. — Pil. Aloes et Myrrhae, Pil. Ferri Comp., Pil. 

Galbani Comp. 
I with Mucilage of Tragacanth, viz. — Pil. Antimonii Comp. 
I. with Acacia and Water, viz. — Pil. Ferri Iodidi. 
I with Glycerin and Water, viz. — Pilulae Phosphori. 
I with Confection of Rose, viz. — Pilulae Aloes et Ferri. 
I with Honey, Syrup and Water, viz, — Massa Ferri Carbonatis. 
I with Glycerin and Honey of Rose, viz. — Massa Hydrargyri. 
I has no excipient, viz. — Massa Copaibae. 

The pharmacopceial directions for the formation of the pill- 
mass vary in each case, but in general they prescribe that the 



OFFICIAL PREPARATIONS. 46 1 

ingredients shall be mixed intimately, then beaten with the ex- 
cipient to form a mass and divided into a certain number of pills. 
Two of the official pills are directed to be coated with an ethereal 
solution of the Balsam of Tolu, viz. — Pilulse Ferri Iodidi and 
Pilulae Phosphori. Full descriptions of the various details of 
pill-making are given in the section on Extemporaneous Phar- 
macy. The number of official pills is 15, for the composition 
of which the student is referred to their several titles in the sec- 
tion on Materia Medica. They are named as follows, viz. — 

Pilulae Aloes. Pilulae Catharticae Compositae, 

Pilulae Aloes et Asafoetidae. Pilulae Ferri Compositae. 

Pilulae Aloes et Ferri. Pilulae Ferri Iodidi. 

Pilulae Aloes et Mastiches. Pilulae Galbani Compositae. 

Pilulae Aloes et Myrrhae. Pilulae Opii. 

Pilulae Antimonii Compositae. Pilulae Phosphori. 

Pilulae Asafoetidae. Pilulae Rhei. 
Pilulae Rhei Compositae. 

Trochisci, Troches, — also called Pastilles, Tablets or Loz- 
enges, — are small flattened cakes of medicinal substances, pre- 
pared from a mass made with a basis of Sugar, some having 
Mucilage of Tragacanth, others Orange-flower Water, Syrup of 
Tolu, etc., as excipients. They are convenient preparations for 
the pocket-case, and are especially useful when the active in- 
gredients are intended to come into contact with the mucous 
surface of the throat. There are 16 official Troches, named as 
follows, viz. — 

Trochisci Acidi Tannici. Trochisci Krameriae. 

Trochisci Ammonii Chloridi. Trochisci Magnesiae. 

Trochisci Catechu. Trochisci Menthae Piperitae. 

Trochisci Cretae. Trochisci Morphinae et Ipecac. 

Trochisci Cubebae. Trochisci Potassii Chloratis. 

Trochisci Ferri, Trochisci Sodii Bicarbonatis. 

Trochisci Glycyrrhizae et Opii. Trochisci Sodii Santoninatis. 

Trochisci Ipecacuanhae. Trochisci Zingiberis. 

Confectiones, Confections, — consist of medicinal substances 
formed into a mass with Sugar, Honey, Water, etc., with the 
object of rendering them palatable and of preserving them from 
change. Electuaries are similar preparations, but this term is now 
obsolete. There are only two official Confections, viz. — 

Confectio Rosae. Confectio Sennae. 

Pulveres, Powders, — are usually prepared extemporaneously, 
but a few compound ones have been made official, the ingredients 
being simply directed to be rubbed together until reduced to a 



4^2 OFFICIAL PREPARATIONS. 

fine powder and thoroughly mixed. Special directions are given 
for the preparation of,two, — the Compound Effervescing Powder 
and the Compound Powder of Morphine. There are 9 official 
Powders, named as follows, viz. — 

Pulvis Antimonialis. Pulvis Glycyrrhizae Compositus. 

Pulvis Aromaticus. Pulvis Ipecacuanhse et Opii. 

Pulvis Cretae Compositus. Pulvis Jalapae Compositus. 

Pulvis Effervescens Compositus. Pulvis Morphinge Compositus. 
Pulvis Rhei Compositus. 

The composition of each of these preparations will be found 
in the section on Materia Medica, and under the title from which 
its name is derived, except that of the Compound Effervescing 
Powder which is placed under the title Potassium. Pulvis Ipe- 
cacuanhas et Opii is really a trituration. 

Triturationes, Triturations, — form a class of powders having 
for their diluent Sugar of Milk, and possessing a definite relation 
between the active ingredient and the diluent. The Pharmaco- 
poeia prescribes a general formula for these preparations, according 
to which 10 parts of the Substance and 90 parts of Sugar of Milk 
are to be well mixed by a spatula, the latter being added in suc- 
cessive quantities, and both triturated in a mortar until the sub- 
stance is intimately mixed with the diluent and finely commi- 
nuted. There is but one official Trituration (Trituratio Elaterini), 
though the Pulvis Ipecacuanhas et Opii practically belongs to this 
class, except in respect of the proportions prescribed. For a 
further discussion of this subject see the article Triturations under 
the heading Extemporaneous Preparations. 

Suppositoria, Suppositories, — are solid bodies containing 
medicinal substances, and intended for introduction into the 
vagina, rectum or urethra. There are no official suppositories 
enumerated, but the Pharmacopoeia prescribes a general formula 
for their preparation, according to which the medicinal portion 
should be incorporated with Oil of Theobroma by rubbing them 
together at a temperature of 95 ° F. The mixture should then 
be poured into suitable moulds, and cooled on ice or in ice-cold 
water. Unless otherwise specified they shall be made to weigh 
about 15 grains each. 

Unguenta, Ointments, — are soft, fatty mixtures of medicinal 
agents with a basis of lard, petrolatum, or fixed oils with a solid 
fat such as wax or spermaceti. They are intended for application 
to the skin by inunction, and have a melting point which is below 



OFFICIAL PREPARATIONS, 



463 



the ordinary temperature of the human body. Of the 26 official 
Ointments 1 is prepared by chemical reaction, ¥iz. — Unguentum 
Hydrargyri Nitratis ; 5 by fusion and 20 by incorporation of 
the ingredients with each other by mixing them through the 
agency of a spatula and a porcelain slab. Unguentum itself is 
prepared by fusing together 80 parts of Lard and 20 of yellow- 
Wax, and is the basis of 3 other ointments, while 16 have Ben- 
zoinated Lard as their basis. 



Unguentum. 

Unguentum Acidi Carbolici (10). 
Unguentum Acidi Gallici (10). 
Unguentum Acidi Tannici (10). 
Unguentum Aquae Rosse. 
Unguentum Belladonna? (10). 
Unguentum Chrysarobini (10). 
Unguentum Diachylon. 
Unguentum Gallae (10). 
Unguentum Hydrargyri (45). 
Ung. Hydrargyri Ammoniati (10). 
Ung. Hydrargyri Nitratis. 
Ung. Hydrargyri Oxidi Flavi (10). 



Ung. Hydrargyri Oxidi Rubri (io), 
Unguentum Iodi (4). 
Unguentum Iodoformi (10). 
Unguentum Mezerei (25). 
Unguentum Picis Liquidae (50). 
Ung. Plumbi Carbonatis (10). 
Ung. Plumbi Iodidi (10). 
Ung. Potassii Iodidi (12). 
Unguentum Stramonii (10). 
Unguentum Sulphuris (30). 
Ung. Sulphuris Alkalinum (20). 
Unguentum Veratrinse (4J. 
Unguentum Zinci Oxidi (20). 



The figures in parentheses show the percentage of extract or 
other active ingredient in the ointment. The composition of 
each may be found in the section on Materia Medica under the 
title from which the preparation is named, except Unguentum, 
which will be found under the title Adeps, and Unguentum 
Diachylon under Plumbum. 

Cerata, Cerates, — are unctuous preparations similar to oint- 
ments but of a much firmer consistence. They all contain Wax 
(Cera), and do not melt at temperatures below 104 F. They 
are intended for external use, and are generally spread on lint 
before being applied. There are 8 official Cerates, including 
Ceratum itself, which is made by fusing together 30 parts of 
White Wax and 70 of Lard. The composition of the others may 
be found in the section on Materia Medica under the appropriate 
titles, but the figures in parentheses below give the percentage of 
drug to basis in each. Of the following-named 6 are prepared 
by fusion and 2 by incorporation. 



Ceratum. 

Ceratum Camphorse (0.6) 
Ceratum Cantharidis (35). 
Ceratum Cetacei (10). 



Ceratum Extractum Cantharidis (30), 
Ceratum Plumbi Subacetatis (5). 
Ceratum Resinse (35). 
Ceratum Sabinse (25). 



Emplastra, Plasters, — are solid compounds, insoluble in 
water, of a tenacious but pliable consistence and intended for 



464 EXTEMPORANEOUS PHARMACY. 

external application to limited areas of the body surface. They 
are prepared by incorporating medicinal substances with certain 
bases, which are usually Lead Plaster (Oleate of Lead), a Gum- 
resin, or Burgundy Pitch. The heat employed should be low so 
as to avoid decomposing the active agents, and should not be 
continued long enough to drive off any volatile constituents. The 
plaster mass is then spread evenly on chamois skin, kid-skin or 
muslin. The constituents of the following-named 17 official 
Plasters may be found in the section on Materia Medica under 
their appropriate headings. 

Emplastrum Ammoniaci. Emplastrum Hydrargyri. 

Emp. Ammoniaci cum Hydrargyro. Emplastrum Ichthyocollae. 

Emplastrum Arnicae. Emplastrum Opii. 

Emplastrum Asafcetidae. Emp. Picis Burgundies. 

Emplastrum Belladonnse. Emp. Picis Canadensis. 

Emplastrum Capsici. Emp. Picis cum Cantharide. 

Emplastrum Ferri. Emplastrum Plumbi. 

Emplastrum Galbani. Emplastrum Resinae. 
Emplastrum Saponis. 

Of the foregoing only two are directed to be spread, viz. — 
Emp. Capsici upon muslin, and Emp. Ichthyocollae upon taffeta, 
the others having no pharmacopceial prescription for the material 
to be used. Plasters after being spread should remain soft, 
pliable and adhesive, without melting at the heat of the body. 
To soften the surface, if old, it should be brushed with a small 
quantity of Tincture of Camphor. 

Chartae, Papers, — consist of strips of paper medicated by 
impregnation of its fibres with medicinal substances, or by being 
coated therewith. Of the 3 official Papers 2 are made with 
sized paper, and are intended for external application as vesicants 
or counter-irritants ; the third (Charta Potassii Nitratis) is unsized 
paper impregnated with Nitre and intended for the inhalation of 
its fumes while burning. Those officially recognized are — 

Charta Cantharidis. Charta Sinapis. 

Charta Potassii Nitratis. 



EXTEMPORANEOUS PHARMACY. 

This division is the most important of the whole subject of Phar- 
macy, embracing as it does the preparation and dispensing of those 
medicines which are designed for immediate use and which are 
compounded on the prescriptions of physicians. Hence it com- 



WEIGHTS AND MEASURES. 465 

prises the chief portion of the daily work of the pharmacist, and 
can only be learned at the dispensing-counter and under the per- 
sonal supervision of a competent master. In the following pages 
are given the most important of the general directions pertaining 
to this subject, with the object of enabling the young medical 
practitioner to familiarize himself with the compounding and 
dispensing of drugs so far as the limits of the book will admit of. 
The drug-store of the present day has degenerated so far from its 
legitimate business that ere long physicians will be compelled in 
self-defence to dispense their own medicines, thereby protecting 
themselves and their patients from the patent-medicine vending, 
the counter-prescribing, and the many other nefarious methods 
which have degraded the pharmacist from his old professional 
position to that of a mere trader in drugs and nostrums. The 
first outfit of every young doctor should include a few pharma- 
ceutical instruments and a small stock of drugs. By daily 
handling of these, the tools of his profession, he will insensibly 
become familiar with the technique of the art, and even if he does 
not continue to dispense his medicines in after years he will 
never regret the practical knowledge which such a course will 
give him. 

Compounding means the mixing or preparing of the drugs 
ordered in a prescription, and comprises all the operations of 
official pharmacy together with many other manipulations which 
will be described in their appropriate places. 

Dispensing is the operation of putting up and issuing the 
drugs ordered in a prescription, and may apply to the already 
compounded preparations of official pharmacy as well as to those 
prepared extemporaneously. 

WEIGHTS AND MEASURES. 

The working formulae of the U. S. Pharmacopoeia are con- 
structed on the system of parts by weight for all articles whether 
fluids or solids, except in the case of fluid extracts, for which the 
metric weights and measures are employed. On this system it 
really makes no difference what unit of weight is adopted in offi- 
cial pharmacy. However, the weights and measures referred to 
by physicians in prescribing and used by pharmacists in dis- 
pensing medicines are in the United States those of the Apothe- 
caries' or Troy System of Weights (having 480 grains to the ounce 
and 5760 grains to the pound) and the Wine Measure, or those 

39 



4 66 



WEIGHTS AND MEASURES. 



of the Metric System. On the other hand, the British Pharma- 
copoeia recognizes only the Imperial Standard (Avoirdupois) 
weights, having 437^ grains to the ounce and 7000 grains to the 
pound. The drachm (60 grains) and the scruple (20 grains) are 
intermediate units which are still used but are rapidly becoming 
obsolete. The units of the Wine Measure are the minim (tri), 
which in water at its maximum density equals gr. 0.95 ; the 
fluidrachm (60 minims) and the fluidounce (8 fluidrachms or 480 
minims). The signs used to denote these units are ttt. minim, 
9 scruple, 5 drachm, g ounce, and in the cases of liquids an 
f to denote fluid is often placed before the sign, thus f5 for 
fluidrachm, f § for rluidounce. The relations between these units 
of weight and measure are as follows : 



Measure. Weight. 

r^j, One minim = 0.95 grains, 

fg j, One fluidrachm = 56.96 " 
f^j,One fluidounce =455.69 " 



Weight. Measure. 
grain j = 1.05 minims. 
3 j = 63.20 " 
I j = 505-60 « 



Table of Troy or Apothecaries' Weight. 



Pound. 


Ounce. 


Drachm. 




Scruple. 




Grain. 


Libra. 


Uncia. 


Drachma. 




Scrupulus. 




Granum 


lb 

1 = 


1 

- 12 

I 


= 96 

= 8 
1 


= 


3 

288 

24 

3 
1 


= 


g r - 

5760 

480 

60 

20 



Pound. 
Libra. 

ft) 

I 



Table of British Phar?7iacopozial Weight. 

Troy grain, Avoirdupois ounce and pound. 

Grain. 
Granum. 

g r - 
= 7000 

= 437 l A 

The Troy ounce contains 42^ grains more than the avoirdu- 
pois ounce, but the Troy pound contains 1240 grains less than 
the avoirdupois pound. The grain is the only unit common to both. 

Table of Apothecaries' or Wine Measure, 



Ounce. 

Uncia. 

OZ. 

16 

I 



Gallon. 


Pint. 


Fluidounce. 


Flnidrachm. 




Minim. 


Congius. 


Octarius. 


Fluiduncia. 


Fluidrachma 




Minimum 


c. 


O. 


M 


<"•? 




HI 


I 


= 8 


128 = 


IO24 


= 


61440 




1 = 


16 = 


128 


— 


7680 






I = 


8 


— 


480 








1 


— 


DO 



WEIGHTS AND MEASURES. 467 

Table of British I??iperial or Pharniacopozial Measure. 



Gallon. 


Pint. 


Fluidounce. 


Fluidrachm. 


Minim. 


Covgius. 


Octarius, 


Fluiduntia. 


Fluidrachma. 


Minimum. 


c. 


O. 


floz. 


fldr. 


min. 


I 


= 8 


= i60 == 


1280 = 


76800 


• 


1 = 


= . 20 == 


160 = 
8 = 
I = 


9600 

480 

60 



The Metric* of Decimal System of Weights and 
Measures, is generally used on the continent of Europe, and 
also by French and German physicians in the United States. 
Its three standard units are the following, viz. — 

A Meter, the standard unit of linear measure and also of the whole system, 
is the ten-miilionth part of the quadrant of the earth, i. e., the forty-millionth 
part of theearth's circumference around the poles. One-tenth of the meter is 
the Decimeter, one-hundredth is the Centimeter, and one-thousandth is the 
Millimeter. 

A Liter, the unit of measures of capacity, is the cube of a decimeter. One- 
thousandth of a liter is the Cubic Centimeter, which measure of pure water at 
its maximum density weighs one Gramme. 

A Gramme, the unit of weight, is the weight of the one-thousandth part of 
a liter of water at its maximum density. Its tenth is the Decigramme, its hun- 
dredth is the Centigramme* and its thousandth part is the Milligramme. 

The metric measures above noted are those used chiefly in 
pharmaceutical practice, but the system embraces many other 
terms of increase which are set forth in the following table. 



1 0000 




Myriameter. 


1 0000 


Myrialiter. 


1 0000 




Myriagramme. 


IOOO 




Kilometer. 


1000 


Kiloliter. 


IOOO 




Kilogramme. 


100 




Hectometer. 


100 


Hectoliter. 


100 




Hectogramme. 


10 




Dekameter. 


10 


Dekaliter. 


10 




Dekagramme. 


1 




Meter. 


1 


Liter. 


1 




Gramme, 




.1 


Decimeter. 




.1 Deciliter. 




.1 


Decigramme. 




.01 


Centimeter. 




.01 Centiliter. 




.01 


Centigramme. 


.1 


001 


Millimeter. 


.001 Cubic Centimeter 


.( 


DOI 


Milligramme. 










or Milliliter. 









The relations between the Metric Weights and Measures and 
the Apothecaries' are as follows, viz. — 

1 meter = 39.370432 inches. 

I liter = 2.1 13433 pints. 

I gramme = 15.43234874 grains. 

I grain = 0.06479895 gramme. 

1 minim = 0.0161613 cubic centimeter. 

The Metric System is making way but slowly in this coun- 
try although its progress is aided by every process of forcing 



468 WEIGHTS AND MEASURES. 

which scientific bodies can bring into action, and it remains to 
be seen how much its adoption in the last edition of the U. S. 
Pharmacopoeia will influence the medical profession in its favor. 
With all the influence brought to bear in its favor it certainly 
has not yet been adopted by any considerable proportion of 
native-born and home-educated physicians and pharmaceutists. 
Its chief disadvantage is one which is inherent to any decimal 
system, viz. — that the number ten cannot be divided more 
than once without producing a fraction. This is partly com- 
pensated for by the practice of dividing five into the three parts 
of 2, 2 and 1, and on this principle metric weights are usually 
constructed. In writing or reading prescriptions it is sufficiently 
accurate to consider a gramme as equivalent to 15 Troy grains, 
and a cubic centimeter (milliliter) as equivalent to 15 minims, or 
one-fourth of a fluidrachm. All other terms, units or prefixes be- 
longing to the metric system may be wholly ignored by the physi- 
cian and the pharmacist. The decimal point after the gramme 
or the cubic centimeter should always be replaced by a line so as 
to avoid errors which in many cases might prove serious from the 
misplacement of a point, the dropping of a spot of ink or the 
intrusion of a fly-speck. The simplest method of writing a metric 
prescription for one not practiced in the system is to first write 
for one dose of the medicine in grains and minims, then by substi- 
tuting the same number of grammes and cubic centimeters {fluid- 
grammes) we get fifteen doses in metric terms. Of course when a 
mixture or solution is desired the proper quantity of vehicle must 
be added to give the dosage in such measures as may be deemed 
convenient for administration. For example, — 

One dose. 1 5 doses metric. 

R. Quininae Sulphatis, m gr. j, I 

Strychninae Sulph., . . gr. ^ or 0.016, 016 

Ext. Glycyrrhizae FL, . "ni iv, 4 

Syrupi, 1U lx, , 60 

This gives a two-ounce mixture approximately, of which the dose would be 
"a teaspoonful thrice daily." 

One dose. 15 doses metric. 

R. Quininae Sulphatis, . gr. j, I 

Massae Ferri Carb., . . . gr. ij, 2 

Ext. Nucis Vomicae, . gr. j^ or 0.25, 25 

Ft. pil. No. xv. Sig. — One pill thrice daily after meals. 

The above rule will answer for all liquids except those which 
are very heavy (as Syrups and Chloroform), or very light (as 
Ether). Measures may be entirely discarded, and all fluid quan- 



WEIGHTS AND MEASURES. 469 

tities expressed in grammes. The average drop of water may be 
considered equivalent to 0.05 cubic centimeter (or gramme), 
the average teaspoonful to 5 c.c., the tablespoonful to 20 c.c., 
the Troy 3 to 30 grammes, the fluidounce to 30 c.c, and 8 fluid- 
ounces to 250 c.c. 

In prescribing Syrups or Chloroform, each Troy fluidounce 
should be reckoned at something more than 30 grammes — say 
40 ; and if this be done, the difficulty of converting one scale 
into the other will be obviated. As to Syrups, Chloroform, etc., 
the following table shows the actual weight in grammes of each 
fluidounce of the substances named : 

Water. Tinctures. Syrup. Chloroform. Ether 

Fluid Oz. (Grammes.) (Grammes.) (Grammes.) (Grammes.) (Grammes.) 

gi. — 29.52 28.00 38.00 4370 22.14 

§ii. = 59.04 56.00 76.00 87.40 44.28 

giv. = 118.08 112.00 152.00 174.80 88.56 

gviii. = 236.16 224.00 304.00 349.60 177.12 

A table of equivalents between Apothecaries , and Metric 
Weights and Measures will be found in the Appendix. 



Approximate or Domestic Measures become necessary 
in apportioning doses for a patient, when liquid medicines are 
used. Of these the measure most commonly employed is the tea- 
spoonful, which is generally taken as equivalent to a fluidrachm, 
though in most cases as now manufactured the teaspoon contains 
about 75 minims, or 25 per cent, more than the theoretical quan- 
tity. The dessertspoonful is about equal to 2 teaspoonfuls, and 
the tablespoonful to about four teaspoonfuls or f^ss, while the 
wineglass is supposed to contain about fgij. The use of graduated 
medicine-glasses is strongly recommended instead of the above 
approximate measures. They may be obtained at a trifling cost 
in any well-stocked drug-store. 

Drops (Guttae) are very variable in size, though popularly 
supposed to equal minims, the variations in their relative dimen- 
sions being due to the viscidity of the liquid, the shape and sur- 
face of the orifice from which they escape, and sundry other 
circumstances. The Syrups and Mucilages produce large drops, 
while Bromine, Chloroform, and other heavy mobile liquids 
produce very small ones. These differences are well illustrated 
in the following table which gives the number of drops in a 
fluidrachm of several liquids of certain classes. \ 



47° PRESCRIPTIONS. 

Syrupus Acacise, 44. Oleum Ricini, 77. 

Syrupus Scillse, 75. Oleum Copaibae, 123. 

Aqua, 60. Oleum Juniperi, 148. 

Liquor Potassse, 62. Spiritus Camphorse, 143. 

Liquor Hydrargyri Nitrat, 131. Spiritus Chloroformi, 150. 

Acetum Opii, 90. Ext. Digitalis Fluid., 134. 

Vinum Opii, 100. Ext. Ipecac. Fluid., 120. 

Tinct. Opii Deodorat., no. Ext. Cinchonae Fluid., 138. 

Tinct. Opii Camph., no. Ext. Zingiberis Fluid., 142. 

Tinct. Opii, 130. Ext. Buchu Fluid., 150. 

Tinct. Iodi, 148. Ext. Hyoscyami Fluid., 160. 

Tinctura Aconiti, 146. Either Fortior, 176. 

Alcohol Dilutum, 137. Bromum, 250. 

Alcohol, 146. Chloroform. Purif., 250. 

Specific Gravity is the relative weight of equal bulks of 
different bodies. The specific gravity of water at a certain tem- 
perature (generally 59 F.) is taken as 1, and that of all other 
substances is expressed in terms of this unit. The Pharmacopoeia 
gives very complete tables of percentages and specific gravities 
of Alcohol, Acetic, Hydrobromic, Hydrochloric, Nitric, Sul- 
phuric and Phosphoric Acids, and of aqueous solutions of Po- 
tassa and Soda. The specific gravity of any substance is expressed 
by the quotient obtained by dividing the weight of a given 
measure of the substance by the weight of an equal measure of 
water. In pharmacy the specific gravity of solids is not of any 
importance, but that of liquids is a matter of constant value, 
and is determined in most cases by means of a specific gravity 
bottle or by a hydrometer, instruments which are described in 
any standard work on chemistry or physics. Modifications of 
the hydrometer with scales adapted to particular work are the 
urinometer, saccharometer, lactometer, etc. 

Specific Volume is the relative bulks of equal weights of 
different bodies. In pharmacy it means the volume of the weight 
of a liquid compared with the volume of an equal weight of 
water at 59 F. The specific volume of a body is therefore in- 
versely as its specific gravity, and is expressed by the quotient 
obtained by dividing unity by the specific gravity. — ^-= 

sp. vol., and therefore sp. gr. X sp. vol. = 1. 

[A table of the specific gravity and specific volume of several 
liquids will be found in the Appendix.] 

PRESCRIPTIONS. 

Extemporaneous Prescriptions are formulae written by 
the physician on the instant {ex tempore) to meet the require- 



PRESCRIPTIONS. 47 1 

ments of individual cases. A prescription should begin with the 
name of the person for whom it is designed, and the date on 
which it is written. Then follows the Latin word Recipe \ usually- 
abbreviated to the sign R, and signifying "Take," or " Take 
thou;" next the names and quantities of the ingredients to be 
used, which are also expressed in Latin ; then the directions 
to the compounder, followed by the directions to the patient, 
the last being now usually expressed in English ; and finally the 
signature of the prescriber. 

A prescription then consists of four parts, viz. — the 

Superscription, — consisting of the name of the party, the date and the 

sign R. 
Inscription, — the body of the prescription, which may consist of the — 

Basis, — or chief, active ingredient. 

Adjuvant, — to assist the action of the basis. 

Corrective, — to correct some injurious quality of the other ingredients. 

Vehicle or Excipient, — giving it a suitable form. 
Subscription, — the directions for the compounder, usually expressed in 

contracted Latin. 
Signature, — the instructions for the guidance of the one administering 

the medicine, in English, followed by the signature of the prescriber. 

A prescription may however contain the base alone, or the 
base with the adjuvant, or the base with a simple vehicle or dil- 
uent, etc. A single ingredient may serve a double or treble 
office, as the Syrupus Rhei Aromaticus with Quinine, in which 
case the syrup serves as an adjuvant to increase the action of the 
quinine, as an excipient to cover the taste, and as a vehicle to 
facilitate the administration of the dose directed. The basis may 
not need any aid in doing its work, and may require no correc- 
tive of its action nor any special vehicle. On the other hand 
there is no limit to the number of ingredients which may be used, 
provided the prescriber has a clear idea of something to be ac- 
complished by each one, and also provided that there is no 
chemical or medicinal incompatibility between them. In olden 
times prescriptions were very complex, and contained a great 
many curious and incongruous ingredients. As Dr. PirTard well 
says, " the tendency of the. present age is toward mono- rather 
than poly-pharmacy, and prescriptions with the orthodox adju- 
vans and corrigens are less frequently seen than formerly.' ' There 
is danger however in carrying this simplicity too far, for there is 
no doubt but that proper combinations of medicines will often 
produce effects for the patient's good, which could not be ob- 
tained from the use of any one remedy. 

An example will perhaps make the foregoing analysis more 
comprehensible, and at the same time serve to indicate the style of 



472 



PRESCRIPTIONS. 



abbreviation usually employed. The following formula is that 
of the Pharmacopoeia for the Compound Infusion of Senna, or 
the old-time " Black Draught/ ' except that approximate weights 
and measures are substituted for the pharmacopoeial parts. 



For Mrs. Steele. 
Recipe, Take, — 

' Sennce 



July 6th, 1886. 



Superscription. 



(Basis.) 

(Adjuvant.) 

(Corrective.) 

(Vehicle.) 



setniunciam, 
Of Senna, half an ounce ; 
Magnesii Sulphatis, 
Magnesium Sulphate, 

{Mannce, ana unciam unam, 
Manna, of each an ounce ; 
f Fozniculi, drachmam unam, 
\ Of Fennel, one drachm ; 
f Aquce Bullientis, jluiduncias octo, 
\ Of Boiling Water, eight fluid-ounces. 
Macera per horam in vase clauso, deinde cola, 
Macerate for an hour in a closed vessel, then strain. \ 

Signa, Mark, or Write thus — A wineglassful every four 
hours till it operates. 

T. F. Wood, M.D. 



- Inscription. 



} 



Subscription, 



Signature. 



Abbreviated in the style usual with physicians the above pre- 
scription would read as follows, viz. — 



$ss 



For Mrs. Steele. 

Sennce, 

Magnes. Sulph., 

Mannce, aa ^j 

Foeniculi, %j 

Aq. Bull. , f3 y iij 

Mac. per hor. in vase clauso, deinde cola. 
Sig. — A wineglassful every four hours till it operates. 



July 6th, 1886. 



Wood. 



The above is given as an example of an ordinary compound 
prescription, but as the result is nearly identical with an official 
preparation, we might write the prescription simply as follows, — 

R. Infusi Sennce Compos, ^viij. 

and this is the manner of prescribing the official compound prep- 
arations. It will be noticed that the term " basis " in the analysis 
of the formula covers two ingredients ; but either of the two 
might be considered the principal agent, and the other one 
classed as an adjuvant. 

As Pareira says, " These four parts of a formula are intended 
to accomplish the object of Asclepiades, curare cito, tute et ju- 



PRESCRIPTIONS. 473 

cunde ; in other words to enable the basis to cure quickly, safely 
and pleasantly y 

The Principles of Combination are so well laid down by 
Dr. H. C. Wood, that his words are appended ver.batim, as fol- 
lows, — 

The art of combining medicines is not a difficult one ; but in practice cer- 
tain principles should not be lost sight of. Chief of these are, to prescribe as 
few remedies as possible, and to use no powerful drug without a very distinct 
idea of what it is intended to do. Whenever it is desired to give a powerful 
remedy in increasing doses until its physiological effect is produced, it should 
always be given by itself. Thus, it may be necessary to give arsenic so as to 
impress the system, at the same time that iron is indicated ; but the two reme- 
dies should be given separately, so that the dose of either can be increased or 
diminished independently of the other. 

The principles of combination formulated below were long ago enunciated 
by Dr. Paris, but are to-day as imperative as ever. Medicines are combined : 

First. To augment, correct, or modify the action of a medicine. Thus, pur- 
gatives act much more kindly when a number of them are united together. 
The chief reason of this probably is, that as different remedies affect different 
portions of the gut, the whole intestine is best reached by a union of the di- 
verse substances. It may take an intense irritation of the mucous membrane 
to purge as actively as does a mild irritation of both the mucous membrane 
and the muscular coat. In the case of neurotics the principle has a very 
limited action, because so many of this class of remedies are physiologically 
more or less antagonistic ; yet sometimes the principle can be advantageously 
applied : thus, the anaesthesia of Chloroform or Ether may be prolonged by a 
hypodermic injection of Morphia; and Chloral and Morphia certainly make a 
mixture which is much more powerfully hypnotic than is either of the sub- 
stances separately. 

Second. To obtain the joint action of two or more diverse remedies. Thus, 
in a cough mixture Morphia may be included to quiet the cough, whilst Ipe- 
cacuanha and Squill (in accordance with the first principle) are added to affect 
the mucous membrane. The application of this principle requires caution, or 
the practitioner will be led into that chief abomination — polypharmacy. It is 
worse than iutile to attempt to prescribe for every symptom. It is the under- 
lying cause of the disorder or the under-stratum of bodily condition which 
must be sought out and prescribed for simply. 

Third. To obtain a special combination, which is really a new remedy, or 
which experience has shown acts almost as a new remedy. Thus, when to 
Iodide of Potassium in solution Corrosive Sublimate is added, a new chemical 
compound is formed, which experience has shown to be of great value in 
syphilitic diseases. Griffith's antihectic mixture is another instance of the 
use of chemical changes, the Proto-carbonate of Iron being formed out of the 
Sulphate of the metal and the Carbonate of Potassium. In the famous Dover's 
powder no chemical change occurs, but the ordinary action of Opium upon the 
skin is so enhanced that the combination maybe looked upon almost as a new 
remedy. 

Fourth. To afford a suitable form. Thus, Acacia is added to make an 
emulsion, or Confection of Rose to make a pill. In the choice of excipients 
care should be. exercised to select a substance free from medical properties, 

40 



474 PRESCRIPTIONS. 

having no chemical incompatibility with the medicinal agent, and of suitable 
physical character. Bread crumbs often make a good basis for pills ; but 
with Nitrate of Silver they are chemically incompatible, on account of the 
chlorides in them. When writing a prescription, the utmost care should be 
taken to use such excipients that the combination should not only be attractive 
to the eye, but also as little repulsive to the palate as may be. Whenever 
possible, the pill-form should be employed with bitter or disagreeable medi- 
cines. The pill may be readily coated with silver-foil; tonic pills maybe 
coated with Iron by shaking or rolling them in Ferri Pulvis whilst soft and 
sticky. Sugar-coated pills and " compressed pills " are apt to get so hard and 
insoluble that their use requires caution. In regard to mixtures, flavoring 
oils should be freely used, and the power of Glycerin to conceal the disa- 
greeable taste of many substances should be remembered. 

In Writing an Extemporaneous Prescription, the first 
step is to put down the superscription, consisting of the name, 
date and the sign R. Next the name of each ingredient should 
be written in Latin and in the genitive case, each one on a sep- 
arate line. Then the quantity of each article sufficient for one 
dose should be mentally determined and multiplied by the num- 
ber of doses which the mixture is to contain, and the result set 
down in signs and Roman numerals. The directions to phar- 
macist and to patient being added, and the prescribed name or 
initials affixed, the prescription is completed ; but when very 
active agents are used, it is a good plan to go over the calcula- 
tions a second time before letting it leave the hands of the person 
most responsible for its action. For pills or powders the same 
process should be employed, slightly varied according to the 
requirements of each case. Frequently the ingredients and 
quantities for but one pill, powder or suppository are named, 
with instructions to make a certain number after the formula. 
When an unusually large dose of any poisonous drug is prescribed, 
it is customary to underline the quantity, so as to call the atten- 
tion of the compounder to the fact that the prescriber is aware 
that the dose is above the average. 

There is no royal road to prescription-writing; practice, care 
and knowledge of the whole subject is necessary to enable one to 
turn out habitually those elegant prescriptions which are properly 
termed "magistral," being the work of a magister, or master of 
his business. A fair knowledge of the Latin language is a sine qua 
non to every professional man, but especially to the physician. It is 
pitiable to see a Doctor write ignorantly of even the genitive case- 
endings of the drug-names which he uses. The teaching of 
Latin is not within the scope of this work, and hence this part 
of the subject will be dismissed with the advice to the physician 
who is ignorant of that language to write his prescriptions wholly 
in English if he cannot write them in decent Latin. * 



PRESCRIPTIONS. 



475 



Abbreviations, though very commonly used by physicians 
in prescribing, are a source of much annoyance to the com- 
pounder, and frequently one of great danger to the patient. 
Physicians who never knew anything of the Latin grammar, or 
those who have forgotten its rules, are very apt to use abbrevia- 
tions to conceal their ignorance of case-endings. Many others 
use them through sheer laziness, and some from force of habit. 
The educated and conscientious man will take pride in turning 
out a full and clear prescription, free from cabalistic letters and 
all elements of uncertainty. In the appendix will be found a list 
of the Latin terms used in prescriptions, with the abbreviations 
in vogue, and the English meaning. Ambiguous contractions 
may result fatally to the patient, as is readily seen by studying 
the following list, which gives a few examples of the dangers 
of careless abbreviation. 



Aconit. 



Ammon, 



Aq. Chlor. 



Acid. Hydroc; — may mean 

f Aconitine. 

\ Aconitum. 

f Ammonia. 

( Ammoniacurm 

J Aqua Chlori. 

\ Aqua Chloroformi. 

a T7 s- I Might easily be read 
Aq. Fontis. < . fo -,-, .. J 
1 \ Aqua Fortis. 

( Chlorine. 
Chlor. \ Chloral. 

( Chloroform. 

( Calomel. 
Hyd. Chlor. 1 Corrosive Sublimate. 

( Hydrate of Chloral. 



f Acidiim Hydrochloricum. 
\ Acidum Hydrocyanicum. 

{ Hydrargyrum. 
| Hydras. 
Hydr. X Hydriodas. 

Hydrochloras. 
Hydrocyanasj 
( Sodium Sulphate. 
Sod. Sulphx 1 Sodium Sulphite. 
( Sodium Sulphide* 
' Sulphur. 
c r^L Sulphide. 

Sulph. j sulphate. 

Sulphite. 
•7- • Di f Zinc Phosphate. 
Zw,rt/ ^-\ Zinc Phosphide 



Prescription Blanks. After many years' experience in 
prescribing on blanks furnished by druggists, the writer has come 
to the conclusion that it is much better for many reasons for the 
physician to have his own blanks, without the address of any 
drug-store thereon. These blanks should be furnished with stubs 
on which to write the prescription at first in rough, afterwards 
copying it out cleanly on the main blank. A careful prescriber 
always writes a formula twice before letting it go out of his hands. 
If he does the first writing on the stub of a book of blanks he 
will always have a copy of such prescription in his possession, 
for which he will often be thankful. The blank used by the writer 
measures 4^ inches by 3^, joined by a perforated edge to a 
stub 2>%. inches by 3^ inches* On the main blank the physician's 
name and address are printed, together with his office hours, and 



47^ PRESCRIPTIONS. 

a place for number and date, also the sign R., and a line for sig- 
nature. On the stub there are printed the words, " Copy of Pre- 

scription No 188 . . For ," and on 

the back of the main blank occurs the following printed legend 
in red ink : 

A Prescription written on this side 

OF THE SHEET MUST NOT BE RENEWED 
UNDER ANY CIRCUMSTANCES WHATEVER, 
WITHOUT MY ORDER. 

, M.D. 

These blanks are bound up in books of 100 each, with a flexible 
morocco cover, from which the book of stubs may be slipped and 
a fresh book inserted as required. The size is ample for all or- 
dinary requirements, and permits of the book being carried in 
the breast-pocket.- 

Renewals. It would be advisable for Pfcys^^Lto always 
write the words " Non i?^0z/tf/#///jH?^s(m 
on all prescriptions which should Thit be repeated without their 
sanction. By so doing they would doubtless cut off a good 
many renewal charges from the receipts of druggists who would 
fear the legal consequences of disobeying the mandate. This 
inconvenience to the drug-seller would be more than compensated 
for in the protection to the drug-taker, who too frequently carries 
in his pocket-book a stock of recipes for his various complaints ; 
and in protection to the physician, who by giving up the dispens- 
ing of his own medicines has placed it in the power of the 
druggist to connive at a direct robbery of the just reward of pro- 
fessional skill and knowledge. 

It is doubtless a fact familiar to every observer, that the old- 
time confidential relations between the professions of physician 
and pharmacist have almost passed into oblivion. In fact, the 
tendency of pharmacy now-a-days is towards the position of a 
mere money-making trade, instead of in the exalted direction 
of a profession. The indiscriminate renewing of prescriptions, 
the open sale of quack nostrums and homoeopathic pellets, the 
readiness with which counter-prescribing is indulged in, the in- 
sinuations too frequently made over the drug-counter in reflection 
on physicians, and many other similar practices, have caused the 
non-combatant profession to regard the average druggist with 
suspicion. If physicians boldly took the dispensing of medicines 
more into their own hands many of these evils would soon elimi- 
nate themselves from the drug-stores. Right here, it may be 



PRESCRIPTIONS. 477 

said that there is nothing unprofessional or derogatory in the 
dispensing of his own medicines by the physician. In England 
it has been the universal practice for centuries in all places except 
the largest cities, and it has only been given up by a part of the 
medical profession as a matter of convenience, not as a right. 
The homoeopaths fought for the reclamation of this practice as a 
right belonging to the medical profession, and succeeded in its 
legal establishment, but not from a worthy motive. They dis- 
pense their own medicines in order to cover up the many frauds 
of which they are daily guilty, and to give them the power of 
administering full doses of powerful drugs in a form which is 
apparently " homoeopathic," with no tell-tale prescription on 
file in a drug-store to give mute but dangerous evidence against 
their honesty. In this way they administer several grains of 
Calomel or eighth-grain doses of Morphine, or correspondingly 
large quantities of active alkaloids, triturated with sugar of milk, 
or dissolved, as many of the latter may be, in alcohol. Chemistry, 
by isolating the active principles of plants, and furnishing them 
to commerce in the form of soluble salts, has enabled the homoeo- 
path to practice this fraudulent method of dispensing drugs, which 
the innocent and ignorant patient, who believes in the power of 
the minimum dose, supposes to be infinitesimal in amount. But 
the physician of the regular profession is too apt to think that if he 
adopts a practice which these quacks have appropriated to them- 
selves, he may be classed with them by his professional com- 
petitors. Hence, many regular physicians are absolutely afraid 
to use such drugs as Aconite, Belladonna, Gelsemium, Arnica, 
Rhus, etc., all of which are official, and most of which are older 
than homoeopathy in medicine; and avoid pocket-cases, drachm- 
vials and triturations, as badges of charlatanism. It is high time 
that we asserted our independence in all these matters, and made 
use freely of those means which are recommended by our indi- 
vidual judgments as promotive of the best results to our patients 
and to ourselves. With a small stock of reliable fluid extracts, 
such as are manufactured by Parke, Davis & Co., of Detroit, or 
Dr. Edward R. Squibb, of Brooklyn, — an equally moderate sup- 
ply of gelatin-coated pills and compressed tablets from the best 
houses, such as McKesson & Robbins, SchierTelin & Co., Warner 
& Co., Wyeth & Co., physicians could check-mate the unscru- 
pulous practices of many druggists to a great extent, save their 
patients many dollars, and retain many a dollar for their own 
pockets, which under the present system goes to their enemies. 
The homoeopaths understand the money part of the argument 
well. When their patients' medicine is exhausted, the doctor 



47§ PRESCRIPTIONS. 

must be seen for a fresh supply, meaning of course another con- 
sultation about symptoms, a change perhaps from Mercurius 
Dulcis to Mercurius Vivus, and another fee. The expense is 
nothing, sugar of milk being cheap, and there is no prescription 
in the patient's pocket-book, to be renewed scores of times (pay- 
ing toll however every time to the druggist), and finally to be 
copied by aunts, mothers and friends, as a sovereign remedy for 
a cough, or a really wonderful receipt in a case of croup. 

Filling a Prescription means a combination of operations 
which requires great care, undivided attention, and a special prac- 
tical apprenticeship at the dispensing desk. In the following 
discussion of extemporaneous preparations such hints are incor- 
porated as are particularly applicable to the compounding of each 
article under consideration ; and they may be prefaced by a few 
general suggestions which will serve to point out the most ap- 
proved method of dealing with this important part of the drug- 
gist's work. 

The prescription should first be slowly read over in a critical 
spirit, but no word or action of unfavorable criticism should 
reach the ears or eyes of the messenger. To shrug the shoulders 
while scanning the items, to laugh or even smile at the phraseol- 
ogy, to question the person offering it as to whom it is for, or what 
complaint it is given for, are instances of such flagrant treason 
to the prescriber as would justify his kicking the offender with a 
copper-toed boot. The compounder has no business whatever 
with the propriety of the recipe for its purpose. It might have 
been given as a placebo for reasons eminently wise and judicious; 
or if not so constituted it has at least been ordered by one who 
is in possession of facts which the druggist knows nothing about, 
even if by education and experience he were competent to judge 
in the matter, which he seldom is. His criticism should be di- 
rected only to the dosage and the pharmaceutical compatibility 
of the ingredients. Even in the latter case he must remember 
that incompatibles are often prescribed with the view of forming 
another agent from the chemical reaction produced. If he 
thinks that there is any mistake, and the drugs ordered are in 
any degree poisonous, it is his duty to make an excuse for delay 
to the messenger and at once communicate with the physician. 
This course, in these days of telephones, is nearly always prac- 
ticable. 

After reading the prescription, it is well to number it and 
write the label. This gives time for the label to dry, and avoids 



PRESCRIPTIONS. 479 

the use of blotting paper, which often mars the writing and 
renders the directions all but illegible. 

A clearly defined method should next be decided on by which 
to compound the prescription. Directions for such plans of pro- 
cedure will be found in the succeeding pages under the titles of 
the various preparations. Next, the ingredients should be care- 
fully weighed or measured out, each one being checked off so as 
to avoid the danger of its being duplicated. In many cases the 
excipient is not specified, its choice being left to the druggist ; 
but in all such a note should be made on the prescription to show 
the article used, in order that in the event of a renewal there may 
be no difference perceptible. No alteration or addition should 
ever be made which would in any degree affect the medicinal 
action of the prescription, or interfere with the obvious intention 
of the prescriber. 

The labelling of the package and the numbering and filing of 
the prescription are matters of mechanical detail which are best 
learned at the counter. Various devices for simplifying these 
operations are in vogue and may be seen in any well-appointed 
drug-store. Poisonous articles sold by the druggist should always 
be labelled " Poison, n and the transaction entered in a book 
usually required by law to be kept for that purpose ; but in the 
case of prescriptions the word " Poison' ' should not appear on 
the package or label unless so directed by the prescriber. 

Stock Solutions of the salts most frequently prescribed are 
kept in many establishments for convenience in dispensing. 
Those most generally used are the following : 

Alum, — ^ijss in a quart of distilled water. Of this solution each fluidounce 
represents gss of the salt. 

Potassium Bicarbonate, — %] in f^iv of distilled water; of which J ss con- 
tains 3J of the salt. 

Potassium Chlorate, — I in 24 of distilled water, will not crystallize as the 
temperature changes. 

Potassium Bro7nide, — I in 3 of distilled water, makes a very convenient 
solution for dispensing purposes. 

Chloral Hydrate, — 1 in I of distilled water : of which each minim contains 
a grain of chloral. 

Morphine Sulphate, — gr. xvj in gj of distilled water, with a grain of Sali- 
cylic Acid or 3 drops of Carbolic Acid to prevent change. Of this solution, 
known as Magendie's, each minim contains gr. ^ of the salt, and Tn_x con- 
tain gr. i. A safer solution is the Liquor Morphiae Sulphatis of the U. S. P., 
1870, which had one grain of the salt in each fluidounce. 

Carbolic Acid, — ^j in f§iv of glycerin, makes a convenient solution which 
will mix with water in all proportions, rrtivss represent gr. j of the acid. 

Tannic Acid, — ]$] in f %iv of glycerin, dissolved by the aid of a gentle 
heat, mivss represent gr. j of the acid. 



480 INCOMPATIBILITY. 

The following rules for the pharmaceutical student are quoted 
from the Chemist's and Druggist's Diary for 1885. They are 
well worth remembering. 

1. Read through a prescription, rapidly and in a manner suggesting no 
suspicion of doubt. 

2. Write directions invariably before dispensing. Avoid thus the use of 
blotting-paper ; a good dispenser uses almost none. 

3. If a mixture contains readily soluble ingredients, never use a mortar. 

4. Avoid effecting solution by heat, for fear of recrystallization. 

5. With syrups and also ingredients not water, arrange in dispensing to rinse 
out the measure and leave it clean ; a skilled dispenser shows very little traces 
of his work. 

6. Carefully clean and put away weights and scales after each operation. 

7. Hold the scales firmly by the left hand, never lift them high above the 
counter, and judge of the weight as much by the indicator as by the position 
of the scale. 

8. Select glass pans for scales, preferably of heavy make, and discard flimsy 
brass material, which corrodes speedily and becomes inaccurate. 

9. Learn to judge of the quantity to be weighed with tolerable accuracy ; 
train the eye as well as the hand. 

10. If in doubt, always begin with that about which you have no doubt. 

11. Be rapid in manipulation. Finish wrapping, tying, or sealing quickly. 
Slow dispensing is bad dispensing, and arises either from deficient practice or 
want of knowledge. 

12. Never, when in a shadow of doubt, hesitate to ask advice from a fear 
of compromising your own dignity. 

INCOMPATIBILITY. 

Incompatibility may be Chemical, Pharmaceutical or Thera- 
peutical, according as the prescribed combination results in chemi- 
cal decomposition, physical disassociation or antagonistic action. 
In the first case the incompatibility may be unintentional or in- 
tentional on the part of the prescriber, for in many cases the 
result of the chemical action affords the substance desired. 

Instances of intentional incompatibility are the mixtures of Calomel and 
Corrosive Sublimate with Limewater, producing the Black and Yellow Oxides 
of Mercury respectively, and commonly known as " Black Wash" and u Yel- 
low Wash." Such combinations should not be filtered (as a novice might 
suppose), but should be dispensed with a "Shake-label," that the precipitate 
may be uniformly distributed before using. 

Chemical Incompatibility generally results from neglect 
on the part of the prescriber of the most common chemical re- 
actions, such as — 

1. Acids tend to combine with bases and to form salts. 

2. Weak acids or bases are displaced from their combinations 
by stronger ones, so that salts in solution when brought together 
generally exchange their radicles, especially if by doing so an 
insoluble compound can be formed. 



INCOMPATIBILITY. 



48l 



3. A salt in solution is easily decomposed by a strong alkali if 
the salt is one having a weak or volatile base. 

4. A substance in solution may be decomposed by another 
without precipitation, the product being soluble in the solution. 

5. Alkak)idal^alts are precipitated from their solutions by the 
addition (Irt^Earees, 



^ri salts which produce insol- 
uble compounds. Oxides of trr£3i1aftTes decompose salts of the 
metals proper, and those of the alkaloids, precipitating their 
bases ; but the base may be soluble in an excess of the alkali. 

6. Tannic or Gallic Acids and vegetable substances contain- 
ing them precipitate albumen, alkaloids and most of the me- 
tallic oxides, and form inky solutions when brought into contact 
with the persalts of Iron. Tannic Acid precipitates gelatin. 

7. Glocusides are incompatible with free acids or emulsi|n|. 

Examples of the neglect of these principles are seen in the prescribing of 
Quinine Sulphate in mixture with Potassium Acetate, resulting in a volu- 
minous precipitate of Quinine Acetate which could not be poured from the 
bottle; — Vinegars or Syrups containing Acetic Acid (Syr. Allii, Syr. Scillae) 
added to a solution of alkaline carbonates, causing decomposition of the latter 
with evolution of C0 2 ; — the addition of Liquor Potassse to a solution of 
Ammonia-alum, setting free gaseous ammonia; — the mixing of Strychnine 
Sulphate and Potassium Bromide in solution, causing the decomposition of 
the alkaloid sulphate and precipitation of Strychnine; — preparations of Cin- 
chona with salts of Iron, forming an inky tannate of iron ; — Elixir of Chloral 
with alkalies, causing the elimination of Chloroform and its subsequent evapo- 
ration, etc., etc. 

The following table shows the most important instances of 
solutions which mutually precipitate each other, the letter P 
meaning " forms a precipitate with M — 



Table of some Mutually 
Precipitant Solutions. 



Solutions of Alkalies 

Tannic Acid 

Carbonic Acid and Sol. of Carbonates 
Sulphuric Acid and Sol. of Sulphates 
Phosph. Acid and Sol. of Phosphates 

Boric Acid and Sol. of Borates 

Hydroch'c Acid and Sol. of Chlorides 
Hydrobr'c Acid and Sol. of Bromides 
Hydriodic Acid and Sol. of Iodides... 

Solutions of Sulphides 

Arsenical Solutions 

Albumen 















10 




10 












a 




G 










co 





C 


O 


10 








C 




O 


•rt 


c 








O 


3 




3 ■ 


. 




trt 
















c 


c 


3 







O >» 


t; >> 


a 








w 


O 




"o"c3 


a 


Jj 


J3 
"O 


O 



(A 

3 
O 


C/3 

(A 

3 


oft 












en 
U 


6 


.s 


c« > -' 


rt^— 


TJ 


V 




W) 


3 


rt 


< 






1— « 

c/3 


"3 

U 


cti 


^2 
< 


O 


P 


p 


p 


P 


P 


P 






P 


p 


p 


P 


, 




P 


P 


P 


p 


p 
p 


P 
P 


P 
P 


P 






P 


p 


p 


P 


P 


P 






P 


p 


p 
p 
p 


P 
P 
P 










P 


p 
p 
p 


p 
p 
p 
p 


P 
P 
P 
P 











482 INCOMPATIBILITY. 

The following more or less insoluble salts will be formed when- 
ever the materials of which they are composed are brought 
together in solutions: the Hydrates, Carbonates, Phosphates, 
Borates, Arseniates and Tannates of most earthy and heavy metals 
and alkaloids, and the metallic Sulphides ; the Sulphates of Cal- 
cium, of Lead, and of the subsalts of Mercury ; the Chlorides, 
Iodides, and Bromides of Bismuth, Silver, Lead, and subsalts of 
Mercury ; the Iodides of Quinine, Morphine and most alkaloids. 

Instances are — Lime water or Aromatic Spirit of Ammonia with Tincture of 
Chloride of Iron, or solutions of Mercury salts, or neutral solutions of Qui- 
nine or Morphine salts. 

Ammonium, Potassium and Sodium carbonates or bi-carbonates with Lime- 
water. 

Solutions of Magnesium Sulphate, Alum, Zinc Acetate or Sulphate with 
solutions of salts of Iron, Manganese, Bismuth, Antimony, Lead, and of most 
alkaloids. 

Ammonium or Sodium Phosphates with solutions of Iron salts, with Lime- 
water, solution of Magnesium Sulphate, of Alum, etc. 

Liquor Potassii Arsenitis with Lime-water, w r ith solutions of basic salts of 
Iron, and of neutral salts of Quinine and Morphine, etc. 

Solutions, decoctions, tinctures and extracts containing Tannic Acid with 
solutions of salts of Iron, Mercury, Antimony, Lead (as also with solutions 
containing albuminous substances and Gelatin). 

Lime-water with solutions of Quinine or Morphine Sulphates. 

Solutions of Lead Acetate with Zinc Sulphate or Alum. 

Sodium Chloride with Silver Nitrate. 

Morphine Hydrochlorate with Lead Acetate. 

Alkaline iodides or bromides with Bismuth Carbonate or Sub-nitrate, with 
Lead Acetate, with Sub-chloride of Mercury, or with neutral solutions of Qui- 
nine, Morphine or Strychnine salts. 

Explosive Compounds result from the admixture of power- 
ful oxidizing agents with substances which are readily oxidizable. 
The most important members of these two classes are as follows: 

Oxidizers. Oxidizable or Covibustible. 

Chromic Acid. Glycerin, Sugar and other Alcohols. 

Potassium Chlorate. Oils and Ethers 

Potassium Permanganate. Sulphur and Sulphides. 

Nitric Acid. Phosphorus. 

Nitro-hydrochloric Acid. Dry Organic Substances. 

Explosions have resulted from mixing Fluid Extract of Uva Ursi with 
certain samples of Spirit of Nitre, Chromic Acid with Glycerin, Permanganate 
of Potassium with Glycerin, Nitric Acid with Glycerin, Nitrate of Silver with 
Creasote, Oxide of Silver in pill with Extract of Gentian, Potassium Chlorate 
with Glycerin and Tincture of the Chloride of Iron. Chloride of Lime tritu- 
rated with Sulphur in a mortar has exploded, so also has Calcium or Sodium 
Hypophosphite when triturated alone. Tincture of Iodine with Ammonia 
forms the Iodide of Nitrogen, which is highly explosive, especially if tritu- 



INCOMPATIBILITY. 483 

rated in the presence of water. Catechu and Potassium Chlorate in a denti- 
frice have exploded in the mouth from the friction produced by a dry tooth- 
brush. 

Poisonous Compounds may be formed by the admixture of 
many substances in solution, such as — 

Potassium Iodide with Potassium Chlorate, in solution together 
do not react at ordinary temperatures, but in the system they 
evolve a poisonous agent, probably the Iodate of Potassium. 

Dilute Hydrocyanic Acid or Potassium Cyanide, with Calomel, 
forms the Bichloride and Bicyanide of Mercury, both virulent 
poisons ; — with metallic hydrates, carbonates, sub-nitrates or 
sub-chlorides, cyanides of the metals are formed which are even 
more poisonous than the acid itself in its usual diluted form. 

Pharmaceutical Incompatibility differs from chemical 
incompatibility in the absence of chemical action, and is gener- 
ally produced by adding one substance to another which, through 
differences in solubility, causes a precipitation of solid matter or 
a separation of part of the liquid. The constituents separated 
may be active and hence important, or inert and therefore unim- 
portant. 

Instances of this are — the addition of an acid to a Quinine and Liquorice 
mixture, resulting in precipitation of the Glycyrrhizwi (relied on to cover the 
taste of the Quinine) by the acid; — or the use of Quinine, Tincture of Ferric 
Chloride and Liquorice together; — or the prescribing of solutions of Chloral 
and Potassium Bromide with an alcoholic preparation, the Chloral separating 
to the top as an alcoholate, and therefore dangerously in excess for the first 
few doses; — or the neglect to prescribe Acacia or some other emulsifier in 
mixtures of an alcoholic fluid extract of a resinous body with an aqueous 
preparation, which would result in the separation of the resin to the surface 
and an overdose with the first teaspoonful. 

When the fluid extracts are diluted with liquids differing in 
composition from those used in the fluid extracts, the gum, albu- 
men, resin, and mucilage are often separated. In such a case as 
Fluid Extract of Cannabis Indica the active resin would be 
thrown out of solution, and floating on top might cause serious 
symptoms ; but in many other instances the precipitate would be 
inert and filtration would be in order. Water is the solvent for 
albuminous, gelatinous, gummy, and saccharine bodies and for a 
large number of inorganic salts ; while Alcohol is the solvent for 
volatile oils and resins, gum-resins, resinoids, balsams, and all 
drugs containing these as their active principles. The solvent 
power of either Alcohol or Water for their particular substances 
decreases in proportion to the amount of the other added. 



484 INCOMPATIBILITY. 

Instances of Pharmaceutical Incompatibility. 
Resinous tinctures or fluid extracts with aqueous solutions. 
Tincture of Guaiac with Spirit of Nitric Ether. 
Compound Infusion of Gentian with Infusion of Wild Cherry. 
Compound Infusion of Cinchona with Compound Infusion of Gentian. 
Essential oils with aqueous liquids in quantities exceeding I drop to ^j. 
Fixed oils and Copaiba with aqueous liquids (except excipients). 
Tinctures made with Alcohol with those made with Diluted Alcohol. 
Alcoholic tinctures and fluid extracts with aqueous preparations. 
Spirit of Nitric Ether with strong mucilages. 
Infusions generally with metallic salts. 

Therapeutical Incompatibility arises when two agents are 
administered together which oppose each other in their action on 
the human system, — as for instance Belladonna in any form with 
Physostigma. But in many cases physiological antagonists are 
designedly prescribed together, one as a guard against the action 
of the other, as in the hypodermic administration of Morphine 
guarded by Atropine. The antagonists to each of the active 
medicinal agents may be found in the section on Materia Medica 
under their various titles ; but they may be well summarized as 
to the most important ones in the following list. 

Physiological Antagonists. 

Aconitine, — Atropine, Digitalin, Strychnine. 

Alcohol, — Strychnine. 

Ammonium Chloride > — Chloral-hydrate. 

Atropine, — ^Aconitine, *Bromal-hydrate, Chloral-hydrate, Hydrocyanic Acid, 
Jaborandi, Muscarine, ^Morphine, Physostigmine, Phytolacca, Pilocarpine, 
Quinine. [Those marked * will not prevent death from a lethal dose of Atro- 
pine, though the latter will prevent death from a lethal dose of either of them.] 

Barium, — Sodium Sulphate, Potassium salts. 

Bromal-hydraie, — Atropi ne. 

Brucine, — Chloral-hydrate. 

Calabarine, — Chloral-hydrate. 

Carbolic Acid, — Chloral-hydrate. 

Chloral-hydrate, — Ammonium Chloride, Atropine, Brucine, Calabarine, Car- 
bolic Acid, Codeine, Physostigma, Picrotoxine, Strychnine, Thebaine. 

Chloroform, — Amyl Nitrite. 

Cocaine, — Morphine. 

Codeine, — Chloral-hydrate. 

Digitalin, — Aconitine, Muscarine, Saponin. 

Gelsemium, — Opium, Atropine. 

Morphine, — Atropine, Caffeine, Chloroform, Cocaine, Daturine, Hyoscyamine, 
Nicotine, Physostigma. 

Muscarine, — Atropine. 

*Opiu?n,— Atropine, Gelsemium, Veratrum Viride. 

Physostigma, — Atropine, Chloral, Morphine. 

Saponin, — Digitalin. 

Strychnine, — Alcohol, Chloral, Hydrocyanic Acid, Nicotine, Nitrite of Amyl. 

Thebaine, — Chloral-hydrate. 



INCOMPATIBILITY. 48 5 

Good Rules to follow in order to avoid the dangers of incom- 
patibility are the following, — 

1. Never use more than one remedy at a time, if one will serve 
the purpose. 

2. Never use Strong Mineral Acids in combination with other 
agents, unless you know exactly what reaction will ensue. They 
decompose salts of the weaker acids and form ethers with alcohol. 
Never combine Free Acids with hydrates or carbonates. 

3. Select the simplest solvent, diluent, or excipient you know 
of, remembering that the solvent power of Alcohol and Water for 
their particular substances decreases in proportion to the quantity 
of the other added. 

4. Generally do not combine two or more soluble salts. 

5. Never prescribe a drug in combination with any of its Tests 
or Antidotes. 

6. Do not order Glucosides (as Santonin, Colocynthin) in com- 
bination with free acids or^|!mulsi|nJ. 

7. Prescribe Aconite only in water, and Mercuric Chloride alone 
in water or simple syrup. The latter is incompatible with almost 
everything, even the Compound Syrup of Sarsaparilla is said to 
decompose it. 

8. Iodide of Potassium decomposes nearly all metallic salts, and 
is one of the drugs whicri^toest given alone. 

9. Acacia or some other emulsifying agent should always be 
added to prescriptions containing resinous tinctures or fluid 
extracts (e. g., Tinct. Cannabis Indicae) with aqueous solutions, 
to prevent the separation of the resin. 

10. Silver Nitrate, and Lead Acetate and Subacetate, although 
incompatible with almost everything, may be combined with 
Opium; the latter forming with Opium a compound which, 
although insoluble, is therapeutically active as a lotion. 

11. The following-named substances are incompatible with so 
many others that it is best to always prescribe them alone ; they 
are best given in simple solution : — 

Dilute Hydrocyanic Acid. Morphine Acetate. 

Dilute Nitro-hydrochloric Acid. Morphine Hydrochlorate. 

Sulphuric Acid. Quinine Sulphate. 

Mercuric Chloride (Corr. Sub.). Liquor Calcis. 

Iodine and Iodides. Liquor Potassae. 

Syrup of the Iodide of Iron. Liquor Potassii Arsenitis. 

Potassium Permanganate. Liquor Ferri Nitratis. 

Potassium Acetate. Tinct. Ferri Chloridi. 

Potassium Bromide. Zinc Acetate. 

Tartar Emetic. Citrate of Iron and Quinine. 

Tincture of Guaiac. Free Chlorine in Solution. 
Tannic and Gallic Acids. 



486 



EXTEMPORANEOUS PREPARATIONS. 



12. Tannic Acid may be prescribed with the proto-saksof Iron, 
but not with its per-salts. Calumba is the best vegetable tonic to 
prescribe with Ferric salts, as it contains neither Tannic nor Gallic 
Acids. 



LIQUID EXTEMPORANEOUS PREPARATIONS. 

Mixtures (Misturae), — in official pharmacy are aqueous prep- 
arations containing some insoluble ingredients held in suspension 
by an appropriate vehicle. In extemporaneous pharmacy, how- 
ever, the term Mixture is applied to every fluid compound 
intended for internal use, except a few which bear distinctive 
titles, such as Emulsions, Draughts, Enemas, Elixirs and Drinks. 
The simplest form of mixture in this extended sense is that in 
which two or more liquids are mixed together ; but a great variety 
of substances may be prescribed in this form, chief among which are 
most of the soluble salts, light insoluble powders, salts which may 
be diffused by agitation, extracts, gum-resins, and the fixed and 
essential oils. They are generally ordered in 2, 3, 4, 6, 8, 10 
and 12-ounce vials. 

The substances suitable to the mixture-form, properly so called, 
are those which, though more or less insoluble in water, will mix 
with it by agitation, trituration, etc. Those most frequently 
ordered are as follows : — 



Diffusible by Agitation : — 
Calcii Phosphas Praecip* 
Cinchona Pulvis. 
Ipecacuanhae Pulvis. 
Magnesia. 
Quininae Sulphas. 
Sulphur Praecipitatum* 

Suspendible by viscid excipients ;- 
Essential Oils, 
Oleum Amygdalae. 
Oleum Morrhuae* 
Oleum Olivae. 
Oleum Ricini. 
Copaiba. 
Ferri Carbonas Sacchafatus. 



Miscible only by trituration 
Ammoniacum. 
Asafoetida. 
Confectio Rosae. 
Confectio Sennae* 
Extractum Aconiti'. 
Ext. Belladonnas. 
Ext. Conii. 
Ext. Hyoscyami. 
Ext. Stramonii. 
Ext. Glycyrrhizae. 
Ext. Krameriae. 
Ext. Taraxaci. 
Guaiacum. 
Scammonium. 
Myrrha. 



Best suspended by the aid of a fixed oil or yolk of egg : — 

Ext. Cannabis Indicae. Oleum Terebinthinae. 

Camphora. Chloroformum. 

Solutions intended for internal administration are classed as 
Mixtures in extemporaneous pharmacy, for the reason stated 



EXTEMPORANEOUS PREPARATIONS. 487 

above. The following list of acids and salts comprises most of 
the solids which are best adapted for use in liquid form, by reason 
of their solubility in water. 

Acidum Citricum. Potassii Carbonas. 

Acidum Tannicum. Potassii Citras. 

Acidum Tartaricum. Potassii Chloras. 

Alumen. Potassii Hypophosphis, 

Ammonii Chloridum. Potassii Tartras. 

Antimonii et Potassii Tartras* Potassii et Sodii Tartras, 

Barii Chloridum. Potassii Bromidum. 

Calcii Chloridum. Potassii Iodidum 

Calcii Hypophosphis. Morphinae Acetas. 

Ferri Pyrophosphas. Morphinae Hydrochloras, 

Ferri Sulphas. Morphinae Sulphas. 

Ferri et Ammonii Citras. Sodii Bicarbonas. 

Ferri et Potassii Tartras. Sodii Boras. 

Ferri et Quininae Citras. Sodii Carbonas. 

Magnesii Sulphas. Sodii Chloridum. 

Mangani Sulphas. Sodii Hypophosphis. 

Potassii Acetas. Sodii Phosphas. 

Potassii Bicarbonas. Sodii Sulphas, 

A few require the use of viscid substances as vehicles or cor- 
rectives. They are as follows: — ■• 

Ammonii Carbonas. Potassa. 

Plumbi Acetas. Potassii Cyahidum. 

Hydrargyri Chloridum CorrosivUm. 

Certain salts are best ordered by prescribing such agents as 
will when in solution together react upon each other and produce 
the desired salt. Instances of this may be found in the pharma- 
copceial processes for most of the official Liquores \ the salts so 
produced being the following: — 

Ammonii Acetas. Ferri Nitras. 

Magnesii Citras. Ferri Phosphas 

Potassii Citras. Potassii Arsenis. 

Ferri Citras. Potassii Hydras. 

Ferri Acetas. Sodii Hydras. 

Ferri Chloridum. Soda Chlorata. 

Hydrargyri Nitras. Zinci Chloridum. 
Arsenii et Hydrargyri Iodidum. 

Certain other substances require the addition of other agents 
in order to form eligible solutions. Such are the following : — 

Quinince Sulphas, — requires acidulated water for its solution, the acid used 
being generally Sulphuric diluted, or the Aromatic Sulphuric. This method 
of prescribing this salt develops its bitter taste to the utmost, and is often 
avoided by ordering the drug to be suspended in a viscid liquid, such as Pulv. 
Acaciae in Syrup of Ginger. In such a case an officious dispenser anxious to 



488 EXTEMPORANEOUS PREPARATIONS. 

show his smartness may add some dilute Sulphuric Acid to dissolve the Qui- 
nine and thus defeat the object of the prescribes 

Sulphate of Quinine may be prescribed with Aromatic Spirit of Ammonia, 
Spirit of Nitrous Ether, Tinctures or other alcoholic preparations together 
with Glycerin or Syrup and Water. In such cases the salt should be first dis- 
solved in the alcoholic portion of the prescription; then the glycerin or syrup, 
and finally the aqueous portions should be added gradually. It may also be 
ordered with dilute Sulphuric Acid and some vegetable infusion containing Tan- 
nin, in which case a precipitate of Tannate of Quinine will be produced. This 
of course should not be filtered, but should be dispensed with a " Shake-label." 

Chinoidin, Cinchonine Sulphate and Quinidine Sulphate, — also require the 
addition of dilute mineral acid for their solution in aqueous mixtures. 

Iodine, — requires the addition of Iodide of Potassium for its solution in a 
convenient quantity of water, as in the case of the official Liquor Iodi Com- 
positus. 

Red Iodide of Mercury, — requires the addition of Iodide of Potassium or 
Mercuric Chloride for its aqueous solution. 

Potassii Bitartras, Cream of Tartar, — requires the addition of Borax or 
Boric Acid for its solution in water. 

Benzoic Acid, — requires the addition of Borax to aid its solubility in water, 
an equal part of the latter making it 5 times more soluble than when alone. 

Lime, — is more soluble in sweetened water than in plain water, the sugar 
aiding its solution. 

Excipients are substances which give form and consistence to 
prescriptions, and serve as vehicles for the exhibition of the other 
ingredients. Some of the excipients are diluents, or agents which 
effect the dilution or division of the active ingredients; while 
others act in the double capacity of diluents and flavoring agents. 
The excipients most generally used in mixtures may be tabulated 
as follows, viz. : — 

Diluents. True Excipients. 

Water (Aqua). Acacia (Pulv.). 

Medicated Waters (Aquae). Tragacanth (Pulv.). 

Syrups. Sugars. 

Mel Rosae. Confections. 

Elixir Aurantii. Some Extracts. 

Yolk of Egg (Vitellus). 

Flavoring Agents. 

Oleum Cari. Tinct. Gentianae Comp. 

Ol. Caryophylli. Tinct. Aurantii Dulcis. 

Ol. Cinnamomi. Tinct. Vanillas. 

Ol. Gaultheriae. Spiritus Anisi. 

Ol. Sassafras. Spiritus Limonis. 

Ol. Amygdalae Amarae. Spiritus Myristicae. 

Tinctura Tolutana. Spiritus Menthae Piperitae. 

Tinct. Zingiberis. Spiritus Menthae Viridis. 

Tinct. Cinnamomi. Spiritus Lavandulae. 

Tinct. Cardamomi. Syrupus Limonis. 

Tinct. Cardamomi Comp. Syrupus Tolutanus. 

Syrupus Zingiberis. 



EXTEMPORANEOUS PREPARATIONS. 489 

Compounding the Mixture is a matter of no slight importance, 
and one which is best learned at the dispensing counter, though 
a few directions may not be out of place. In the case of the 
simplest form of mixture, where two or more fluid preparations are 
prescribed together, the only operations required are the measur- 
ing of the several ingredients and pouring them into the designed 
vial. In doing this the compounder should pursue a regular and 
definite order of procedure. Taking in his left hand a graduate 
of sufficient capacity to hold the whole quantity prescribed, he 
should walk along the shelves, and with the right hand pour from 
the stock-bottles the requisite quantity of each ingredient in the 
order in which they are entered on the prescription. A skilful 
clerk will hold the graduate between the thumb and first finger, 
the prescription between the second and third fingers, and the 
stopper of the stock-bottle between the little finger and the hand, 
leaving his right hand free for the manipulation of the bottles 
containing the ingredients. 

When an actively poisonous agent is ordered it should always 
be the last thing put into the mixture. Attention to this rule 
will prevent the danger of the toxic substance being put in 
twice. 

The order in which the ingredients are put together is not of 
so much importance in compounding a simple mixture as in the 
case of an emulsion, and the order of the prescription can usually 
be followed, with the exception noted in the preceding paragraph. 
Still, when several alcoholic preparations, syrups and waters are 
ordered together, it is good practice to first mix the alcoholic 
fluids, then to add the syrups and finally the water, so as to avoid 
the precipitation of resinous principles which would occur if the 
alcoholic solutions were added to the water. Distilled water 
should always be used, in order to insure uniformity in taste and 
appearance, and also as a matter of purity and cleanliness. All 
mixtures should be well shaken before being labelled. 

Solids which are comparatively insoluble or only slowly soluble 
require to be rubbed up in a mortar with one or more of the fluid 
ingredients. Glass mortars are much employed for this purpose, 
and many compounders mix all the ingredients in such a mortar 
before transferring them to their vial. Vegetable powders (as 
Rhubarb, Ipecac, etc.), or finely pulverized inorganic substances, 
are often ordered in intimate mixture with water, thickened with 
mucilage or syrup. In such cases the mixture should be made in a 
porcelain or wedgwood mortar, enough mucilage or syrup being 
added at first to make a thick paste, and after this is rubbed 
smooth the water may be gradually added during the continued 

41 



490 



EXTEMPORANEOUS PREPARATIONS. 



process of mixing. This process will answer for all inorganic 
substances in powder, except Magnesia, which is best mixed by 
being thrown on the surface of the water, and after it has sunk 
to the bottom as a uniform sediment the other ingredients may- 
be added, and the whole well shaken. Froth upon the surface of 
the liquid, which often arises after agitation, and may prevent the 
corking of the bottle, will quickly subside on the addition of a 
few drops of alcohol. 

The following are samples of prescriptions for medicines to be 
administered in mixture form : — 



Bismuth Mixture for Children. 
R. Bismuthi Subcarbonatis, . gij. 
Syrupi Acaciae, 

Aquae Cinnamomi, aa, ^ij. 

Misce. Signa, — A teaspoonful 
every hour in choleraic diarrhoea. 



Qui?iine Mixture for Children. 
R. QuininaeSulphatis(pulv.), sjss. 
Pulveris Acaciae, . . £ss. 

Syrupi Zingiberis, . . giv. 
Fiat mistura. Signa, — A teaspoon- 
ful thrice daily. 



Emulsions (Emulsiones), — are mixtures containing an oil or 
a resinous substance in a state of minute subdivision, and sus- 
pended in water by the aid of some viscid excipient, as gum, 
soap, alkali, or yolk of egg. 

Natural Emulsions comprise two classes of substances, — (i) 
those emulsions which exist ready formed in nature, as milk, 
yolk of egg y the milky juices of plants, etc. ; and (2) the mixtures 
formed by rubbing up gum-resins (as Ammoniacum, Myrrh, 
Asafetida) with water. Each of the latter substances contains, 
together with its resin, enough gum to make a perfect emulsion when 
triturated with water. The manufactured emulsions are simply 
imitations of the natural ones, sufficient gum being added in case of 
a resinous substance to cause its suspension in the aqueous diluent. 

Emulsification consists in the division of the oily or resinous 
substance into very minute globules, and surrounding each 
globule with a thin envelope of the excipient. If property done 
the globules will remain mechanically suspended in the water, 
without any tendency towards recombination. Milk is the best 
illustration of a natural emulsion, its butter existing in the aqueous 
portion as very minute globules, each surrounded by a thin 
film of casein. Yolk of Egg is a dense emulsion, consisting of 
oil suspended in water by means of albumen. 

The Exctpients which may be used for emulsification are the 
following, arranged in the order of their most frequent employ- 
ment, viz. : — 

Mucilage of Acacia, — used for oils and resins. Powdered Acacia is even 
better, being made into a mucilage by the process of emulsirication ; such a 
mucilage having the advantage of being perfectly fresh when incorporated 



EXTEMPORANEOUS PREPARATIONS. 49 1 

with the other ingredients. To give uniformly good results the following 
proportions in parts by weight should be used, viz. : — 

Gum Acacia. Water. 
I part of Fixed Oils or Copaiba requires, y^ z£ 

1 " " Balsam of Peru " . 2 1% 

1 " " Oil of Turpentine, " . . 1 1 

Mucilage of Tragacanth, — may also be used for oils and resins, but it has 
not proved so satisfactory as the preceding. The same may be said of pow- 
dered Tragacanth. 

Vitellus, Yolk of Egg, — is an excellent agent for emulsifying oils, but mix- 
tures made with it must be used within a few days, as they will not keep long. 
One yolk will emulsionize an ounce of fixed oil, and is about equal to half an 
ounce of Acacia. It is best suited to emulsions of cod-liver oil intended for 
immediate administration. The official Mistura Chloroformi is an emulsion 
made with yolk of egg. Glyceritum Vitelli or Glyconin is an official prepa- 
ration consisting of glycerin and yolk of egg. (See ante, page 392.) One 
ounce of it will emulsify three ounces of fixed oil. 

Liquor Pot as see, — may be used for oils, the resulting compound being however 
a soap rather than an emulsion. Copaiba is usually emulsified by using both a 
gum and an alkali ; a similar process being employed for many of the fixed oils. 

Tincture of Senega, — will emulsify fats and oils very efficiently, and even 
in very small quantities, Tn_x emulsifying an ounce of fixed oil. 

Tincture of Quillaia (Soap-bark), — is a good emulsifier for oils, and is 
much used in Europe for this purpose. 

Milk, — is used to emulsify Scammony in the Mistura Scammoniij which is 
official in the British Pharmacopoeia. 

Syrups, Confections and Extracts, — may be used in making emulsions, but 
are rarely so employed. 

Soap, — is occasionally used for emulsifying Oil of Turpentine. 

The Method of preparing an emulsion which experience has 
shown to be the best, is as follows : — Add the oil, resin, etc., to 
a proper quantity of the excipient, and mix both thoroughly in a 
wedgwood mortar. Then add enough water to equal one^half the 
weight of the previous mixture, and triturate the whole rapidly and 
unceasingly until the emulsion is homogeneous and of a whitish 
color. Next, add the remainder of the water slowly, with contin- 
ual stirring ; finally incorporating the other ingredients, if any. 

Emulsions are sometimes flavored and at the same time 
colored, with such a preparation as the Compound Tincture of 
Cardamom ; but they present a better appearance when perfectly 
white. Alcoholic preparations should not be added in large 
quantity to emulsions made with Acacia or Yolk of Egg, as 
alcohol will precipitate the emulsifying agent. Volatile Oils 
require admixture with a fixed oil before being made into an 
emulsion. Soluble salts should never be prescribed with emul- 
sions of oils. Acids are incompatible with mixtures which have 
been emulsified by an alkali. Mucilage used for emulsions should 
always be freshly prepared. 



492 



EXTEMPORANEOUS PREPARATIONS. 



Cod-liver Oil Emulsion. 



. Olei Morrhuse, 




3* 


Vini. Albi, . 




giss. 


Ac. Phos. Dil., . 




3 n J- 


Syrupi, 




3^ 


Vitellum, 




j. 


Aq. Amygd. Amar. 


ad . 


S vii J 


Misce, et fiat emulsic 


). 




Sig. — Tablespoonful 


doses. 





The following examples of prescriptions for emulsions will 
represent those generally met with: — 

Alkaline Emulsion of Copaiba. 
R. Copaibae, 

Liq. Potassae, . . aa 31J. 
Misce, et adde— 
Pulv. Acacise, 

Pulv. Sacchari, . . aa £ij. 
Aq. Menth. Viridis, ad . £iv. 
Misce, et fiat emulsio. 
Sig. — Tablespoonful doses. 

Elixirs (Elixiria), — are mixtures containing alcohol, water 
and sugar, with certain medicinally active ingredients, and sup- 
posed to be so prepared as to be particularly palatable, which is 
seldom true. There is one official elixir, Elixir Aurantii (see 
ante, page 91), which may be used as a basis for the extempo- 
raneous prescribing of these preparations. The manufacturers 
have put on the market a great variety of elixirs, and most drug- 
gists keep a stock of them on hand prepared in the shop ; but 
they may be ordered by prescription just as any other mixture 
would be. The substances generally used in this form are as 
follows : — 



Arsenic. 

Bismuth. 

Bromide of Ammonium. 

Bromide of Lithium. 

Bromide of Potassium. 

Calisaya Bark. 

Chloral Hydrate. 

Coca. 

Gentian. 



Guarana. 

Iron, Tincture of the Chloride. 

Iron, Phosphate. 

Iron, Pyrophosphate. 

Liquorice. 

Pepsin. 

Quinine. 

Strychnine. 

Taraxacum. 



Valerianate of Ammonium. 

Many of these agents are combined with each other, as in the Elixir of 
Bismuth and Strychnine ; Elixir of Calisaya, Iron and Strychnine ; Elixir of 
Gentian with Tincture of Chloride of Iron; Elixir of Iron, Quinine and 
Strychnine, etc., etc. 

A Draught (Haustus), — is an extemporaneous mixture con- 
sisting of a single dose, and usually ordered in a vial containing 
from one to two fluidounces. 

Effervescing Draught is one of the best known. It is prepared by neu- 
tralizing a watery solution of Potassium Bicarbonate with Lemon-juice or 
Citric Acid, and may be drank during effervescence. When the C0 2 has 
escaped it is a solution of Potassium Citrate in water, and corresponds to the 
official Mistura Potassii Citratis, or Neutral Mixture. (See ante, page 310.) 

Black Draught is another well-known preparation of this class. It is offi- 
cial as Infusum Sennas Compositum. (See ante f page 354.) 



EXTEMPORANEOUS PREPARATIONS. 



493 



A Drink (Potus), — is a solution or a mixture intended to be 
used ad libitum, and generally consists of a Potassium or Sodium 
salt, or a mineral acid, in dilute solution, sweetened and flavored. 

The " Imperial Drink" is made after the following formula: R. Potassii 
Bitartratis, ^ij ; Olei Limonis, ntv; Aquae Bullientis, q. s. ad ^xx. M. Fiat 
pctus. Sig. — Use as a drink. 



A Gargle (Gargarysma), — is a mixture or solution for appli- 
cation to the pharynx or to the mouth (mouth-wash). It should 
never contain any active drug, which would produce dangerous 
symptoms if swallowed ; nor any agent which would injure the 
teeth or the mucous membrane. Gargles are ordered and com- 
pounded in the same manner as mixtures. They usually contain 
astringent or disinfecting salts (Alum, Borax, Sulphate of Zinc, 
Chlorate of Potassium), with a vegetable astringent, and often 
Honey. The following formulae will illustrate prescriptions of 
this class. 



R. Tr. Guaiaci Ammoniatae, 

Tr. CinchonaeComp., aa ^ij. 

Mellis Despumat., . ^vj. 
Bene simul agita, et adde — 

Potassii Chloratis, . gr. lxxx. 

Aquae, q. s. ad . £iv. 

Fiat gargarysma. Sig. — Gargle. 



R. Acidi Tannici, . . . ^ij. 
Potassii Chloratis, . • 3J- 
Glycerini, . . . 5j. 

Aquae, .... gvij. 
Misce. Sig. — Gargle, to be used 

every two hours. 



A Lotion (Lotio) or Wash, — is a solution or mixture of 
medicinal agents, intended for external application; and usually 
consists of some soluble, astringent salt, dissolved in water, with 
perhaps some glycerin or alcohol. A Fomentation (Fotus) is a 
similar preparation used hot. A Collyrium is an eye-wash, and 
generally contains a soluble astringent salt dissolved in rose-water 
or distilled water, in the proportion of gr. j-iv to the 3- The 
only official preparation suitable for a lotion is the Liquor 
Plumbi Subacetatis Dilutus, or Lead-water. A well-known 
anodyne, refrigerant and astringent lotion is that represented 
by the first two of the following prescriptions. 



Lead-water and Laudanum. 
R. Liq. Plumbi Subacetatis, %}. 
Tinct. Opii, . . • t ?j- 
Aquae, q. s. ad . . . §viij. 

M. Fiat lotio. Sig. — Lotion. 

Gross. 



Lead and Opium Wash. 
R. Liq. Plumbi Subacetatis, 

Tinct. Opii, . . aa £j. 
Aquae, q. s. ad . . Jviij. 

M. Fiat lotio. Sig. — Lotion. 

Sturgis. 



494 



EXTEMPORANEOUS PREPARATIONS. 



Colly rium. 
R. Sodii Boratis, . . . gr. x. 
Aquae Camphorae, . . ^ij. 
Mucil. Cydonii, 

Aquae Destil., . . aa t ^ss. 
M. Fiat collyrium. Sig. — Eye- 
water ; a few drops to be put into the 
eye three or four times daily. 



Colly riu7?i of Four Sulphates. 
R. Zinci Sulphatis, 

Ferri Sulphatis, 

Cupri Sulphatis, 

Aluminis, . . aa gr. j. 

Aquas Destillatae, . • 2J- 
M. Fiat collyrium. Sig. — For use 
with brush to palpebral conjunctivae, 
and to be washed off with clean water. 



Liniments (Linimenta), — are mixtures intended for external 
application to the skin with friction. The official liniments are 
solutions of various substances in oily liquids or in alcoholic 
liquids containing fatty oils, and are enumerated on page 457. 
Extemporaneous liniments may correspond to the official ones or 
they may be simple mixtures of fluids without either fat or soap. 
A prescription for each kind is appended. The official Lini- 
mentum Saponis (Soap Liniment) is a good basis for extempo- 
raneous preparations of this class. 



Compound Chloroform Liniment. 



r. 



;ss. 



Extracti Belladon. Fl 

Extracti Aconiti FL, 

Chloroformi Venalis, 

Spiritus Camphorae, 

Alcoholis Diluti, ad 
M. Fiat linimentum. 
Sig. — Poison. To be rubbed on 
the painful part. 



aa 31 j. 
. 3viij. 



Anodyne Liniment. 

R. Tinct. Aconiti, . . gij. 

Tinct. Opii, . . . ,^iv. 

Tinct. Arnicae, . . gj ; 

Chloroformi, . . . Sjij. 

Linim. Saponis, ad . giv. 
M. Fiat linimentum. 
Sig. — Poison. Liniment. 



Stokes 1 Liniment. 



r. 



Olei Terebinth., 

Acidi Acetici, . 

Olei Limonis, . 

Vitellum, . 

Aquae Rosae, 
Mi Fiat linimentum. 
Sig. — Liniment* 



gss. 

j- 



Army Medical Wagon Liniment. 

1J. Liq. Ammoniae, 
Ol. Terebinthinae, 
01. Olivae, 

aa, partes aequales. 
M. Fiat linimentum. 
Sigi — Liniment. 



An Embrocation is a similar preparation, but of thinner con- 
sistence. The term is almost obsolete. 

Injections (Injectiones), — are liquid preparations intended 
for introduction into the cavities of the body by means of a 
syringe. When thrown into the rectum they are termed E?temas 
(Enemata), or Clysters, and are usually prepared at the bedside. 
Enemata may be demulcent, laxative, nutritive, stimulant, or ver- 
mifuge in character ; and always have warm or tepid water as their 
diluent, with which are incorporated such medicaments as may be 



EXTEMPORANEOUS PREPARATIONS. 



495 



desired. They may consist simply of water to act as a wash for the 
cleansing of the bowel. Injections are termed vaginal, urethral, 
vesical, nasal, hypodermic, etc., according to the locality in which 
they are employed. Special forms of syringes are employed for 
each kind, the discussion of which belongs rather to the domain 
of surgery than that of medicine. Those used for the nasal cav- 
ities are often arranged with small holes or an atomizing attach- 
ment, so as to deliver the injection in the form of a fine spray. 
A Collunarhcm is a nasal douche or wash. In the appendix will 
be found a list of formulae for hypodermic injections ; a few pre- 
scriptions for other forms are appended below. 

Enema for Stricture of the Rectum. 
R. Bismuthi Subcarb., . . gj. 
Extracti Opii Aquosi, . gr. ij. 
Glycerini, Aquae, . aa ,^ij. 
M. Fiat enema. Sig. — Two table- 
spoonsful to be injected thrice weekly. 



Demulcent Enema. 

R. Tincturae Opii, . . rrixx. 
Decocti Amyli, . . ^iv-vj. 
M. Fiat enema. 



Vermifuge Enema. 
R. Extr. Quassiae Fl., . . Jfjss. 
Aquae, .... Jijss. 
M. Sig. — A tablespoonful with an 
equal quantity of warm water, as an 
enema, to be retained as long as pos- 
sible. 

Nasal Injection (DobelPs). 

R. Ac. Carbolici, . . £Jss. 

Sodii Bicarb., 

Sodii Boratis, . aa ^iv. 

Glycerini, . . . ^xivss. 

Aquae, q. s. ad . 3 VU J- 

M. Sig. — A tablespoonful diluted 
with an equal quantity of tepid water, 
to be used thrice daily with a nasal 
sprayer. 



Injection for Gonorrhoea. 


(Injection Brou.) 




R. Zinci Sulphatis, 
Plumbi Acetatis, 


• 


. gr. viij. 
. gr. xv. 


Tincturae Opii, 
Tinct. Catechu, 


• 




Aquae Rosae, q. s 
M. Fiat injectio. 


. ad 
Sig.- 


. 3vj 

—Use with 


a urethral syringe. 







Injection for Chronic Urethritis. 

R. Hydrarg. Chi. Corrosivi, gr. }£. 

Zinci Choridi, . . gr. ss. 

Aquae Destillatae, . . 3 V ^J* 
M. Sig. — A teaspoonful to be in- 
jected well down into the urethra 
thrice daily. 



Vaginal Injections for Leucorrhcea. 
R. Aluminis, . . . gj. 

Zinci Sulphatis, . . ^ss. 

Sodii Boratis, . . gr. iv. 

M. Sig. — Dissolve in half-a-pint 
of warm water, and use with a vag- 
inal syringe. 

R. Acidi Tannici, . . t fj. 
Glycerini, . . ^iv. 

M. Sig. — One-half with an equal 
quantity of water to be injected twice 
daily. 



Baths (Balnea), — are often medicated, and then become 
medicinal preparations. The ingredients only are ordered in a 



4<?6 EXTEMPORANEOUS PREPARATIONS. 

prescription, as per the following examples, each of which is 
intended for a bath of 25 to 30 gallons : 

Balneum Acidi Nitrohydrochlorici. 
R. Acidi Nitrici, 

Acidi Hydrochlorici, . aa ^j. 
M. Sig. — Use with 30 gallons of 
hot water, as a bath. 



Balneum Sulphur is Compositum. 

R. Sulphuris Praecip., . . 5ij. 
Sodii Hyposulphitis, . . 3}. 
Acidi Sulphurici Dil., . £ss. 
Aquae, . . . . Oj. 
M. Sig. — For a 30-gallon bath. 



SOLID EXTEMPORANEOUS PREPARATIONS. 

Pills (Pilulae), — are described on page 460, where also the offi- 
cial pills are enumerated. They constitute a form of medicine very- 
much used in extemporaneous pharmacy, and one with the prep- 
aration of which the compounder should be perfectly familiar, 
for it will constitute fully one-third of his work at the dispensing 
counter. Pills should not exceed 5 grains in weight, unless the 
ingredients are very heavy, as Bismuth, Calomel, Hydrargyrum 
cum Creta, etc., of which 6, 8 or 10 grains may be made into a 
pill which may be readily swallowed. 

A Bolus is a similar mass, but larger than a pill, while the 
names Granule and Parvule are given to masses smaller than the 
average pill. 

The Process of Pill-making is briefly as follows: The in- 
gredients ordered in the prescription are separately weighed out 
in the order of their bulk, commencing with that one of which 
the smallest quantity is to be used. If any require pulverization 
they should first be placed in the mortar, and reduced to powder ; 
then the other dry ingredients, next the soft extracts and the ex- 
cipient selected, and the whole is worked up into a mass, the 
Pill-mass, by the aid of the mortar and pestle. The perfect pill- 
mass should be uniform throughout, should not show any particles 
of any one ingredient, should have such a consistence that the 
pills made from it will retain their shape, should not be too hard, 
nor too dry, nor should it stick to the fingers. The mortar should 
be large and shallow, of unpolished wedgwood ware ; having a 
thick, smooth and well-formed bottom, and a pestle which fits it. 
The operation of working up the mass is one of kneading it be- 
tween the end of the pestle and the side of the mortar, and if 
proper ingredients and excipient are used, and if the work is well 
done, the mass will eventually loosen itself from both mortar and 
pestle. If it does not do so it should be removed with a spatula 
when sufficiently worked, and may then be kneaded for a few 
minutes between the fingers. It should then be placed upon the 
tile or slab previously dusted with a little Lycopodium or Starch 



EXTEMPORANEOUS PREPARATIONS. 497 

in fine powder, and rolled into a long cylinder by the aid of a 
broad-bladed spatula, until the mass is of a length corresponding 
to the divisions on the tile-scale which represent the number of 
pills to be made. The mass should then be placed along the scale, 
and a cut made through it with the spatula at each division of the 
scale, the pieces being at once rounded separately into pills by 
the thumb and two fingers of each hand. A pill-machine is often 
employed, consisting of two metal plates having semicylindri- 
cal grooves on one side, and set into wooden boards, the whole 
forming a convenient apparatus for rolling the mass and then 
cutting it into the required number of pills by one movement. 
The pills are then left to dry upon the slab while the label is being 
written, after which they are placed in a pill-box, or in a wide- 
mouthed bottle if they contain volatile ingredients, and surrounded 
by a conspergative powder (Lycopodium, powdered Chalk, dusted 
Talc), to prevent their adhering together or losing their shape. 

Excipients used in pill-making are seldom mentioned in the 
prescription, but are usually left to the choice of the compounder. 
Some substances need no excipient, but may be made at once into 
pills j such being the softer Extracts and some Gum-resins, the 
former if too hard only needing a little water, and the latter a 
few drops of spirit to soften them to the required degree of plas- 
ticity. Every druggist has his favorite pill-excipient, many using 
a paste made of powdered Tragacanth 1, Glycerin 3^ and Water 
1 part, while others use Extract of Malt, or a mixture of Syrup 
and powdered Acacia, for general use. Powdered Tragacanth to 
give tenacity, Glycerin to keep the mass soft, and Water to de- 
velop the adhesive qualities of many ingredients, will answer for 
fully nine-tenths of all the cases which occur in practice. These 
three excipients should stand on the dispensing counter ready for 
use, and all ready-made pastes or mixtures should be discarded, as 
being slovenly, dirty and liable to change. The excipients de- 
scribed below are those in general use, and are arranged in the 
order of their comparative importance, viz. : — 

Liquid Excipients. 

Glycerin, — is a very valuable excipient, as it continually attracts moisture 
from the atmosphere, and pills made from it do not get hard. It should be used 
always for Quinine pills. Glycerites of Starch or Tragacanth are generally use- 
ful excipients. The former is official, the latter is made in the proportion of £ss 
to the g. 

Glucose, — is a good excipient, being colorless, adhesive, and not readily 
volatilized at ordinary temperatures. Since its introduction by Mr. Lascheid 
for this purpose it has steadily grown in favor. 

Honey, — may be used for dark-colored substances. It should be evaporated 
to one-half its bulk, and then if mixed with a little Tragacanth, it makes an 
excellent excipient for insoluble powders. 

42 



498 EXTEMPORANEOUS PREPARATIONS. 

Extract of Malt, — is a pretty fair excipient, but has the disadvantage of its 
dark color. 

Syrup, — is a fair excipient for powders, but it should not be used for 
metallic salts, especially Calomel, which it reduces in a short time. Syrup of 
Acacia is good where there is little room left for the excipient, but if kept 
long, pills made with it become very hard and insoluble. 

Mucilage of Acacia, — is very adhesive, but not a good excipient for the 
same reason as given for the syrup. 

Water, — is only used alone as an excipient when the ingredients possess 
sufficient adhesiveness to be developed by the water. Such are the following 
powders : Aloes, Rhubarb, Kino, Tannic Acid, Opium, Squill, Asafetida, — 
also Citrate of Iron, Sulphate of Berberine, etc. 

Alcohol, — is used to soften Camphor, Compound Extract of Colocynth, 
Guaiac, resinous extracts, gums, etc. 

Solid Excipients. 

Tragacanth, — is an excellent excipient, especially for substances which are 
too soft, giving them body and elasticity. 

Acacia* — is added to give more adhesiveness than can be obtained from 
viscid liquids alone. Pills made with it are generally very hard. It is used 
for Nitrate of Silver, which may explode if mixed with vegetable extracts or 
glucose. 

Soap, — is the best for resinous and fatty substances, increasing the solubility 
of the former. It is more employed in the official pills than any other ex- 
cipient, but should not be used for substances which are decomposed by an 
alkali, nor for Tartar Emetic. 

Bread-crumb (Mica Panis), — is an excellent excipient for Croton Oil, or 
other powerful liquid substances, as Volatile Oils. 

Confection of Rose, — is too bulky for general use, but is a good excipient 
for very active agents, like Strychnine, which are used in small quantity. 

Althcea, — is good for absorbing and adhesive purposes, but is too bulky for 
general use. 

Petrolatum, Cacao Butter and Resin Cerate, — are used for oxidizable sub- 
stances, as Potassium Permanganate. 

Kaolin, — is well adapted for Nitrate of Silver, and other substances which 
are easily decomposed. 

Liquorice, — is an old excipient, but not much employed now. In powder 
it may be used for oils. 

Conspergatives, — are absorbent powders which are dusted 
upon the finished pills and put around them in the box or vial in 
which they are dispensed, to keep them from sticking together 
and losing their shape. Powdered Liquorice was formerly much 
used for this purpose, but the best conspergatives are Lycoftodium, 
Talc, Althcza, and Rice Flour, the latter especially for white pills. 

Substances Suitable for the pilular form of medicine are the 
following : 

Those acting in small doses. Heavy, insoluble substances. 

Those intended to act slowly. Fetid substances. 

Those to act on the lower bowel. Vegetable extracts. 
Gum-resins, Balsams, Turpentine. 



EXTEMPORANEOUS PREPARATIONS. 499 

When the basis is an unadhesive substance, one of the other 
ingredients' should be an extract or a vegetable powder, which 
will form a mass by moisture alone. Attention to this rule in 
prescribing pills will often prevent the increase of their size by 
inert excipients. 

Difficult substances to combine, except by peculiar treat- 
ment, are met with frequently. The following notes will cover 
most of these cases. 

Aloes, — is best treated on a heated slab with alcohol in very small quantity. 
Soap is the excipient in the official Pilulae Aloes. 

Butyl Chloral Hydrate ', — should be treated with a little Confection of Rose 
and thick mucilage. 

Calcium Sulphide ; — should be well triturated with an equal quantity of 
Sugar of Milk, and then worked up with a little powdered Liquorice-root and 
Tragacanth Mucilage. 

Camphor, — should be powdered with a little alcohol, and may be worked 
into a pill-mass with Glycerite of Tragacanth after the evaporation of the al- 
cohol. 

Carbolic Acid, — requires nearly an equal part of wheaten flour or bread- 
crumb, with a very minute quantity of Glycerite of Tragacanth. Creasote 
may be made into a mass by the addition of powdered Liquorice with a very 
little bees' wax. If made into a pill with Oxide of Silver it will explode un- 
less the silver salt be first diluted by trituration with Liquorice, Gentian or 
some other inert powder. 

Citrate of Iron and Quinine, — is very deliquescent with most excipients. 
Canada Balsam is the best for it. 

Copaiba, — may be made into pill-mass by the addition of a little Carbonate 
of Magnesium or Wax. 

Croton Oil, — is best worked up with bread-crumb, though powdered Li- 
quorice and mucilage may be used. 

Ferrum Iodide, — in pill form requires special manipulation and protection 
to remain unoxidized. The official Pil. Ferri Iodidi is prepared with Iodine 
and Reduced Iron, has Liquorice, Sugar and Acacia as excipients, and is pro- 
tected by a coating of Balsam of Tolu (see ante, page 191). In other fcn> 
mulae Acacia, Althaea, Cocoa-butter, Elm-bark and Liquorice are used as ex- 
cipients. 

Ferri Sulphas, — is used in Blaud's Pill and in the official Pil. Ferri Com- 
positae, with Carbonate of Potassium, to form by mutual decomposition Fer- 
rous Carbonate, which quickly passes into the ferric salt by exposure. Myrrh 
in powder and Syrup are the excipients used for the official pill. 

Gallic Acid, — makes a good pill with a very small quantity of Glycerin. 
Tannic Acid requires about one-fifth its weight of Glycerin and one-tenth of 
Mucilage. 

Phosphorus, — presents the problem of combining it in pill without letting 
it oxidize. This is believed to be accomplished by the pharmacopoeial direc- 
tions for the Pil. Phosphori, according to which the Phosphorus is dissolved 
in Chloroform in a test-tube, then quickly worked into a mass with Althaea, 
Acacia, Glycerin and Water, and finally the pills are coated by shaking with 
an Ethereal solution of Balsam of Tolu. Carbon Bisulphide is a better sol- 
vent, but when it is used the pill-mass retains its disgusting odor. 

Potassium Acetate, — requires Canada Balsam to secure its stability in pill 



500 



EXTEMPORANEOUS PREPARATIONS. 



form. Potassium Iodide is best manipulated by rubbing into a smooth paste 
with a very little water, then adding a small quantity of Liquorice powder. 
Potassium Permanganate should be worked up with kaolin and a very little 
water. Resin Cerate, Soft and Hard Paraffin and Cacao-butter are also used 
as its excipients. 

Quinine, — requires very clean hands and tools, and a colorless excipient, 
as Glycerin or Glucose, to make a nice looking pill. If one part of Tartaric 
Acid is added to four of the Quinine salt the mass will be less likely to crumble 
and will be of less bulk. Sulphate of Quinine may be made into small and 
soluble pills by simply triturating it with Aromatic Sulphuric Acid nxiij to 
each 5 grains of the salt. The moulding into pills should be done at the mo- 
ment when the mass has begun to dry. A drop of syrup or honey, added at 
this time, will prevent the too rapid hardening of the mass. 

Rhubarb, — in powder makes a good mass with one-fifth of its weight of 
Glycerin ; but Soap is the excipient ordered for the official Pilutae Rhei. 

Substances Unsuited to the pilular form are: — 
Those requiring large doses, and those which are volatile.* 
Emetics, and other agents administered for immediate effect. 
Essential Oils in quantity exceeding half a drop to each pill. 
Oils and other bodies which require much solid matter to make a 
mass; except those having a very small dose, as Croton Oil. 
Deliquescent Salts, unless intended to be used immediately. 
Efflorescent Salts, unless deprived of their water of crystalliza- 
tion. 



Deliquescent Salts, 

Ammonii Iodidum. 

Nitras. 

Valerianas. 

Auri Chloridum. 

Calcii Chloridum. 

Chinoline Salts, except the Tartrate, 

which is stable. 
Lithii Citras. 

Bromidum. 

Salicylas. 

Magnesii Citras. 
Potassa. 

cum Calce. 

Potassii Acetas. 

Carbonas. 

Citras. 

Cyanidum. 

Hypophosphis. 

Sulphis. 

Tartras. 

Sodii Hypophosphis. 

Iodidum. 

Zinci Bromidum. 

Chloridum. 

Iodidum. 



Efflorescent Salts. 

Alumen (slightly). 
Ammonii Carbonas. 

Phosphas. 

Ant. et Potass. Tartras (slightly). 
Cupri Acetas. 

Sulphas. 

Magnesii Sulphas (slightly). 
Potassii et Sodii Tartras (slightly), 

Ferrocyanidum (slightly). 

Quininae Bisulphas. 

Sulphas (after a time). 

Soda. 

Sodii Acetas. 

Arsenias (slightly). 

Benzoas. 

Boras (slightly). 

Carbonas. 

Hyposulphis. 

Phosphas. 

Santoninas (slightly). 

Sulphas. 

Sulphis. 

Strychninae Sulphas. 
Zinci Acetas. 
Sulphas. 



EXTEMPORANEOUS PREPARATIONS. 501 

Coated Pills are manufactured upon a large scale by the large 
drug houses, extensive machinery being employed for the pur- 
pose. The coating material used is either Sugar or Gelatin. The 
U. S. Pharmacopoeia directs that two of the officials pills shall 
be coated by being shaken with a solution of Balsam of Tolu in 
Ether, viz.— Pil. Ferri lodidi and Pil. Phosphori. In extempo- 
raneous pharmacy it is rarely practicable to coat pills with any 
thing except gold or silver leaf, and this is sometimes directed by 
the prescriber, the word " Deaur enter — let them be gilded" 
being used in the subscription. To do this neatly the pills should 
have no trace of powder on them, but should be first coated with 
a trifle of fresh mucilage by rolling between the mucilage-moist- 
ened fingers, each pill being then dropped directly on to a sheet 
of gold or silver leaf, until a dozen or more are so deposited. 
The leaf and its pills are then allowed to slide into a globular 
boxwood shaker, or the leaf may be first placed in the shaker 
and the pills dropped on it there. A cautious circular movement 
being given to the shaker the pills are caused to travel around its 
walls, and when the cover is removed they will be found to have 
each received an even coating of the metal used. Gold leaf 
should always be employed for pills of Blue Mass or Asafetida, 
as silver is amalgamated with the former and turned black by the 
latter. 

Albumen may be used for coating small numbers of pills, which should be 
of very firm consistence before the coating is applied. Each pill is rolled 
between two fingers with a little white of egg f and then revolved in a warm 
pan. Another method of finishing them is, after coating with albumen, to 
rotate them in a tray with powdered French chalk until their surfaces become 
smooth and shiny. When carefully done this process gives a very nice finish. 

Compressed Pills, as now largely manufactured by several 
reliable firms, consist of various medicinal powders pressed into 
pill or tablet shape by machinery. They are extremely conven- 
ient preparations for the physician's use, as quite a variety can 
be carried in a pocket-case, and as slight pressure is sufficient to 
reduce them to powder, they can be dispensed with facility and 
accuracy of dosage. Messrs. John Wyeth & Brother, of Phila- 
delphia, manufacture a very extensive line of these pills, includ- 
ing nearly all those put up in the sugar-coated or gelatin-coated 
form by other houses. The trade-list of this firm should be in 
the hands of every physician who keeps a small stock of medi- 
cines in his office, or who carries a pocket-case of drugs. The 
following list includes the most important of these preparations, 
•the figures representing the number of grains in a pill in each 
case. 



502 



EXTEMPORANEOUS PREPARATIONS. 



Acid, Arsenious, ^, ^, ^, ^- 

Benzoic, 5. 

Gallic, 5. 



Salicylic, 2^, 5, 



11^, et Gentian ^, 



Salicylic 2j^, and Morphine r ^. 

Tannic, 2, 5. 

Aconitia, -g^. 

Aloes, 2. Aloes et Ferri (U. S. P.). 

Aloes 2, et Myrrh 1. 

Aloes % y et Rhei 

Aloin, £, J, J. 

Ammonium Bromide, 5, 10. 

Ammonium Chloride, 3, 5, 10, 

Atropine, ^. 

Bismuth Subcarb., 5. 

Subnitrate, 5, 10. 

Borax, 5. 

Caffeine Citrate, 1. 

Calcium Sulphide, y 1 ^, J, J, I. 

Calomel, %, %, 1, 2, 3,5. 

Calomel 2, Opium 1. 

Camphor Monobromated, 2, 3, 5. 

Cathartic Comp. (U. S. P.) and Imp'vd, 

Cerium Oxalate, 2. 

Cinchona Alkaloids (Mixed). 

Cinchonine Sulphate, 2, 3, 4, 5. 

Cinchonidine Sulphate, 2, 3, 4, 5. 

Codeine, y. 

Digitaline, -fa. 

Extract of Cannabis Indica, %. 

Extract of Ignatia Amara, %, %. 

Extract of Nux Vomica, X, j^. 

Ferrum (Quevenne's), 1, 2. 

The following prescriptions represent the composition of a few 
unofficial pills in general use. A complete pill formulary is easily- 
obtained, being published annually by each of the principal 
manufacturers. 



Ferrum Arseniate, %, }(. 

Proto-carb., 3, 5. 

Lactate, 1. 

Pyrophosphate, 2. 

and Quinine Citrate, 2, 3, 5. 

Hydrargyrum, 1, 3, 5. 

Chlor. Corros., ^, ? ^, fo ^ 

Iod. Rub., ^, T V 

Proto-Iodide, ^, J, J, J, J. 

Ipecac, et Opii, 2, 3, 5. 
Morphine Sulphate, T ^, £, £, J, J. 
Opium Deodorized, 1. 
Opium y 2 > and Lead Acetate 1^. 
Pepsin Sacch., 2, 5. 
Podophyllin, T \, #, %, X> x » 2 - 
Potassium Bromide, 5, 10. 

Chlorate, 5. 

Iodide, 5. 

— — Nitrate, 5, 

Permanganate, ^, 1, 2, 

Quinine Bisulphate, y Zi 1, 2, 3, 4, 5. 

Salicylate, 2. 

Sulphate, y 2i 1, 2, 3, 4, 5, 

Quinquinine, 2, 3. 
Rhubarb, 3. Rhei Co. (U. S. P,). 
Rhei 2, et Magnesiae 2. 
Salicin, 2 



/a, > 
Santonin, 1. 

Santonin 1, et Calomel I, 
Sodium Bicarbonate, 5. 

Salicylate, 3, 5. 

Strychnine, T J T , fo 9 up to 2V 
Zinc Phosphide, -^ 2 up to J. 



R 



B. 



Pills of Iron. 


Astringent Pill, 


. Ferri Reducti, . , gr, 1. 


JJ . Plumbi Acetatis, . . gr. xvj 


Mannae, , . . gr. xv. 


Pulv. Camphorae, . . gr. xij 


Glucosi, q. s. 


Pulv. Opii, . . . gr, iij. 


Fiat massa, et div. in pil. xxv. 


Bismuthi Subcarb., , gr. xij 


Sig. — One after each meal. 


Ext. Gentianse, q. s. 




Fiat massa, et div. in pil. xij. 




Sig. — One thrice daily. 


Emmenagogue Pill [Otto), 




. Ferri Sulph. Exsic, . gr. xlviij. 




Pulv. Aloes, . . gr. xij. 


Astringent Pill. 


Terebinthmae, . . gr. xxxij. 


R. Argenti Nitratis, . gr. xx. 


Ol. Terebinth., . . mx. 


Pulv. Cretse (Gallicae), gr. lxxx. 


Fiat massa, et div. in pil. xxx. 


Petrolati, q. s. 


Sig. — Two, three times a day. 


Fiat massa et div. in pil. xl. 



EXTEMPORANEOUS PREPARATIONS. 



S03 



Hooper s Female Pills. 

R. Pulv. Aloes Socot., . gr. xlviij. 

Ferri Sulph. Exsic., . gr. xxiv. 

Ext. Hellebori Nig., 

Pulv. Myrrhss, 

Saponis, . . aa gr. xij. 

Pulv. Canellae Alb., 

Pulv. Zingiberis, aa gr. vj. 

Aquae vel Syrupi, q. s. 
Fiat massa, et div. in pil., quisque 
pondo gr. ijss. 

Sig. — One to three at a dose. 



R 



Tonic Pill for Women. 
. Strychninse Sulph., 

Ac. Arseniosi, . aa gr. 

Ext. Belladonna, . gr. 

Quininae Sulph., . gr. 

Massae Ferri Carb., . gr. 
Fiat massa, et div. in pil. xxxv. 
Sig. — One three times daily. 



J. 
v. 

xxxv. 
xc. 



R 



Anaphrodisiac and Sedative. 
. Camphorse, . . . gr. xxx. 

Lupulini, . . . gr. xx. 
Fiat massa, et div. in pil. xx. 
Sig. — One thrice daily. 



R 



Cholagogue Pills {Squibb). 
. Resinae Podophylli, . gr. vj. 

Ext. Belladon. Alcohol., gr. iij. 

Pulv. Capsici, 

Pulv. Sacch. Lactis, aagr. xxiv. 

Pulv. Acaciae, . . gr. vj. 

Glycerini, Syrupi, q. s. 
Fiat massa, et div. in pil. xxiv. 
Sig. — One or two as required. 



R 



Aperient Pills. 






. Pulv. Aloes Socot., . 


g r - 


xxiv. 


Pulv. Rhei, 


gr- 


xlviij 


Hydrarg. Chlor. Mitis, 


gr. 


iv. 


Ant. et Potas. Tart., . 


gr- 


ij. 


Fiat massa, et div. in pil. 


xxiv. 


Sig. — One or two as needed. 





R. 



Anti-bilious Pills. 
Pulv. Scammonii, 
Pulv. Aloes Socot., 
Pulv. Gambogiae, 
Hydrarg. Chlor. Mitis, 
Potass. Bitart., . . aagr. 



xx. 



Ext. Taraxaci, 



q.s. 



Fiat massa, et div. in pil. xx, 



Gelatin Capsules are to be obtained from the drug stores of 
various sizes from o to 10. They are a convenient means of ad- 
ministering oils or nauseous solids, and when filled may be swal- 
lowed as easily as a large pill. By some of the manufacturers 
Soluble Elastic Capsules are prepared, each containing an ordi- 
nary dose of such medicines as Castor Oil, Cod-liver Oil, etc. 
The largest of these capsules makes a bolus which may be swal- 
lowed with a little effort, as it is quite compressible and changes 
its shape to suit the calibre of the passage. The ordinary cap- 
sules are easily filled by the aid of a paper funnel, and the end of 
a pen -holder as a packer; but simple devices {capsule-fillers) may 
be obtained for the purpose of facilitating the operation. 



R. Pulv. Opii, . . . gr. x. 
Pulv. Camphorse, . . gr. xx. 
Sacch. Alb., q. s. 
Trit., et nant capsulae x. 
Sig. — One at bedtime for chordee; 
repeat in two hours if necessary. 



R. Copaibae, . . . . ^iss. 
Oleo-resinae Cubebae, . ^ss. 

M., et nant capsulse xij. 

Sig. — Two capsules three times 
daily, soon after meals, for gonor- 
rhoea. 



504 



EXTEMPORANEOUS PREPARATIONS. 



Troches (Trochisci), — also named Tablets, Pastilles, Loz- 
enges, etc., and Compressed Pills, are not readily compounded 
at the dispensing counter, but may be obtained in all first-class 
shops, being prepared in great variety by the manufacturers. Be- 
sides the official Troches (see ante, page 461), those named in 
the following list are generally for sale : — 



Troches (Lozenges), 
Alum, gr. ij. 

Alum gr. 1^, Catechu gr. ij. 
Ammonium Chloride gr. ij, and Cu- 

bebs gr. j. 
Ammon. Chlor. gr. ij, Liquorice gr. 

viij. 
Benzoic Acid, gr. }£. 
Borax, gr. iij. 

Bismuth, gr. ij, and Charcoal, gr. v. 
Bronchial, — 01. -res. Cubebs, gr. £, 

Tolu, gr. £, 01. Sassafras, gr. y 1 ^, 

and Ext. of Liquorice, gr. vij. 
Brown Mixture. 
Carbolic Acid, gr. j. 
Ginger and Sodium Bicarb. 
Guaiac, gr. ij. 
Kino, gr. ij. 
Lettuce, gr. j. 
Lime-juice. 
Logwood, gr. ij. 
Magnesia, gr. iij. 
Pellitory, gr. j. 
Pepsin, gr. iij, Charcoal, gr. iij, 

Magnesia, gr. ij, and Ginger, 

Potassium Bitartrate, gr. iij. 

Potassium Citrate, gr. iij. 

Santonin, gr. y 2 , and Calomel, gr. y^. 



2 off* 



aa gr. 



Compressed Tablets, 
Ammonium Chloride, gr. iij. 
Charcoal, gr. x. 
Cocaine Hydrochlorate. 
Dover's Powder. 
Mercury, Yellow Oxide, gr. 
Pepsin and Pancreatin. 
Potassium Bicarb., gr. v. 
Potassium Chlorate, gr. v. 
Potas. Chlorate and Borax, 

Potas. Chi. and Ammon. Chloride. 
Spencer's Chloramine Pastilles. 
Sodium Bicarb., gr. iv., Ammon Carb., 

gr.tf.Ol. Menth. Pip., gtt. j/ 6 . 
Sodium Salicylate, gr. iij. 
Antiseptic. Hydrarg. Chlor. Corr., 

gr. vijss. 
Fehling's Test for grape-sugar in the 

urine. 

Hypodermic Tablets, 
Morphine Sulphate, gr. T \ to \, 
Morph. Sulph. and Atropine Sulph. 
Atropine Sulphate, gr. -^fa 
Strychnine Sulphate, gr. 
Apomorphine Muriate, gr. ^, j 1 ^. 
Pilocarpine Muriate, gr. -fa - \ 

(And several others.) 



1 

TUG' 



1 

sir- 



Confections (Confectiones), and Electuaries (Electuaria), 
— are very seldom prescribed, and therefore can have but little 
place in extemporaneous pharmacy. They are medicinal powders, 
etc., beaten up with sugar, honey or molasses, to the consistence 
of a thick paste, and are administered with a spoon like preserved 
fruits. The two official confections are described on page 461, 
and a few old formulae for similar preparations are given below 
as pharmaceutical curios. The first is a meritorious prescrip- 
tion. 



EXTEMPORANEOUS PREPARATIONS. 



505 



Electuary for Piles. 

R. Potassi Bitartratis, 
Potassii Nitratis, 

Pulv. Jalapae, . . aa ^ss. 
Confectio Sennae, . . Jj. 
Syrupi Zingiberis, q. s. 
M. Fiat electuarium. 
Sig. — A piece the size of a marble 
to be taken thrice daily. 



The Chelsea Pensioner. 
R. Sulphuris Loti, . 
Potassii Bitart., . 
Pulv. Rhei, 
Guaiaci Resinae, 
Mellis Despum., 
Myristicam Pulv., 
M. Fiat electuarium. 
Sig. — A tablespoonful twice daily, 
as a laxative. 



a* 

%. 

j. 



Confectio Damocratis. 

[An ingredient of Warburg's Tincture.] 

This preparation was official in the London Pharmacopoeia of 1745. It 
contained 1 grain of Opium in ^ss, and consisted of 45 ingredients, as fol- 
lows, viz. : Cinnamon, 14 parts; Myrrh, II parts; — White Agaric, Spikenard, 
Ginger, Spanish Saffron, Treacle, Mustard Seed, Frankincense and Chian 
Turpentine, of each 10 parts ; — Camel's Hay, Costus Arabacus, Zedoary, In- 
dian leaf, Mace, French Lavender, Long Pepper, Seeds of Harwort, Juice of 
ripe Cistus, strained Storax, Opponex, strained Galbanum, Balsam of Gilead, 
Oil of Nutmeg, Russian Castor, of each 8 parts ; — Water Germunder, Balsam- 
tree Fruit, Cubeb, White Pepper, Seeds of Cretian Carrot, Poley Mont, 
strained Bdellium, of each 7 parts; — Gentian-root, Celtic Hard, Leaves of 
Dittany of Crete, Red Rose, Seeds of Macedonium, Parsley, Sweet Fennel 
Seed, Seeds of Lesser Cardamom, Gum Arabic, Opium, of each 5 parts; — 
Sweet Flag, Wild Valerian, Anise-seed, Sagapenum, of each 3 parts ; Spig- 
rul, St. John's Wort, Juice of Acacia, Catechu, Dried Bellies of Skunk, of 
each 2^ parts; — the roots finely powdered and the whole mixed thoroughly 
into a paste with Clarified Honey. 



Powders (Pulveres), — as prepared extemporaneously are 
generally compound, and may be mixed on a slab with a spatula, 
but a much better method of mixing them is by trituration in a 
mortar. The latter should always be employed except in the 
case of substances which may explode if so treated, as Potasssium 
Chlorate with oxidizable substances. (See ante, page 482.) The 
Diluent best employed in powders is Sugar of Milk, on account 
of its hardness, its density and its comparative insolubility. A 
coloring agent, as Carmine in minute quantity, is a useful ingre- 
dient, enabling the eye to judge of the degree of mixing and 
subdivision obtained. Powders containing soluble salts, extracts, 
volatile oils, camphor, or any other hygroscopic or volatile sub- 
stances, should be dispensed in waxed paper. For ordinary 
powders the plain white paper of the drug-stores will answer, but 
a better paper for small powders is one having a high surface 
finish and made very thin, as the white glazed French demy. 
Powders are often ordered in Wafers (Cachets), to be swallowed 



506 



EXTEMPORANEOUS PREPARATIONS. 



without unfolding. The division of powders into the number of 
papers ( Chartulajh ordered, and folding them neatly, requires a 
considerable amount of practice. A small machine is used over 
which the ends of the papers are bent, in order to have them of 
the proper size for the box in which they are usually dispensed. 
If they are to be put into an envelope less exactness of folding is 
required, and the mechanical contrivance may be dispensed with. 
Substances suitable to administration in the form of powders 
are those which are insoluble, those which would be chemically 
incompatible in fluid form, and certain pulverizable extracts. 
Those which are unsuited to this form are such as have a very 
nauseous taste or odor, substances of which the dose is large, those 
which are deliquescent, efflorescent or very volatile, and those 
which liquefy on mixing. A list of deliquescent and efflorescent 
salts is found on page 500, while the following named, though 
dry alone, become moist when triturated together, viz. : — 

Sodium Sulphate and Potassium Carbonate. 
Zinc Sulphate and Lead Acetate. 
Camphor and Chloral Hydrate. 

Many substances cannot be powdered without the intervention 
of another body : thus Opium requires a hard substance like Sugar 
of Milk or Potassium Sulphate, Camphor requires a minute quan- 
tity of Alcohol, Myrrh needs Sugar or Gum, etc. Substances, as 
the alkaloids and their salts, which are very active and are used 
in very small doses, require some inert substance to give them 
bulk enough for division and handling. Sugar of milk will be 
found the best agent for this purpose. Prescriptions may order 
the ingredients for a single powder, with directions to dispense a 
certain number of the same composition ; or they may give the 
quantities for the whole number of powders ordered, with instruc- 
tions to divide into a certain number. The dispenser should 
carefully scan the prescription in order to avoid the multipli- 
cation of quantities where division is intended. The official 
powders are enumerated on page 462 ; and the following formulae 
will serve to illustrate those generally prescribed. 



Astringent Powder for Infants. 
R. Plumbi Acetatis, . . gr. ij. 
Pulveris Opii, . . gr. ss. 

Camphorse, . . . gr. j. 
Sacchari Lactis, . . gr. iij. 
Trit.,-et div. in chartulas xij. 
Sig. — One every 2 or 3 hours in 
diarrhoea of infants. For an adult the 
above represents one dose. 



Bismuth and Soda. 
R. Bismuthi Subnitratis, 

Sodii Bicarb., . aa gij. 

Pulv. Zingiberis, . . gr. xl. 
M., et div. in chartulas xij. 
Sig. — One after each meal. 
Corrective in dyspepsia, acne and 
eczema. 



EXTEMPORANEOUS PREPARATIONS. 



507 



R 


Gastric Sedative. 

. Bismuthi Subnitratis, . 

Pulveris Rhei, 

Pulveris Aromat., . . 
M., et div. in chartulas vj. 
Sig. — One before each meal 


aa 


81 • 

3 SS 


R 


Laxative Powder. 

. Hydrarg. Chlor. Mitis, . 
Sacchari Lactis, 


X. 
. XX 



M., et fiant pulv. x. 

Sig. — One powder twice daily. 



Antipruritic Powder. 

R. Pulveris Camphorse, . . gj. 
Zinci Oxidi, . . . ^iv, 
Pulv. Amyli, . . . §j. 
M., et fiat pulvis. 

Sig. — Use locally as a dusting pow- 
der to relieve itching. 



Catarrh Powder. 
I£. Bismuthi Subnitratis, 
Pulv. Acacise, . 
Pulv. Talc, 
Morphinse Muriatis, . 
M. Sig. — Use by insufflation. 



3 n J- 

g r - i- 



Compressed Pills are really powders which have been com- 
pressed into pill shape by machinery. A little pressure from the 
blade of a spatula will restore them to powder- form. (See ante, 
page 501.) 

Triturations (Triturationes), — are powders containing mi- 
nute doses of very active agents diluted with Sugar of Milk, and 
possessing a definite relation between the active ingredient and 
the diluent, namely 1 in 10, according to the general formula of 
the U. S. Pharmacopoeia, which, as well as the one official tritu- 
ration, is described on page 462. Sugar of Milk is employed as 
the diluent because of its hardness and its comparative insolu- 
bility. The first of these qualities secures the fine comminution 
of the active ingredient whereby the action of the medicine is 
increased and better distributed. Its insolubility makes it the 
best diluent for powders or triturations administered from a spoon 
or glass with fluid, as is so often done, for unlike cane sugar it is 
not readily dissolved and does not leave the active substance 
behind on the surface of the utensil. Triturations are excellent 
forms for the administration of powerful alkaloids, which may 
thus be divided with great accuracy into the minute quantities 
required. Mercury and its salts are especially adapted to this 
method of preparation, being more uniformly divided and hence 
more active than when administered in any other form. Tritu- 
rations of mercury with sugar were commonly used in England a 
hundred years ago, and triturations of many substances were 
employed by the Arabian physicians of the 13th century. But 
the subsequent adoption of these preparations by the homceopa- 
thists produced such a prejudice against them in the ranks of the 
regular profession that until recently any one using them stood in 
danger of being stigmatized as a homoeopath. Their recent recog- 



508 



EXTEMPORANEOUS PREPARATIONS. 



nition by the U. S. Pharmacopoeia under their proper title does 
away with any such implication, though it is much to be regretted 
that the compilers of the last revision of the British Pharmacopoeia 
should have shown their fear of a name by continuing the title 
" Pulvis Elaterini Compositus M to designate a preparation which 
in every respect is a trituration. The preparations of Pepsin 
daily prescribed by physicians all over the country are really sugar- 
of-milk triturations of that ferment, and not pure Pepsin as many 
suppose. Prof. H. G. Piffard, Med. Dept. Univ. of the City of 
New York, in his treatise on the Materia Medica and Thera- 
peutics of the Skin (N. Y., 1881), after detailing several micro- 
scopical examinations of pills and triturations, uses the following 
language : 

" It is to be expected, therefore, that the protoiodide trituration will prove, 
ceteris paribus, more active than the pill, and such we have found it Io- 
dides of Mercury .... Since we have used the triturations, however, in 
preference to the ordinary pills, patients more rarely complain of disagreeable 
sensations. We have been enabled to materially reduce the size of the dose 
in order to obtain the desired effect. In other words, a larger proportion of 
the drug is utilized for specific purposes, while but a small amount remains to 

give rise to local irritation I have nothing to add to this, except that 

I continue to use triturations of Mercury and other substances with increasing 
satisfaction. Besides those mentioned I employ Calomel, Cyanide of Mer- 
cury, Black Oxide of Mercury and Corrosive Sublimate in this form." 

The following examples will illustrate the mode in which Trit- 
urations may be prescribed : — 

a. 



R. Hydrarg. Oxidi Flavi, . gr. ss. 
Sacchari Lactis, . . gr. 1. 
Trit., et div. in chartulas xxiv. 
Sig. — One twice daily. 



R. 



Hydrarg. Chlor. Mitis, . 

Sacchari Lactis, q. s. 
Trit., et div. in chartulas x. 
Sig. — One powder daily. 



gr. x. 



Morphinae Sulph., 

Sacchari Lactis, . 
Trit. et div. in chartulas viij. 
Sig. — One every six hours. 



gr. xvj, 



R. 



Acidi Arseniosi, . . gr. 

Sacch. Lactis, . . gr. 

Trit., et div. in chartulas xx. 
Sig. — One powder thrice daily. 



Suppositories (Suppositoria), — are small, conical, medicated 
bodies intended for introduction into the rectum, uterus, or 
urethra (bougies), occasionally into the vagina. No official sup- 
positories are enumerated, but a general formula is prescribed by 
the pharmacopoeia for their preparation (see ante, page 462). The 
basis is usually Cacao-butter, but for those intended for the ure- 
thra or uterus a mixture of Gelatin and Glycerin is considered 
the best excipient, being firmer and more plastic than cacao- 



EXTEMPORANEOUS PREPARATIONS. 509 

butter, and more easily handled. Hollow cones of cacao-butter, 
or some composition resembling it, are kept in the shops, and 
will be used by the average druggist in filling prescriptions for 
rectal suppositories unless prohibited, as they save him consid- 
erable labor ; the active drug being simply placed in the centre 
of the cone which is then sealed with a plug fitting in its base. 
These contrivances are by no means so efficient as the regular 
suppository, in which the medicinal agent is thoroughly incor- 
porated with the excipient, for the former smear the rectum with 
a quantity of melted grease before the active portion of the prep- 
aration is permitted to come into contact with its walls. The 
agents used in suppositories are chiefly extracts and alkaloids ; 
some few powders, and a few metallic salts are occasionally em- 
ployed. Those for the adult rectum should contain from 15 to 
30 grains of the excipient, for the vagina a drachm of cacao-butter 
is the average quantity. Those for the uterus and urethra are 
made of cylindrical instead of conical form, and about the di- 
ameter of a No. 9 catheter. 

The methods of compounding suppositories are two, viz. : — that 
by the use of moulds (the official method), and that by hand. 
The former process is described on page 462, but many prefer 
the hand method, which is as follows: The medicament is mixed 
with finely shaved Cacao-butter by the aid of a spatula on aboard 
or tile lightly dusted with Lycopodium or Starch. After a smooth 
and uniform mixture is thus obtained, the mass may be rolled into 
cylindrical form, cut into the required sizes and with the spatula 
given the proper shape. When dispensed, they should be placed 
in a powder-box, between layers of cotton. 

Bougies or Pencils, as urethral and uterine suppositories are 
often termed, may be prepared by melting together White Gela- 
tin 3, Glycerin 1, and Distilled Water 1 part by weight, then 
adding the medicament, and drawing the mass into a glass tube 
previously oiled inside. When cold the bougie may be pushed 
out and cut into suitable lengths. 

The Br. Pharmacopoeia describes 8 official suppositories, as fol- 
lows, viz. — 

Suppositoria Acidi Carbolici cum Sapone, — Carbolic Acid, 12 grains; Curd 
Soap, in powder, 180 grains; Glycerin of Starch, 40 grains ; to make 12 sup- 
positories, each containing I grain of Carbolic Acid. 

Suppositoria Acidi Tannici, — Tannic Acid, 36 grains ; Oil of Theobroma, 
144 grains; to make 12 suppositories, each containing 3 grains of Tannic 
Acid. 

Suppositoria Acidi Tannici cum Sapone, — Tannic Acid, 36 grains ; Glycerin 
of Starch, 30 grains; Curd Soap, in powder, 100 grains; Starch in powder 
q. s.; to make 12 suppositories, each containing 3 grains of Tannic Acid. 



5io 



EXTEMPORANEOUS PREPARATIONS. 



Suppositoria Hydrargyria — Mercurial Ointment, 60 grains; Oil of Theo- 
broma, 120 grains; to make 12 suppositories, each containing 5 grains of 
Mercurial Ointment. 

Suppositoria Iodoform^ — Iodoform, 36 grains ; Oil of Theobroma, 144 
grains; to make 12 suppositories, each containing 3 grains of Iodoform. 

Suppositoria Morphince, — Morphine Hydrochlorate, 6 grains ; Oil of Theo- 
broma, 174 grains; to make 12 suppositories, each containing )/ 2 grain of the 
Morphine salt. 

Suppositoria Morphince cum Sapone, — Morphine Hydrochlorate, 6 grains ; 
Glycerin of Starchy 30 grains ; Curd Soap, in powder, 100 grains ; Starch, 
q. s. to make 12 suppositories, each containing y 2 grain of the Morphine salt. 

Suppositoria Plumbi Composita, — Acetate of Lead, 36 grains; Opium, in 
powder, 12 grains; Oil of Theobroma, 132 grains; to make 12 suppositories, 
each containing 3 grains of Lead Acetate and 1 grain of Opium. 

Suppositories and Bougies may be prescribed in the manner 
illustrated by the following formulae : 

Wade's Bougies. 

R. Iodoformi, . . . £j. 

Bismuthi Subnitrat., . ^j. 

Chloralis, . . . gr. viij. 

Morphinae Sulphat., . gr. iij. 

Ol. Rosae, . . . Tn_x. 



R. 



Anodyne Suppository, 

Ext. Opii, 

Ext. Belladonnas, . 

Ext. Hyoscyami, . 

Olei Theobromae, q. s. 
M. Fiant suppositoria vj. 
Sig. — One into the rectum morning 
and night. 



gr. vj. 

gr. ss. 

g r - ij- 



Anthelmintic. 

R. Santonini, . . . gr. xij. 
Olei Theobromae, . . gj. 

M. Fiant suppositoria vj. 

Sig. — One into the rectum as di- 
rected. 

Quinine Suppository . 

R. Quininae Sulphatis, . . gr. v. 
Olei Theobromae, . . gr. x. 
Fiat suppositorium unum, mitte tales 
sex. 



Gelatini, et Glycerini, q. s. 
M. Fiant boUgia xij. 
Sig. — One into urethra thrice daily. 



Bougie for Gleet. 



R 



Zinci Sulphatis, 

Ac. Carbolici, 

Pulv. Hydrastis, . 

Ext. Belladonnae, . 

Gelatini, et Glycerini, q. s. 
M. Fiant bougia xij. 
Sig.— One into urethra night and 
morning. 



g r - V J- 

TTillj. 

gr. xij, 
gr. xij. 



Ointments (Unguenta) and Cerates (Cerata), — are fre- 
quently ordered on extemporaneous formulae, though the 34 official 
preparations of these classes (see ante, pages 462, 463) would seem 
to give the physician a sufficiently wide field of selection. The 
basis used is usually either the official Ceratum or Unguentum, 
but Petrolatum, Lard, Lead Plaster with a fixed oil, etc., may be 
used. Lard is probably the best basis for all ointments, as it 
softens the skin better than any other similar substance. Its dis- 
advantage is that it soon becomes rancid, so that preparations 
made with it must be quickly used. Cerates only differ from 



EXTEMPORANEOUS PREPARATIONS. 



5" 



ointments in their firmer consistence, melting at tempera- 
tures above 104 F., while the latter melt below the ordi- 
nary temperature of the body. Oleates are described fully on 
page 34. 

The process of compounding an ointment or a cerate is suffi- 
ciently simple, being generally a mere matter of triturating the 
ingredients together in a mortar, or of their incorporation on a 
slab by means of a spatula. Rarely will melting be required in 
the compounding of extemporaneous ointments. When extracts, 
powders or gritty substances are ordered, the ingredients should 
be first pulverized into a fine powder, then triturated with a small 
quantity of the basis into a smooth, impalpable paste ; the remainder 
of the basis being added gradually, until the whole is thoroughly 
incorporated. A warm mortar may be required for hard extracts. 
Soluble salts should be triturated with a little water before adding 
the excipient. Camphor needs a little alcohol to enable it to be 
pulverized ; and Iodine should be rubbed to a fine powder, then 
a little alcohol added and finally the excipient by degrees. Iodide 
of Sulphur requires persevering work with a small portion of olive 
oil. Borax should be triturated with glycerin and Red Oxide of 
Mercury with distilled water. A bone or horn spatula should be 
used for all ointments, as steel or iron blades will injure many 
substances, particularly alkaloids, free acids, tannin or iodine, 
and several of the mercurial salts. Volatile substances should be 
added last, and quickly worked in, so that their evaporation may 
be as slight as possible. 

Ointments are dispensed usually in amber-colored glass pots 
with wooden or metallic covers, or in porcelain jars called Galli- 
pots. In hospital and dispensary practice the common chip pill- 
box is used, but soon becomes excessively dirty and disagreeable 
to handle. 



B 



Ung. Iodoformi Comp 


OS. 


Unguentum Anti-pruriticum. * 


. Iodoformi, 


• Eh 


R. Camphorae, 


Ol. Anisi, 


. mxx. 


Chloralis Hydrat., . aa £j 


Ol. Rosae, 




Tere una ad liquorem, dein 


Ol. Ylang-ylang, 


aa TUv. 


adde cum tritu — 


Ung. Aquae Rosae, . 


• s- 


Unguenti Aquae Rosae, . §j 


M. Fiat unguentum. 




M. Fiat unguentum. 


Sig. — Ointment. 




Sig. — Ointment. 



Plasters (Emplastra), — are rarely prepared extemporaneously, 
the official and many other ones being produced on a large scale 
by the manufacturers, and kept in stock by all druggists. As a 
consequence the compounding and spreading of a plaster by the 



512 EXTEMPORANEOUS PREPARATIONS. 

pharmaceutist has become a lost art. The official plasters are 
enumerated and described on page 464. and may be ordered by 
prescription in the manner illustrated below. Blisters may be 
produced by the application of any preparation of Cantharides 
sufficiently strong for the purpose. Either of the official Cerates 
of Cantharides [see page 120), may be spread on Adhesive Plaster 
(Emplastrum Resdnae), making a blistering plaster ; or Cantharidal 
Collodion (^see page 120, may be painted over the surface. 
Plasters are usually ordered by the square inch, but a model of 
the shape and size may be drawn on paper, and the plaster be 
directed to conform thereto, as in the first of the following pre- 
scriptions. Two of the official Papers (Chartae) are practically 
plasters, viz. — Charta Cantharidis and Charta Sinapis. 

Emplastrum Vesicatorinm. Counter-irritant and Anodyne. 

R. Ceraii Cantharidis. q. s. R. Chaitae Sinapis, 

Extende supra Emplastrum Resinae Emplas. Belladonna, aa, 3 // X6 // . 

hujus formae et magnitudinis. Sig. — Apply the mustard paper first, 

Sig. — Blistering Plaster, to be ap- to be followed by the plaster when the 

plied over the region of the heart. surface has been well reddened. 



Poultices (Cataplasmata\ — are usually prepared at the resi- 
dence of the patient, the ingredients only being ordered from the 
druggist. They are generally employed as a means of applying 
heat and moisture to a certain part of the body, but are sometimes 
medicated with anodyne, counter-irritant or disinfectant agents. 
Poultices are not official in the U. S. Pharmacopoeia, but are in 
the British, the following list including all so recognized. 

Catapiasma Carbonis, — Wood Charcoal I, Crumb of Bread 4, Linseed 
Meal 3, Boiling Water 20 parts. 

Catapiasma Ccnii, — Hemlock-juice I, evaporated to half its volume, Lin- 
seed Meal 4, Boiling Water 10 parts. 

Catapiasma Fermenti, — Beer Yeast 3, Wheaten Flour 7, Water at ioo° F., 
3 parts. 

Catapiasma Lini, — Linseed Meal 2, Boiling Water 5 parts, mixed with 
constant stirring. 

Catapiasma Sinapis, — Mustard, Linseed Meal, Boiling Water and Water, 
of each a sufficiency. 

Catapiasma Soda. C ; :.':n'natcr, — Solution of Chlorinated Soda I, Linseed 
Meal 2, Boiling Water 4 pans. 



Paints (Pigmental. — are preparations for external use. which 
cannot be classed with the preceding. They are generally pre- 
scribed in skin-diseases, for use over inflamed joints, or for appli- 
cation to the throat with a camel's-hair brush. 



GASEOUS PREPARATIONS. 



513 



R. Tinct. Iodi, . . . |j. 

^Etheris Fort., . . . giij. 

Tinct. Aconiti, . . . gss. 

Ext. Belladon. Fl„ . . giv. 

Morph. Sulph., . . gr. ij. 

Iodi, .... 3Jss. 
M. et fiat pigmentum. 
Sig. — Paint 4 or 5 coats freely over 
the inflamed and painful parts. 



R. Alcoholis, Saponis Viridis, 

Olei Cadini, . . aa ^j. 
M. et fiat pigmentum. 
Sig. — Paint over the part. 



R. OleiTiglii,. . . . 3J. 
^Etheris Fort., . . . gij. 
Tinct. Iodi, . . . ^v. 
M. Sig. — Paint on once in 3 days. 



GASEOUS PREPARATIONS. 

Vapors (Vapores) and Inhalations (Inhalationes), — are 
medicines in the form of a vapor, a gas or an atomized spray, to 
be inhaled by the patient for their local action on the respiratory 
tract. The well-known steam-atornizer is the agent by which 
most of these preparations are administered, though many sub- 
stances may be inhaled from the surface of hot-water, from a 
sponge in a bottle surrounded by a hot cloth, or from a heated 
shovel. They are prescribed in the usual manner, as follows: — 



Stimulant Inhalation, 
R. Olei Cubebae, 

Magnesii Carbonat, . 
Aquae, . . 
M. Sig. — A teaspoonful in 
of water at 150 F., for each inhala- 
tion. 



a pint 



Oil of Pine, 
R. Ol. Pini Sylvestris, . , sjij. 
Magnesii Carb., . . ^i. 

Aquae, .... |jiij. 
M. Sig. — A teaspoonful on a pint 
of hot water for each inhalation. 



Carbolized Inhalation. 

R. Acidi Carbolici, . . -ntxrviij. 
Aquae, q. s. . . ad Jjij. 
M. Sig, — Use one-half in the cup 
of a steam-atomizer for each inhala- 
tion. 



Tar and Turpentine. 
R. 01. Picis Liquidae, 

Ol. Terebinth., . . aa ^ij. 
M. Sig. — Pour slowly on a hot 
shovel in the sick-room, keeping the 
vapor confined therein. 



The official Charta Potassii Nitratis, Nitre-paper (see ante, page 
464), is a preparation intended for use as an inhalation, its vapors 
while burning being taken into the lungs* 



43 



PART III. 

SPECIAL THERAPEUTICS. 



Applied Therapeutics may be studied either with the 
various therapeutic agents as the objects of chief consideration, 
as in the first part of this work; or with the different diseases 
and morbid conditions forming the objects of study in respect to 
their modification and treatment by medicines. In the following 
pages the latter method is followed, the therapeutics of each affec- 
tion being exhibited in the form of an Analytical Index to the 
recognized text-books of the day. Every indication for the use 
of a drug, or statement regarding its value, is followed by the 
initial (in parentheses) of its author: these references enabling 
the book to be used as an index to the authorities, for more strict 
differentiation between indicated remedies, — while the brief an- 
alyses given include enough to make each section a complete 
synopsis of the most advanced therapeutics of the disease forming 
its title. 

The principal authors to whom references are made, and the 
various initials indicating them, are comprised in the following 
list. 

References and Bibliography. 

(A.) Aitken. — The Science and Practice of Medicine, 7th edition, revised, 
Philadelphia, 1885. 

(Ag.) Agnew. — The Principles and Practice of Surgery, Philadelphia, 1878, 
3 vols. 

(B.) Bartholow. — Materia Medica and Therapeutics, 5th edition, New 
York, 1884. 

(Br.) Brunton. — Pharmacology, Therapeutics and Materia Medica, Phila- 
delphia, 1885. 

(C.) Carter. — A Practical Treatise on Diseases of the Eye, edited by Green, 
Philadelphia, 1880. 

(CI.) Clarke. — A Manual of the Practice of Surgery, New York, 1 881. 

(D.) Druitt. — A Manual of Modern Surgery, I2th edition, London, 1882. 

(E.) Emmet. — Principles and Practice of Gynaecology, 3d edition, Phila- 
delphia, 1884. 



ABDOMINAL PLETHORA. 5 I 5 

(El.) Ellis. — A Practical Manual of Diseases of Children, 3d edition, 
London, 1883. 

(F.) Fothergill. — The Practitioner's Handbook of Treatment, 2d edition, 
London, 1884. 

(G.) Goodell.-~~Lessons in Gynaecology, Philadelphia, 1882. 

(H.) Hamilton. — Nervous Diseases, their Description and Treatment, 2d 
edition, Philadelphia, 1881. 

(L.) Leishman. — A System of Midwifery, 3d edition, Philadelphia, 1884. 

(M. & P.) Meigs and Pepper. — A Practical Treatise on Diseases of Chil- 
dren, 7th edition, Philadelphia, 1882. 

(N.) Niemeyer. — A Text-book of Practical Medicine, 9th edition, New 
York, 1884. 

(P.) Phillips. — Materia Medica and Therapeutics, revised edition, Phila- 
delphia and London, 1886. 

(Pf.) Piffard.— Materia Medica and Therapeutics of the Skin, N. Y. 1881. 
Editor of Phillips's Materia Medica and Therapeutics, Vegetable Kingdom, 

1879. 

(R.) Ringer. — A Handbook of Therapeutics, I ith edition, New York, 1886. 

(Ros.) Rosenthal. — A Treatise on Diseases of the Nervous System, New 
York, 1884. 

(S.) Stille. — Therapeutics and Materia Medica, 4th edition, Philadelphia, 
1880. 

(St.) Sturgis. — The Student's Handbook of Venereal Diseases, New York, 

1883. 

(T.) Tanner. — An Index of Diseases and their Treatment, 2d edition, 
Philadelphia, 1882. 

(Tr.) Trousseau and Pidoux. — A Treatise on Therapeutics, 9th edition, 
New York, 1880. 

(Tt.) Tait. — Diseases of Women, by Lawson Tait, New York, 1879. 

(W.) Wood, H. C. — Therapeutics, Materia Medica and Toxicology, 6th 
edition, Philadelphia, 1886. 

(Wa.) Waring. — Practical Therapeutics, 4th edition, edited by Buxton, 
Philadelphia and London, 1886. 

Besides the above named, occasional references are made to other works 
by the same authors. References will also be found, with names in full, to 
Anstie, Brown-Sequard, Clymer, Cohen, Da Costa, Fordyce-Barker, Gross, 
Hammond, Hilton, Lister, Mitchell, Nelaton, Noyes, Nussbaum, Ricord, 
Roosa, Simpson, Thomas, and others. When a statement is not followed by 
any reference it is to be understood as coming from the writer of this book. 

Abdominal Plethora. 

Cathartics. The saline and hydragogue cathartics are of value in conges- 
tion of the portal circulation (B.). Saline Mineral Waters, especially the 
purgative saline waters, as Vichy and Saratoga, in plethora of the abdominal 
viscera (B.). Grape-cure has helped many cases, particularly those of he- 
patic engorgement and sluggish portal circulation ; is best used after a pre- 
liminary course of powerful mineral waters (P.). Ali?nent is very important. 
A dry diet is particularly indicated in cases of dyspepsia and hepatic en- 
largement due to excessive beer-drinking. Avoid much bread, also salted 
or twice-cooked meats, rich sauces, solid vegetables especially cucumbers, 
soups and fruit. Biscuits, fresh meat, lemons, fish, fowl and game, may be 
used. [Compare Hepatic Congestion, Obesity.] 



5 i6 



ABORTION — ABSCESS. 

Prescriptions. 



R. Potassii Bicarbonatis, 

Sodii Sulphatis, . . aa £iv. 

Dissolve in i^ pint of Water, and 
add Acidi Tartarici (cryst.) . gij. 

Cork quickly and firmly. y£d to be 
taken thrice daily. 



R. Resinae Podophylli, . gr. vj. 
Ext. Colocynthidis Co , . gr. xij, 
Ext. Belladonnas, . . gr. iij. 

Fiat massa, et div. in pil. no. xij. 

Sig. — One pill every night. 



Abortion. 

Opium, cautiously in threatened abortion, is often very valuable (Wa.) ; — 
the tincture, ttt,xx-xxx by rectum (Parvin) ; — Opium to check uterine action 
and Ergot to restrain hemorrhage (B.). Ergot, small tonic doses give excel- 
lent results in threatened abortion (P.). Tannin, combined with Opium and 
Ipecac. (Wa.). Cimicifuga, to prevent miscarriage when uterus is irritable 
and prolapsed (R.). Savine, the dried powder of the leaves, gr. xv-xx, thrice 
daily, one of the most powerful remedies against the hemorrhage indicative of 
approaching abortion (Wa.) ; — the tincture in doses of 5 to 10 drops, every ]/ z 
to 3 hours, useful against the hemorrhage (P.). Aurum Chloride, to avert the 
tendency to habitual abortion ( B.). Iron, with Potassium Chlorate, throughout 
the pregnancy, when fatty degeneration the cause of habitual abortion ( Mc- 
Lane). Tamponade of the cervix uteri, with cotton or sponge, dipped in vinegar 
or glycerin, when abortion is inevitable and it is desirable to hasten it and re- 
strain hemorrhage. Empty uterus thoroughly with the finger, placenta-forceps 
liable to do harm (Barker). Abortifacients, see pages 207 and 428/ Quinine and 
Ergotin, of each gr. ij in pill every 3 hours, the routine abortifacient of many 
irregular practitioners. Only by the production of such violent irritation of 
the abdominal and pelvic organs as generally endangers life, can the pregnant 
uterus be stimulated to expel its contents (P.). The abortifacient effect of 
Savine and other drugs cannot be obtained unless by the administration of a 
quantity sufficient to endanger life (B.). 

Prescriptions. 

R. Acidi Tannici, . . gr. xv. 

Pulv. Ipecacuanhas, . gr. xij. 

Extractii Opii, . . gr. iij. 

Ft. pil. xij. Sig. — One every six 
hours. 



B. Ext. Ergotae Fluidi, . . £v. 

Tinct. Opii Deodorat, . 3 iij 

Syrupi Limonis, . ' %)- 

M. Sig. — A teaspoonful thrice 

daily. 



Abscess. 

Poultices, to check or to assist in maturation, may be smeared with Bella- 
donna or Opium (R.). Belladonna, as plaster to subdue (B.) ; painted around 
areola (Wa.); internally often successful in aborting (R.). Sulphide of Cal- 
cium, half-grain doses frequently repeated, to abort abscess or to hasten forma- 
tion of pus (B.); gr. ^ every hour or two, gives striking results in healing 
large abscesses (R.). Phosphate of Calcium, in large abscesses (R.). Mercury 
and Morphine, the Oleate locally, diminishes induration due to old abscesses 
and prevents the formation of new ones (R.). Carbolic Acid, a weak solution 
as injection after evacuation, also as a dressing (Lister). Silver Nitrate, a strong 
solution in Nitrous Ether if applied early to adjacent surface will check inflam- 
mation (B.). Blisters or Iodine, as counterirritants around or adjacent to seat of 
disease (R*). Potassium Permanganate,^} to the pint of water, to correct fetor 



ACIDITY. 



517 



(B.). Iodine, the tincture injected after opening large abscesses (R.) ; especially 
in scrofulous abscess ( Wa.). Salicylic or Boracic Acid, as dressings (B.). Sar- 
saparilla, a very useful remedy in chronic abscess with profuse discharge (P.). 
Cod-liver Oil, improves and lessens discharge from scrofulous abscesses (Wa.). 
Surgical. Opening necessary in all deep abscesses, or Avhen on face, near 
anus, mammary, or if danger of its opening into an internal cavity. Open with 
grooved director and forceps (Hilton). Never open a deep abscess with a 
plunge. Drainage-tube may be required,- also irrigation of the cavity and 
pressure (Agnew). Weaning of child necessary in chronic mammary abscess 
(Gross). Psoas abscess may result from strain or laceration of muscle, as by 
heavy lifting, effort to recover balance when skating, etc., as well as from 
spinal disease. Symptoms often obscure and simulating those of chronic ma- 
laria. Early opening by lumbar incision necessary ; then tonics, good food, 
and daily irrigation of the cavity with an antiseptic solution. [Compare Sup- 
puration, Carbuncle.] 



Prescriptions. 



R 



Syrupi Ferri, Quininae et 
Strychninae Phosphatum, §vj. 
Sig. — A teaspoonful in water thrice 
daily. To repair waste from suppura- 
tion. 

R. Syrupi Hypophosphitum, . ^vj. 
Sig. — A dessertspoonful thrice daily. 



R. Quininiae Sulph., . 


• 3J- 


Ferri Pyrophosphatis, 


• 31- 


Strychninae Sulph., . 


• g r -j 


Ac. Phosphor. Dil., . 


• 3ij- 


Syrupi Zingiberis, . 


• |?j- 


Aquae, q. s. 


ad £iv. 


M. ft. mistura. Sig. — A 


teaspoon- 


ful thrice daily. 





Acidity* 

Acids, Hydrochloric or Phosphoric before meals; acid wine, a genuine 
Rhine wine best ; Sulphurous Acid n\ v-xxx well diluted ; for acid fermenta- 
tion of starchy foods (R.) ; acids after meals for alkaline pyrosis (R.). Tan- 
nic Acid, useful in pill,gr iv. with mj of glycerin (B.). Carbolic Acid, often 
arrests eructations (B.). Alkalies^ after meals for immediate relief, effects 
only temporary, bicarbonate best (R.); frequent use of alkalies enhances the 
mischief (B.). Nux Vomica, gtt. ij-iij of tincture before meals, excellent in 
small doses (B.) ; especially in acidity of pregnancy (R.)< Pulsatilla, gtt. v 
of tincture every 4 hours in acid dyspepsia (P.). Silver Oxide v extremely 
useful (B.). Manganese Oxide, gr. x-xx of the purified black oxide relieves 
(B.). Kino, a favorite remedy (B.). Ipecacuanha, in acidity of pregnancy 
(RA Mercury, gr. ss of gray powder ter in die, when acidity with clayey 
stools (R.). Bismuth gives excellent results, combined with Opium or Mor- 
phine, sometimes with Magnesia (R.). Diet. Use lemon-juice, aerated or old 
bread, plain biscuits. Avoid new bread, pastry and vegetables. 



Prescriptions 

r. 



R. Bismuthi Subnitrat, . giij. 
Acidi Cafbolici* \ . gr. ij-v 
Mucil. Acaciae, . • S- 
Aq. Menth. Pip., . . giij. 
M. Sig. — A tablespoonful 3 of 4 

times daily for adults. 



M 



Sodii Bicarb., . . gij. 

Spt. Ammoniae Aromat., . 5jij. 
Tinct. Zingiberis, . . Jjj. 

Infus. Gentianae Co. (U. 

S. P., 1870), q. s. ad gviij. 

. Sig. — A tablespoonful or two. 



5 i8 



ACNE. 



Acne. 

Alkalies, internally yield the best results in a number of cases (Bulkley) ; 
alkaline lotions for cases with seborrhoea (B.). Borax, a weak solution in 
rose-water (3J-^viij), of great benefit locally in acne simplex (Wa.). Po- 
tassium Bromide, in moderate doses has proved curative in some obstinate 
cases (R.). Sulphur, internally and as a lotion. In severe forms an ointment 
of the iodide or hypochlorite, ^ij ad ]|j (R.). Belladonna locally, is of some 
service, checking the abundant secretion from the sebaceous follicles (R.). 
Arsenic, in old cases, especially in acne indurata, but often disappoints. Given 
with bromides it prevents the bromic acne (R.). Phosphorus, is an excellent 
substitute for arsenic (B.) ; the compound syrup of the hypophosphites in acne 
indurata (R.). Mercury, in lotion is much employed (B.) ; a weak lotion of 
the bichloride to the face two or three times daily (R.). The iodo-chloride 
(g r - v-xv ad £ ) as irritant application (Fox); or ointments containing the 
bichloride or biniodide may be employed instead of the green soap applica- 
tion (Pf.). Glycerin, internally, has been used with success (B.). Berberis, 
tti,v of a fresh tincture thrice daily for the acne of girls at puberty. Bromide 
of Arsenic is adapted to the majority of cases of acne vulgaris (Pf.). Calcium 
Sulphide is indicated in cases characterized by a tendency to pustulation (Pf.). 
Bismuth, locally as a cosmetic (B.). Magnesium Sulphate, as a purgative 
daily before breakfast, in cases of acne vulgaris depending on derangement 
of stomach and bowels (Duhring) ; the salt, finely triturated, is an excellent 
dusting-powder for cases of acne rosacea. Water, hot sponging for 15 or 20 
minutes several times a day, followed by glycerite of starch to allay irrita- 
tion (R.) ; the local use of very hot water is of the greatest benefit in all in- 
flammatory forms of acne (Bulkley). Puncturing each papule with a lancet 
point, followed by very hot water, and ointments of sulphur iodide, ammoni- 
ated mercury, etc., diluted (Pf.). Ergot is well used in acne rosacea and 
other forms of acne ; a good fluid extract with glycerin and water, giving 
sjss internally per diem (B.). Diet and Hygiene, require careful attention (B.) ; 
powerful tonics are often required (Bulkley). Sapo Viridis, as an active irri- 
tant in subacute cases, applied every night as long as bearable, then emollients 
until irritation subsides, when the green soap should be removed (Pf.). [Com- 
pare Seborrhcea.] 



Prescriptions. 



R 



Potassii Acetatis, . . ,? ss- j' 
Tinct. Nucis Vomicae, . £ij. 
Ext. Rumicis Fluidi, . giv. 
Misce. Sig. — A teaspoonful, largely 
diluted, half an hour before meals. 



R. Potassii Acetatis, . . 5j. 

Spt. Etheris Nitrosi, . Jjss. 

Ac. Acetici Dil., . . ^j. 

Ext. Taraxaci FL, . . 31J. 
Misce. Sig. — A teaspoonful, well 
diluted, on an empty stomach. 



R 



. Sulphuris, 

Glycerini, 

Aquae Rosae, . 
M. Sig. — Lotion. 



;vij. 



R 



gr. x. 



Hydrarg. Chlor. Corr., 

Alcoholis, q. s. 

Aquae Destil., . . . ^ij. 
M. Fiat. sol. Sig. — A teaspoonful 
in % pint of water as a lotion, twice 
daily. 



ADDISON S DISEASE — ADYNAMIA. 



519 



R. Magnesii Sulphatis, . gjss. 

Ferri Sulphatis, . . gr. xvj. 

Acidi Sulphurici, . . jij. 

Aquae, . . q. s. ad %vii]. 
M. Sig. — A tablespoonful in a glass 
of water before breakfast. 



R. 



39- 



Potassii Acetatis, . 
Tinct. NucisVom., 
Infusi Quassiae, vel 
Tinct. Cinchonae Co., ad JJiv. 
M . Sig. — Teaspoonful in water after 
meals, as an antacid tonic. 



R. Liq. Potassae, . . . £j. 
Aquae Rosae, . . ad £\v. 
M. Sig. — Apply with a soft sponge 
twice daily. 



R 



B 



. Bismuthi Subnit., . • 3J- 

Ung. Hydr. Ammoniat, . s;ij. 

Ung. Aq. Rosae, . . ad ^j. 

M. et fiat unguentum. 



Hydrarg. Iodo-chlor., . g. v-xv. 
Adipis, . . . . |j. 
Fiat unguentum. An irritating ap- 
plication, requiring care. 



Addison's Disease. 

Arsenic, with cod-liver oil, gives the best results (Da Costa). Iron, and 
other tonics are useful, especially a combination of the chloride, glycerin and 
chloroform (Greenhow). Phosphorus, has seemed to exert a beneficial in- 



fluence (Wilks). Treatment must 
disease being always fatal (H.). 



be symptomatic, and is of little use, the 



Prescriptions. 



K 



Tinct. Ferri Chloridi, . ?j. 
Spt. Chloroformi, . . Ij. 
Glycerini, . . . gvj. 

M. Sig. — A dessertspoonful in wa- 
ter thrice daily. 



R. Quininae Sulph., 
Ferri Reducti, 
Ac. Arseniosi, 
Strych. Sulph., 
Confect. Rosae, q. s. 
M. et div. in pilulas lx. 



aa gr.iij. 



Adynamia. 

Cinchona or Quinine, with arsenic, for pale, badly-fed town-dwellers (R.); 
as a general tonic when flesh flabby, skin perspiring (P.). Arsenic, for swelled 
feet of old or weakly persons, and breathlessness from weak heart (R.) ; tonic 
in continued doses of gr. -fa to T ^ (Wa.). Nux Vomica, in adynamia of drunk- 
ards. R. Tinct. Capsici gvj ; Tinct. Nucis Vom. gij ; gtt. xx in water every four 
hours (B.). Lime Salts, the phosphate, when from prolonged town-life or 
overwork, gr. j, with grain j each of Phosphate of Iron and Carbonate of Lime, 
for a dose (R.); Hypophosphites, of Lime or Soda, in nervous or general 
debility (R.)« Iron, promotes appetite and digestion; gr. j-iij of the Sul- 
phate, or the official iron and aloes pill, or with manganese (B.); anaemic 
subjects (R-). Hydrastine, as substitute for Quinine, to promote appetite and 
digestion and improve assimilation (B.). Digitalis or Eucalyptus, in debility 
with weak heart-action (B. ). Bitters, especially Calumba and Gentian, useful for 
a short time (B.). Sanguinaria, when stomach needs stimulation (P.). Sar- 
saparilla, broken-down, syphilitic constitutions (P.). Alcohol, is of great 
value, but has been abused ; hurtful when it increases temperature and pulse, 
dryness of tongue, etc. (B.) ; a wine with much ether in debility of old age, 
especially where sleeplessness, indigestion and stomach cramps (R.). AH- 



520 



AFTER-PAINS — AGALACTIA — ALBUMINURIA. 



ment, sugar and saccharine fruits, vegetables, oil, milk, cod-liver oil, wine of 
good body and strength (B.). Porter or rum-and-milk for town-living women 
(R.). Sea-bathing is useful in chronic illness, with much debility (R.). Turk- 
ish Baths, when debility is caused by the tropics, but caution necessary. When 
town dwellers become stout and flabby, are easily tired, suffer from a lack of 
energy and from mental depression, a course of baths is beneficial (R.). [Com- 
pare Anemia, Convalescence.] 

Tonic Prescriptions. 



gr. xxx. 



R. Quininae Sulph., . 
Ac. Sulph. Dil.,q. s. 
Tinct. Ferri Chlor., . pj. 
Aquae, . . ad gij. 

M. Sig. — A teaspoonful thrice daily. 



R. Tinct. Ferri Chlor., . . giv. 

Ac. Phosphor. DiL, . . gvi. 

Sp. Limonis, . . . gij. 

Syrupi, . . q. s. ad gvj. 

M. Sig. — A dessertspoonful in wa- 
ter after each meal, 



R. Quininae Sulph,, 

Strychninae Sulph., 

Tr, Ferri Chloridi, 

Ac. Phosph. Dil„ 

Syr. Limonis, . 
M. Sig. — A teaspoonful in water 
thrice daily, in nervous debility. 




R 



Ac. Arseniosi, 
Quininae Sulph., 
Ferri et Pot. Tart., 

M. Fiant pil. no. xl. 

Sig. — One after each meal. 



g r -J- 
gr. xl. 
gr. lxxx, 



After-pains. 

Opiufn, more certain in action than any other remedy (Wa.); Morphine 
and Atropine (gr. \ and gr. T ox>)> combined (B.), hypodermically (Wa.). 
Belladonna, as ointment, much used in France (L.). Camphor, gr. x with gr. 
j4 of morphine, an effective remedy (B.) ; ^j in ^ vj of mucilage, tablespoonful 
doses every hour or two ( Wa.). Chloral, will stop the pains, but large doses, 
gr 4 xx-xl, are necessary (R.). Chloroform, the linimentum chloroformi gj 
with linim. Saponis gvj, applied on flannel to the abdomen (Barker). Qui- 
nine, gr. v-x night and morning, with the above chloroform liniment locally, 
in neuralgic after-pains which do not yield to opiates, the uterus being tender 
on pressure (Barker). Gelsemium, suspends them, large doses (ntxx) neces- 
sary (B.). Cimicifuga, relieves the pains, and allays general nervous excite- 
ment (P.). Ergot, is better than cimicifuga (R<)- Poultices, warm, over the 
hypogastrium, with soothing injections into the vagina (L.). 



Agalactia. 

Ricihis Communis, gr. v of extract, or ^j-ij of strong decoction, daily in water ; 
also the leaves, or an infusion, locally to mammae (T.). Gossypium, an emul- 
sion of the seeds has repute in India, as a galactagogue. A wineglass of the 
decoction every 20 or 30 minutes (P.). Pilocarpus, remarkably increases the 
secretions (B.). Tea, a good black tea promotes the milk-supply. [Com- 
pare Lactation.] 

Albuminuria* 

Aconite, in incipient, high body temperature (R.). Lead, diminishes the 
albumen (R.). Turpentine, gtt. ss-j, every 2 to 4 hours, or one to two drop 



ALCOHOLISM. 521 

doses night and morning, of great value in chronic albuminuria without marked 
symptoms of Bright's disease (P.)- Gallic Acid, the most efficient agent in 
the acute form to restrain loss of albumen (B. P.). See Aitken's formula 
below. Cannabis Indica, is indicated when bloody urine (R.). Chimaphila, 
has unquestioned power over albuminuria (P.). Cantharis, rnj every three 
hours, of the tincture, after the subsidence of acute symptoms, especially when 
bloody urine (R.). Fuchsine, in doses of gr. j-iij, completely arrested albu- 
minuria in many cases with oedema (Bouchut). Alkalies, the citrates and 
acetates as diuretics (R.); the Buffalo Lithia Water of Virginia, is highly 
recommended. Nitro-glycerin, try of a one per cent, solution to dilate the 
peripheral vessels, relieving the heart and lessening the renal congestion (B.). 
Turkish Baths, benefit by relieving the kidneys of work (R.). Milk-cure, 
with buttermilk, has proved very efficient in many cases (B.). Chalybeate 
Waters, especially those having purgative qualities, are beneficial (B.). [Com- 
pare Bright's Disease.] 

Prescriptions. 

R. Mist. Ferri et Ammonii Ace- 



R. Acidi Gallici, . . . gj-ij. 
Ac. Sulphurici Dil., . ^ss. 

Tinct. Lupuli, . . . zj. 

Infusi Lupuli, . . ad gyj. 
M. Sig. — Tablesp. thrice daily. 

[Ait ken.) 



tatis (U. S. P.), . . gvj. 
Sig. — Teasp. to a tablesp. according 
to age, well diluted, thrice daily. 

(B as ham.) 



Alcoholism. 

Arsenic, for distressing vomiting, one drop of liquor arsenicalis before 
breakfast (R.). Capsicum, in dyspepsia of chronic alcoholism, and to induce 
sleep; also as a substitute for the alcohol. Gr. x, with honey (B.). With 
bromide or arsenic and bitters to assist in overcoming habit, by removing the 
distress at pit of the stomach. The tinct. in io-minim doses should be taken 
shortly before meals, or whenever there is depression or craving for alcohol. 
It obviates the morning vomiting, and promotes appetite and digestion (R.). 
Ammonia, a full dose (£ss) of the spirit will often sober a drunkard speedily 
(R.); — a few drops of liquor ammonia, diluted, have prompt action (S.); — 
^j of the aromatic spirit with capsicum, see formula below. Quinine, espe- 
cially the cinchona rubra, for gastric catarrh of drunkards (B.) ; gr. ij-vj daily 
to raise the nervous tone (P.j. Nux Vo??iica, for after stomachal disorders 
(B.); in tremor of chronic alcoholism, of much value (P.). Bromides,^ 
every 4-6 hours in the " horrors " (B.). Phosphorus, in chronic alcoholism, 
recommended by Anstie (R.). Opium, cautiously, if at all (B.); — Morphine 
with tonics before meals for pain, nausea and want of appetite (R.). Cocaine, 
has been pronounced of great benefit, restoring appetite, inducing sleep and 
promoting digestion, while it soothes the brain and induces a feeling of con- 
tentment and calm (R.)- Cimicifuga, is said to be useful in the treatment of 
the drunkard's stomach (R.). Chloral, is very successful, gr. xv-xx, but must 
be cautiously used with old worn-out drunkards (B.). Picrotoxin, small doses 
for the tremor, gr. J~ repeated (B.). Lupulin, is the best substitute for alco- 
holic stimulants, and extremely serviceable in delirium tremens (B.). Zinc 
Oxide, is very useful in chronic alcoholism, to diminish the craving, to relieve 
the gastric catarrh and lessen the tremor (B.). Acute Alcoholic Poisoning 
requires an emetic or the stomach-pump, cold douche to the head and breast, 

44 



522 



ALOPECIA. 



warmth to the feet and limbs. Artificial respiration may be required. Milk, 
mucilaginous drinks, and black coffee, are the principal remedies. A milk 
diet often creates a disgust for alcohol. [Compare Delirium Tremens and 
Vomiting.] 

Prescriptions. 

R. Tinct. Capsici, . . . t ^ss. 

Potass. Bromidi, . . ^ss. 

Vel Liq. Potass. Arsenit, . tti 1. 

Vel Tinct. Nucis Vom., . ^ij. 

Spt. Ammoniae Aromat., . t ^iij. 

Syr. Tolutani, . . ad Jvj. 
M. Fiat mistura. Sig. — A dessert- 
spoonful in water four or five times 
daily. 



R. Tinct. Nucis Vom., . . %]. 

Tinct. Gentianse Co., . giij. 

Spt. Limonis, . . . ttlvj. 

Spt. Chloroformi, . . £j. 

Aqua?, . . q. s. ad ^vj. 
M. Sig. — One-sixth to be taken 3 
or 4 times daily, for insomnia. 



R. Zinci Oxidi, . 


. Si- 


Piperinae, 


. gr. xx. 


M. Fiant pil. no. xx. 


Sig. — One 


pill thrice daily. 




R. Ext. Lupulini Fl., .. 


• a- 


Ext. Aromatici FL, 1 




Tinct. Capsici, . >- 


. aa gvj. 


Mucil. Acaciae, . ) 




Aqua? Menth. Viridis, 


. ad ^iv. 


Fiat emulsio. Sig. — A 


teaspoonful 


or two as required. 





R. Tinct. Gentianae Co., . ^ij. 
Tinct. Calumbae Co., . ^ij. 
Tinct. Nucis Vom., . tttIxxx. 
M. Sig. — A dessertsp. before each 
meal, for rum-stomachs. (Loomis.) 



Alopecia. 

Cantharides tincture, 1 part to 8 of castor oil, well rubbed into roots of hair, 
night and morning (Wa.). Arsenic, tti v of liq. arsenic, ter die, exercises a 
more or less powerful influence (Wa.). Nitric Acid, with olive oil, makes a 
serviceable liniment (Wa.). Pilocarpine, has a decided influence on the 
growth of the hair (B.). Glycerin, in combination with the above remedies 
(Wa.). Sulphur Iodide, has been found very effectual, used internally and 
externally (Wa.). Frequent shaving may often save the hair in alopecia after 
illness. Use clean brushes with long bristles, and brush against the natural 
lay of the hair. [Compare Tinea.] 



Prescriptions. 



R . 01. Amygdalae Expres., 
Aq. Ammoniae, 
Ol. Rosmarini, 
Alcoholis, 
Aquae Destillat., 
Mellis Despumat., 
M. Sig. 



aa 



8- 

■' ¥-' 

ad 3viij. 
Lotion for the hair. 

( Wilson.) 



r. 



Tinct. Macis, . . . ^jss. 
Olei Olivae, . . ad 3 i j . 
M. Sig. —Lotion for baldness. 

(Hebra.) 



R. Tinct. Cantharidis 
Tinct. Capsici, 
Glycerini, 
Spt. Odorat., . 
M. Sig. — Hair tonic 




R. Pilocarpin. Hydrochlorat., gr. j. 
Aquae Destillat., . . gj. 
M. Sig. — Ten to thirty drops twice 
daily, according to age, to improve the 
growth of the hair. [Bart ho low.) 



AMAUROSIS AND AMBLYOPIA — AMENORRHEA. 523 

Amaurosis and Amblyopia. 

Arnica, has long been a popular remedy for amaurosis in Germany. Man- 
noir employed it with much success (P., Wsu). Rue, in minim doses night 
and morning, for dimness of vision from functional amaurotic condition. Elga- 
jaki says it produces dimness of vision, and in smaller doses improves the eye- 
sight (P.). Strychnine, may cure, in functional amaurosis from lead, tobacco 
and alcohol (B.). Gr. -^ hypodermically (Nagel). Hypodermically in 
tobacco and traumatic amaurosis, and in progressive nerve atrophy not 
dependent on inter-cranial disease (R.). Guaiac, is advised for cases of 
amaurosis occurring in persons of a rheumatic diathesis ( Wa.). Santonin, has 
given very satisfactory results in amaurosis (Wa.). Vera trine, as lotion 
brushed over eyelids, brows and temples once a day, is often useful, but should 
not be permitted to touch the conjunctiva, or great pain will result. See formula 
below (Wa.). Potassium Iodide, in amblyopia from lead-poisoning (Wa.). 
Seton, a small seton in the temple, kept open for a long period, has been found 
effectual when other remedies failed (Wa.). Amaurosis and Amblyopia are 
names formerly much used to denote the various conditions of blindness, before 
ocular diagnosis became as exact as it now is. Amblyopia is still used to 
designate certain impairments of vision not accounted for by any organic 
changes visible [Roosa). 

Prescriptions. 



R. Yeratrinae, . . . gr. x. 

^Etheris, . . . . ^ij. 

Alcoholis, . . • ,?j- 
M. Sig. — Use with a brush once a 
day over eyelids, eyebrows and tern- 



R. Strychninae Sulphatis* . gr. j. 
Alcoholis, . . • 7t\- 

Aquae Destillatae, . ad giv. 
M. Fiat solutio. Sig — A teaspoon- 

ful thrice daily before meals, when not 



pies. used hypodermicallyi. 

Amenorrhoea. 

Aconite, sudden suppression from cold or wet feet (B., R., P.). Pulsatilla, 
in sudden suppression, also aconite (B.) ; often of the greatest value in func- 
tional form (P.). Iron, when from anaemia, the most frequent cause. Small 
doses preferred. Solution of acetate, or ferri et ammonii citras (gr. ij), or ferri 
et strychninae citras (gr. j), also chalybeate waters. Caution. — Careful diag- 
nosis before giving iron (B.). Aloes, when dependent on anaemia (B.); at 
the periods, with hot pediluvia, friction, etc. (R., P.). Potassium Perman- 
ganate, gr. j thrice daily increased to gr. ij, is the best of all remedies for 
bringing back the menses, having specific action on the uterine tissue (R.) ; — 
excellent in amenorrhoea from cold feet, and is by far the best emmenagogue. 
In pill it may explode ; best in capsule with powdered elm or liquorice ( Par- 
vin). Apiol, when from functional inactivity. First give iron for the blood; 
next aloetic purgatives, then apiol (gr. xv) just preceding the period ; or a daily 
dose for a week, or several days before (B.). The best emmenagogue next to 
Potass. Permang. (Parvin). Senega, a saturated decoction of the root, to 
extent of a pint in 24 hours, during preceding two weeks, advantageous (P.). 
Polygonum, has given excellent results when used in gss doses four times 
daily for a week (B.). Cimicifuga, has been recommended (R.) ; is of very 
great value (P.). Arsenic, combined with iron, when from functional inac- 
tivity of ovaries (B.). Aurum Salts, from torpor of ovaries (B.). Ignatia, 
in suppression of hysteria (P.). Cinnamon, causes a flow of blood to the 



524 



ANEMIA. 



womb (Goodell). Nux Vomica, small doses of the extract, of benefit in some 
obstinate cases (Wa.). Silver Nitrate, in substance lightly to the os uteri, at 
time of expected discharge (Wa.). Colocynth, in chlorotic amenorrhcea (P.). 
Ergot, has cured when due to plethora (B.); when anaemia after use of iron 
(R.) ; in chlorotic (P.) ; ny every y£ hour for 5 or 6 hours the day before 
and that of the expected flow, is very efficient when the cessation is not due 
to anaemia (A. A. Smith). Senecio Aureus, seems to have a well-founded 
reputation. Rue, in functional inactivity. Ol. rutae, mj-v (B., P.). San- 
guinaria, functional amenorrhcea, in absence of plethora (B., P.). Savine, 
general atony. Extractum sabinae fl„ rriv-x (B., R., P.). Serpentaria, with 
anaemia or chlorosis (B.). Ammonium Chloride, for headache (R.). Sitz- 
baths, hot, for six days before period; mustard may be added at period. 
Often effectual in sudden suppression (B.). Spinal-ice-bag, to lower dorsal 
and lumbar vertebrae; or cold sponging useful (R. ). Electricity, in atony of 
uterus and ovaries (B.). [Compare Anemia, Chlorosis.] 



Prescriptions. 



R 



3J- 



Olei Sabinae, 
Olei Rutae, 

Tinct. Polygon. Hydropip., 
Ol. Amygdalae Expres., 
Mucil. Acaciae, 

Aquae Menthae Pip., . aa £ij. 
Fiat mistura. Sig. — A teaspoonful 
two or three times daily. 

(Bartholow.) 



R. Extr. Aloe Aquosi, . . ^j. 

Ferri Sulph. Exsic, . . gij. 

Asafoetidae, . . . giv. 

Fiant pilulae 100. Sig. — One pill 

after each meal, gradually increased 

to three. (Goodell.) 



R. Tinct. Ferri Chloridi, 

Tinct. Cantharidis, . 

Tinct. Guaiaci Amnion., . 

Tinct. Aloes, 

Syrupi, . . q. s. ad 

Fiat mistura. Sig. — A tablespoon- 

ful thrice daily, in simple atonic amen- 

orrhoea. (H. C. Wood. Dewees.) 



R. Quininae Sulphat, 


. £jss. 


Extr. Nucis Vom., 


. gr. xij. 


Olei Sabinae, 


. ^ss. 


Aloes Socotrin., . 


. gr. viij. 


Cantharidis, 


. gr. xxiv. 


Fiant pilulae xlviij. 


Sig. — One pill 


thrice daily. 





Anaemia, 



Nux Vomica, stimulates blood-making organs, and is used as an adjunct to 
restorative remedies (B.). Iron, its chief value is to improve digestion; also 
furnishes haematin to the blood. The most astringent preparation is the best, 
and should be used after meals. Also chalybeate waters (B.). Some stom- 
achs, with irritable mucous membrane, require bland preparations. A pale, 
flabby tongue indicates large doses of the perchloride or sulphate (R-). 
Arsenic, as adjunct to iron, and where iron cannot be borne, or fails (B.). 
Quinine, for badly-fed town dwellers (R.). Hypophosphites, are useful, but 
should not be given with iron, cod-liver oil, or stimulants (R.). Phosphate 
of Calcium, in anaemia of growing persons, and of women weakened by rapid 
child-bearing or excessive menstruation (R;)« Lacto-phosphate of Calcium, 
for nursing mothers, or in waste from suppuration (B.J. Acids, added to 



ANEMIA. 



525 



purgative salts as tonics to the mucous membrane (R.). Pepsin, is recom- 
mended by Hollmann (B.). Manganese, alone not of much use; is best 
combined with iron (B.). Is not, like iron, found in the faeces, nor does it 
cause constipation (Wa.). Galvanization, as aid to remedies (B.). Cold 
Sponging, needs great caution, or may lower tone by minute degrees (R.). 
Diet and Hygiene, of prime importance. Nourishing, digestible food, in as 
large quantities as can be assimilated — milk, eggs, animal broths ; afterwards, 
fish, poultry, game, mutton, etc. Moderate daily out-of-door exercise, in pure 
air, is indispensable. Bathing, especially sea-bathing, aids restoration. 
Wines, often useful. Red wines are the best. 



Tonic Prescriptions. 



R. Tinct. Ferri Chloridi, . ^iv. 
Ac. Phosphorici Dil., . gvj. 
Spt. Limonis, . . . gij. 
Syrupi, . . q. s. ad ^vj. 
Misce. Sig. — A dessertspoonful in 
water after meals. To the above may 
be added ^ij of the Liquor Strych- 
ninae Hydrochloratis of the B. P. 

(Goodell.) 



R. Hydrarg. Chlor. Corr., 
Liq. Arsenici Chlor., 
Tinct. Ferri Chlor., . 
Ac. Hydrochlor. Dil., 
Syrupi, 
Aquae, . . q. s. 



. 31V. 

• Wv 

ad ^vj. 



Misce. Sig. — A dessertspoonful in 
a wineglassful of water after each 
meal, as an alterative tonic. 

(A. H. Smith.) 



R. Tinct. Nucis Vom., . . ^ijss. 
Tinct. Cinchonae, . ad ^iv. 
M. Sig. — A teaspoonful after each 
meal. 



R. Tinct. Ferri Chloridi, 
Potassii Chloratis, . 
Liq. Strychninae (B. P.] 
Syr. Simplicis, 
Aquae Cinnamomi, . 
Misce. Sig. — One or 

spoonsful after each meal. 



. 


3 n J- 


. 


7>y 


i • 


XV 


. 


giv. 


ad 


^iv. 


two 


tea- 



R. Quininae Sulphatis, . gr. xx. 

Ferri Sulph. Exsic, . gr. xl. 

Strychninae Sulph., . gr. ss. 
Fiant pilulae xx. Sig. — One pill 
thrice daily. [Bartholow.) 



aa gij. 



R. Ferri Sulph. Exsiccat., 

Potass. Carbonatis, . 

Syrupi, q. s. 
Fiant pilulae no. xlviij. Sig. — One 
pill after each meal, gradually in- 
creased to three. (Blaud.) 



R. Acidi Arseniosi, 
Quininae Sulphat., 
Ferri et Potass. Tart. 
M. Ft. pil. no. xxx. 

pill after each meal. 



• g r -J- 

- si- 

Sig. — One 



R. Pil. 

Sig.- 



Ferri Comp. (U. S.), . xlviij; 
-One to three after meals. 



R. Pil. Ferri Iodidi (U. S.), . xlviij, 
Sig. — One to three after meals. 



R. Massae Ferri Carbonat., . £j. 
Acidi Arseniosi, . . gr. j. 
Quininae Sulphatis, . gr. xl. 

Fiat massa, et div. in pilulas xl. 
Sig. — One or two thrice daily. 



5 26 ANESTHESIA ANEURISM. 

Anaesthesia. 

Morphine, subcutaneously before inhalation, diminishes the danger, and 
lessens the after- pain if an operation is to be performed (Nussbaum) ; Mor- 
phine gr. -^ and Atropine gr. T | ? , hypodermically, after emergence from an- 
aesthesia, will relieve the nausea and vomiting. A preliminary injection of 
Morphine lessens the stage of rigidity and spasm, enables a smaller quantity 
of the anaesthetic to be used with full effect, prolongs the stage of insensibility, 
prevents shock, and antagonizes the cardiac and respiratory depression (B.). 
Atropine, is decidedly the best antagonist to the respiratory paralysis of 
Ether, and should be given hypodermically (gr. ¥ ! ff ) as soon as alarming 
symptoms manifest themselves (Amidon). The writer of this book has saved 
at least four subjects of chloroform-narcosis by the hypodermic use of Atro- 
pine after both heart and respiration had apparently failed. Alcohol, ^j-ij of 
whiskey or brandy, before inhalation, to sustain the heart and prolong nar- 
cosis (B.). [Compare pages 45 and 142, ante, for the general subject of 
Anesthesia, and page 402, for a list of Local Anesthetics.] 

Aneurism, 

Potassium Iodide, in large doses (gr. xv-^ss), 3 or 4 times a day, gives 
great relief, and has cured (B.) ; combined with recumbent position and re- 
stricted diet (R-). Veratrum Viride, aids surgical expedients; also in large 
internal aneurisms, with absolute recumbence and a little Opium to relieve 
pain, vomiting to be avoided (B.). Ergot, with recumbent position; favors 
coagulation of the blood in sac (B.); Ergotin (P.). Gallic Acid and Iron, 
internally, have cured cases of aortic aneurism (SpeerV Chloroform, inhala- 
tion, great dyspnoea (R.). Plumbic Acetate, a valuable auxiliary to the more 
important items of rest, diet, and mechanical appliances, gr. iij-v ter die (Wa.) ; 
its use limited to the sacculated form (S.). Electrolysis, galvano-puncture in 
deep aneurisms ; not very successful (B.). The object sought is the coagu- 
lation of blood within the aneurismal sac. Cures have not been attained 
by this treatment, but in many it has produced great amelioration of the most 
distressing symptoms (Petit). Aliment, milk regimen, for denutrition (B.) ; 
a low diet, with absolute rest ; Ergotin and Iodide of Potass, for deep aneu- 
risms beyond reach of surgical treatment (B.). Rest, in recumbent posture, 
and light, unstimulating diet, are primary and essential elements in treatment 
of aneurisms. Surgical Treatment includes ligation of the vessels, also 
pressure by a tourniquet or bags of shot, the operator's fingers, etc , applied 
to the main artery above the tumor. 

Prescriptions. 



U. Potassii Iodidi, 

Tinct. Veratri Viridis, 

Tr. Cinchonae Co., . 

Tr. Cardamomi Co., 

Tr. Gentianae Co., . 

Syrupi Simplicis, 

Alcoholis, . . aa 

Aquae, . . q. s. ad gxvj. 
Misce. Sig. — §ss thrice daily. Each 
dose has gr. xv of Pot. Iod. 



R. Acidi Gallici, t . • gj. 

Ext. Ergotae, . . gr. xx. 

Digitalis, , . . gr. xx. 
Fiat massa, et div. in pil. xx. 
Sig. — One every two hours. 



R. Plumbi Acetatis, T gr. xxxvi. 
Extracti Opii, . gr. iv. 

Confectionis Rosae, q. s. 
Ft. pil. xij. One eyery four hours. 



ANGINA PECTORIS — ANUS, FISSURED — APHONIA. 527 

Angina Pectoris. 

Aconite, believed by Gubler to be appropriate, and by Fleming to have 
been curative in many severe cases resisting other remedies (P.). In cardiac 
disease its action is uncertain (Br.). Arsenic, lessens or prevents paroxysms, 
if used in the intervals (B., R., Anstie). Amyl Nitrite, as inhalation, affords 
signal relief (R., B.) ; unsafe in advanced degeneration of cerebral vessels 
and fatty degeneration of heart (B.) ; gives great relief during paroxysms 
(Br.). Nitrite of Sodium, is less rapid in action than Nitrite of Amyl, but 
is more efficient in preventing return of symptoms (Br.). Laurocerasus, as 
anodyne (P.). Strychnine, in the milder forms; very small doses, gr. T J ff 
to g 1 ^ (P.). Glonoinum, doses of ""Ijtrjj have been used with success (Pf., R.). 
Chamomile, in pseudo-spasms of hysterical persons (P.). Ether aborts a 
mild attack (B.) ; Sulphuric Ether, in nervous form; a spoonful immediately 
on commencement of attack will greatly mitigate it (Anstie). Phosphorus, 
often serviceable (R.). Morphine, hypodermically, especially in cardiac 
dyspncea; strengthens the heart (R.). Turpentine, applications, hot, over 
chest, to mitigate severity of the paroxysms, especially in the aged (Wa.). 
Quinine, when intermittent (Wa.) or when any malarial taint (Br.). Brandy, 
in frequent small doses, with hot bran poultice over heart, and warmth to ex- 
tremities. 

Anus, Fissured. 

Hydrastis, locally, promotes healing (B.). Rhatany, as injection, night 
and morning, after enema in the morning to move the bowels (Pf., Tr.). 
Iodoform, improves, and relieves pain (B.). Iodo- tannin, well applied, effec- 
tive (B.). Belladonna, locally, of great service for painful spasms of sphinc- 
ter (P.). Opium, with gall-ointment for fissures of anus; mild purgatives 
should be simultaneously employed (R.). Sulphur, as a mild purgative, to 
cause soft motions (R.). Tannin, ^-glycerin ^ij; introduced on a tent, 
night and morning, with great advantage (Wa.). Collodion, as protective 
covering (P.). Potassic Bromide, with 5 parts glycerin, as local application 
(R.). Castor Oil, as a mild purgative (R.) ; to keep motions soft (Br.). Sur- 
gical Means, the most efficient; forcible dilatation of sphincter, or partial 
division in severe cases, through the mucous membrane, and a few fibres of 
sphincter. 

Prescriptions. 



R. Tinct. Kramerise, . . 3J. 

Ext. Krameriae, . . gij. 

Aquae, ad gviij. 

M. Sig. — One-fourth as injection, 

night and morning, after using enema. 



R. Sulphuris, . . . ^j. 

Pulveris Aromat., . . gij. 

Confec. Rosae, . . ^ij. 

Misce. Sig. — One-third to be taken 
at bedtime as a laxative. 



Aphonia. 

Tgnatia, in hysterical women (P.). Atropine, in hysterical aphonia, and 
for fatigue of vocal chords, gr. t |q to ^, morning and evening (B.). Nitric 
Acid, TUv-x of the dilute acid, for hoarseness of singers, in fatigue of vocal 
chords, and when stomachal (B.). Benzoin, the tincture by inhalation in 
laryngeal catarrh (Br.). Oil of Rue, as inhalation in chronic catarrh (Br.). 
Nitrate of Uranium, as spray in very chronic catarrh (Br.). Alum, gr. x-^j 
aq., as spray, in chronic coughs and hoarseness (R.). Borax, a piece the size 



5 2 S APHTHA — APOPLEXY. 

of a pea allowed to dissolve in the mouth (R.). Glycerin of Tannin, locally* 
in chronic inflammation of the throat (R.). Sulphurous Acid, by inhalation, 
spray or fumigation, in clergyman's aphonia (R-). Ipecacuanha, wine, as 
spray, when congestion of vocal chords ( R.) ; in laryngeal catarrh (Br.). Am- 
monium Chloride, vapor inhaled, of great value in catarrhal aphonia (Wa.). 
Turkish Bath, at commencement of a feverish cold ( R. ) ; in acute laryngeal 
catarrh (Br.). Galvanism, localized, the best means for hysterical aphonia. 

Prescriptions. 
R. Liq. Ammoniae, . . . 5J. R. Acidi Nitrici Dil., . jij. 

Aquae, . . . 5J. Tinct. Calumbae, . . * 

M. Sig. — A teaspoonful in a pint of Aquae, . . . ^ 

hot water for each inhalation. M. Sig. — A dessertsp. in a wirz 

I of water thrice daily. 

Aphthae. 

Potassium Chlorate, the best remedy. Solution of gr. x to the ^, as wash, 
alone or with borax (Br.), and gr. x to xx by the stomach (B.). Borax, with 
honey, or as glycerin of borax, frequently used (R.) ; crystals allowed to dis- 
solve in the mouth (W.). Sulphurous Acid, as solution, strong or diluted, 
locally (R-); dilute as spray (B.h Mu .ids, formerly much used (B.). 

Mercury. Hydr. cum creta in small doses to remove the indigestion on which 
aphthae often depends (Br.), borax being used locally, when aphthae exist in 
the mouth (Wa.). Copper Sulphate, a weak solution painted over mucous 
membrane (R.). Potassium Iodide, gr. J-V-5J aquae, locally (B.). Salicylic 
Acid, one port (dissolved in alcohol) to 250 of water (R.). Quinine 
every 2 or 3 hours, in infants (B.), especially when consequent on diarrhoea 
(Br.). Coptis, the infusion has repute in New England B. }. Bismuth, freely 
to parts (B.); as a local application (Br.). Glycerin, will sometimes cure 
(R. ) . Rhubarb, the compound powder of rhubarb, to remove indigestion ( Br.) ; 
— is highly useful in small doses (Wa.). 

Prescriptions. 



R. Ac. Sulphurosi, . . . ~ 
Aquae, ad gij. 

M. Sig. — Mouth- wash, or use as a 
spray. 



R. Pulv. Rhei Co - :;. 

Sacch. Lactis, q. s. 
Triuirat. et div. in pulv. xij. Si^.— 
One thrice daily. 



Apoplexy. 

Aconite, full strong pulse ; hot, dry skin, plethoric cases. The best remedy 
(P.) ; — to lower blood-pressure and prevent further hemorrhage, where the 
pulse is strong and the arterial tension high (Br.). Elaterium, as a purga- 
tive; a large dose (gr. ij) in suppository with soap, or as an injection into 
large bowel (P.). Croton Oil as purgative, a drop may be put on the back of 
the tongue (Br.) ; — nt % or *^each hour (R.). Colocynth, as a derivative purga- 
tive (Br.) ; appears to act well (P.). Cold Water, often harmful, though fre- 
quently used. Injurious when face pale, surface cool, circulation depressed 
(B.). Electricity. Very mild galvanic currents to promote absorption. 
Caution necessary, especially if much headache and vertigo (B.). Ditt 
and Hygiene, of great importance in patients subject to apoplexy. Avoid 
stimulating food and drink (especially beer), overeating, excitement, haste, 



APPETITE ASCITES. 5 29 

exposure to hot sun, heated rooms, etc. At no subsequent period should a 
full animal diet or the use of undiluted wines be indulged in (A.). Diagnosis. 
Should be carefully differentiated from drunkenness, with which it is often 
confounded. [Compare Cerebral Congestion.] 

Prescriptions. 



R. Tinct. Aconiti, . . . m_x. 
Aquae Cinnamomi, . ad §ij. 
M. Sig. — A teaspf. every % hour 
for 2 hours, then every half-hour. 



R. Ext. Colocynthidis Co., . gr. xx. 
Olei Tiglii, . . . TTiij. 

Fiat massa, et div. in pil. iv. 

Sig. — One pill as required, until free 
purgation ensues. 



Appetite. 

Ignatia, will correct diseased appetite (P.) ; especially in hysterical sub- 
jects (Br.). Anthemis, will stimulate the appetite. Bitters, to stimulate the 
appetite (R.). Food should be savory and well cooked. Habits require 
examining into, when lost appetite complained of. Fluorides of Sodium or 
Potassium will produce almost total anorexia, and may be employed with 
advantage in bulimia (Da Costa). [Compare Dyspepsia.] 

Prescriptions. 



R. Gentianae, Quassiae, 

Cinnamomi, . . . "aa ^ij. 

Sig. — Put into a pint of boiling 

water and when cold, strain; take 



R. Anthemidis, 

Quassias, . . . aa £j. 

Sig. — Put in a pint of boiling water, 

and when cold strain; take a winegl. 



a winegl. thrice daily as an appe- I thrice daily before meals as an appe- 
tizer. I tizer. 



Ascites. 

Digitalis, of the greatest service, except where aortic regurgitation and 
cardiac hypertrophy (P.); fresh infusion best (R.); — its action increased by 
combination with squill and pil. hydrargyri (Br.). Arsenic, when from feeble 
heart, and in old age (B.). Apocyntim Cart., an active diuretic (P.). Copaiba, 
excellent in hepatic dropsy (Br.). Jaborandi, has given good results (B.). 
Stillingia, in ascites due to hepatic changes (B.). Jalap, the compound 
powder, with podophyllum, the most generally approved hydragogue purga- 
tive (B.). Elaterium, to produce free watery evacuations. Cautiously in 
debilitated subjects. Contraindicated when ^astro-intestinal irritation or 
inflammation. Is depressant (B*). Milk-diet^ successful ; an ancient practice ; 
causes profuse alvine and urinary discharges (B.) ; — sometimes very useful 
when the kidney action is inadequate (Br.). [Compare Dropsy.] 

Prescriptions. 



R. Resinae Copaibae, . . ^iij. 

Alcoholis, . . . £v. 

Spt. Chloroformi, . . , gj. 

Mucil. Acaciae, . . ±ij. 



R. Hydrarg. Chlor. Mitis, 
Pulv. Digitalis, 
Pulv. Scillae, . . aa gr. vj, 

Fiat massa, et div. in pil. vj. 



Aquae, . . q. s. ad 3xij. Sig. — One pill thrice daily, in as- 
M. Sig. — A tablesp. thrice daily. . cites from hepatic changes. 



5 30 ASTHENOPIA— ASTHMA. 

Asthenopia. 

The proper glasses ; cold douche ; rest of eyes. Atropine, systematically- 
instilled, to prevent strain, and control spasm of the accommodation (C). 
[Compare Myopia.] 

Asthma. 

Aconite, in spasmodic (P.) ; often averts the attack, if given at commence- 
ment ; useful also in the asthma following coryza and sneezing in children 
(R.). Ipecacuanha, the wine as spray to the fauces, sometimes useful in severe 
bronchial asthma, but not of much service in genuine asthma (R.) ; nauseating 
and emetic doses in spasmodic form (B.). Lobelia, gtt. x of tincture every % 
hour during paroxysm ; lUx ter die, with additional doses at night, in bronchitic 
asthma when worse at night. Cautiously if heart disease (R.). Often gives 
permanent relief (B.). Arsenic, as cigarettes as well as by internal adminis- 
tration (B.). One drop of liquor arsenicalis ter die, in attacks from bronchitis, 
local irritation, etc., allied to hay fever (R.). Belladonna, relieves paroxysm 
when expectoration abundant, skin cool and moist (B.). Internally in large 
doses, also in cigarettes (Br.). Atropine hypodermically is more efficient, 
gr. -Jq at bedtime to abort morning paroxysm (B.). Large doses required, 
but very satisfactory (R.). Was much valued by Dr. Salter and M. See (P.). 
Potassium Iodide, when from acute bronchial catarrh, gr. xv-xx each 2, 3, or 
4 hours. [See Bromides.] (B., R.) Nux Vomica, in nervous subjects (B.) ; 
in spasmodic asthma, often of great benefit ( P. ) . Chloral, may arrest paroxysm 
(B., R.). Chloroform, inhaled from warm waiter. Anaesthetics relieve, but 
increasing doses required, leading to habit (B., R.). Ether, full dose, may 
abort a mild attack (B.). Amy I Nitrite, inhaled, quickly checks spasmodic 
asthma (B., R.). Antimony, in an affection of children like asthma. Dissolve a 
grain of tartar-emetic in half a pint of water, and give a teaspoonful of this every 
% hour for the first hour, then hourly. If vomiting induced, lessen the dose 
(R.). Coffee, a small cup of very strong coffee often useful in a paroxysm (R.). 
Asthmatics should not use it as a beverage (P.). Stramonium, twenty grains 
of the dried leaves or ten of the powdered root may be smoked. Datura tatula 
sometimes better. Stramonium preparations often bad. Asthmatics advised to 
grow the drug themselves (R.). Grindelia, gives relief in spasmodic form (B.) ; 
three grains of extract thrice daily to prevent attacks, or TUxx-xxx of liquid 
extract every half-hour or hourly from onset of paroxysm (R.). Ethyl Iodide, 
very valuable in spasmodic form, and lessens liability to subsequent attacks. 
TUv-xx thrice daily by inhalation (B.). Cannabis Indica, has been useful 
(R.). Sulphurous Acid, by inhalation, spray, or fumigation (R.). Morphine, 
hypodermically, quickly cuts short a paroxysm (B.); in some cases morphine 
will induce a paroxysm (R.). Apomorphine, gr. y 1 ^ hypodermically, has been 
found effective ; or gr. ^ every 3 or 4 hours in camphor water, with or without 
morphine or ipecacuanha. Tobacco, smoking sometimes relieves (R., P.). Asa- 
fostida,ha.s been recommended (R.) ; palliative only (P.). Colchicum, in gouty 
subjects (R.). Bromides, relieve, but soon lose effect (B., R.). Eucalyptus, 
smoked with stramonium, belladonna, tobacco (B.). Quinine, after acute 
symptoms subside, as antipyretic to succeeding fever and restorative tonic (B.) # 
Potassium Nitrate, the inhalation of fumes of burnt nitre paper will sometimes 
avert a paroxysm. Different methods of preparation useful for different cases 
(R.). Oxygen, when no heart disease (R. ). Silver Nitrate, sometimes injected 
into trachea (R.). Chamomile Oil, has been found very serviceable (P.). San- 
guinaria, is very useful in humid asthma, and occasionally so in the spasmodic 



ASTIGMATISM. 



531 



form (B.). Galvanism of pneumogastric often relieves; + P°le beneath mas- 
toid process ; — pole to epigastrium. Faradism of no use (B.). Prophylaxis, 
avoidance of exciting causes, especially indigestible food, wet, damp, and sud- 
den changes of temperature. Attention to the stomach will do most for many 
asthmatic patients. An important point is to take the heaviest meal early in 
the day, and very little solid food after 2 p.m. Shower-bath and out-of-door 
exercise, not, however, to a fatiguing extent (R.). 



Prescriptions. 



Arsenical Cigarettes. 
R. Sodii Arseniatis, . . gss-j. 
Aquae Destillatas, . • 3J- 
Moisten unsized white paper, and 
roll into cigarettes, each containing 
gr. J^ to gr. j of the salt. Two or 
three of these to be inhaled daily. 

(Bartholow.) 



R 



Belladonna, etc., Cigarettes. 

Belladonnas Fol., . . gj. 

Stramonii Fol., 

Hyoscyami, . , aa £ss. 

Extracti Opii, . . gr. 

Aquae Lauro-cerasi, q. s. 

Dissolve the opium in the water, 

and moisten the leaves therewith. 

When dry, roll into twelve cigarettes. 

Smoke two to four daily. ( Trousseau.) 



nj, 



R v Chart. Potass. Nitratjs, . j. 

Burn in a close room and inhale the 
fumes. 




R. Ammonii Bromidi, 
Ammonii Chloridi, 
Tinct. Lobelias, . 
Spt. Etheris Comp., 
Syrupi Acacias, 
M. Sig.— A dessertsp. in water, 
every hour or two, for the paroxysm. 

(Pepper.) 

R. Spt. Etheris Comp., , , gj. 
Tinct. Belladonnas, . . £j. 
M. Sig. — A teasp. ter in die. 



a 



M 



Ext. Grindelias, 
Ext. Lobelias Fl., 
Ext. Belladonnas Fl. 
Potassii Iodidi, 
Glycerini, 

Sig. — A tablesp. as required.. 
(Barlholow.) 



gss. 

;hj. 



R. Tinct. Sanguinarias, 
Tinct. Lobelias, 
Ammonii Iodidi, 
Syr. Tolutanij 



aa 



Eh 
3 V J< 



M. Sig. — A teasp. every 2, 3 or 4 



hours, in humid asthma. 



R 



Tinct. Lobelias, 
Ammonii Iodidi, 
Ammonii Bromidi, . 
Syrupi Tolutani, 

M. Sig. — A teasp. every 

hours. 



1,2, 



(B.) 



Si. 

3 u h 

3 l 'h 
3 or 
(B.) 



R. Spt. Etheris Compos., 
Liq. Morph. Sulph. 

(gr.j adg), . aa gj. 
M. Sig. — A teasp. every half-hour 
or hour in the paroxysm. 



R. Potassi Bromidi, . . 5j. 

Potassii Iodidi, . . ±ss. 

Aquas Cinnamomi, . . ^iv. 

M. Sig. — A teasp. in water every 

half -hour or hour. (B.) 



Astigmatism, 

Atropine, a weak solution to aid examination of eye by dilating pupil, and 
paralyzing accommodation (B.). Duboisine, as substitute for atropine, has 



532 ATHEROMA — ATROPHY — BALANITIS — BED-SORES. 

more rapid action, with shorter duration of effects, and less conjunctival irri- 
tation. Glasses, of suitable form, cylindrical in simple astigmatism, bi-cylin- 
drical in mixed astigmatism. Pray 's Test Letters, to determine degree and 
direction of the defect (C). 

Atheroma. 

Phosphorus, in minute doses, for atheroma, with cod-liver oil (B.). Ar- 
senic, often of great value in atheroma, especially where imperfect action of 
kidneys (Br.) ; indicated when there are puffy eyes, drowsiness, intellectual 
torpor (B.). Quinine, gr. iij-x daily, in atheroma, with advantage (B.). Am- 
monium Bromide, in atheroma, to promote absorption of deposit (Wa.). Digi- 
talis ; may be useful in general capillary atheroma ; cautiously ! (W.) Cod- 
liver Oil, with phosphates, hypophosphites, or the lacto-phosphate of lime, in 
combination (B.). [Compare Aneurism.] 

Atrophy. 

Cod-liver Oil, has proved beneficial (Wa.). Olive Oil, by inunction, 
every 12, 6, or 4 hours, successfully employed (Wa.). Arsenic, has had re- 
markable success in muscular atrophy (Tr.). Electricity, in progressive 
muscular atrophy, the induced current very strong at first, then weaker as 
improvement; interrupted currents from vertebral column and plexuses to 
nerves of affected muscles; in more extended forms, the constant current to 
the nerves, the induced to the muscles (Ros.). Massage, removes the waste 
products and restores the muscular power (Br.). [Compare Emaciation, Lo- 
comotor Ataxia.] 

Balanitis. 

Mercury, Hydr. Chlor. Corr. gr. j to §jss aquae calcis, as lotion, if not much 
inflammation (Br.). Oil, on linen, to inflamed part, beneath foreskin, which 
must be again drawn forward ; strict cleanliness. Astringent Lotions, Alum, 
Sulphate of Zinc, with warm water injections (Br.). Lime-water, the best 
lotion if much inflammation (D.). Tannin, in alcohol, equal parts, as dress- 
ing after washing with a weak solution of common salt. Carbolic Acid, a 5 
per cent, solution, on cotton rag after washing, thrice daily, is generally suffi- 
cient. [Compare Phimosis, Gonorrhoea.] 

Bed-sores. 

Alcohol, Brandy, or eau-de-cologne, to harden skin of parts exposed to pres- 
sure (R.) ; as wash to parts threatened ( B. ) . Glycerin, or glycerin-cream, rubbed 
over the parts exposed to pressure, after washing, morning and evening, is one 
of the best preventives (R.). Alum, ^ss, whites of four eggs, Tinct. Cam- 
phorse ^ij, an excellent application (B.). Charcoal, sprinkled over the black 
slough, which is then covered with poultice (R.). Galvanic Couplet, of zinc 
and silver, connected by a copper wire ; one element on sore, the other on 
adjacent part (B.). Silver Nitrate, a solution (gr. xx-gj) to be painted on 
threatened but unbroken skin, as soon as it becomes red, will prevent sores ; 
if Nitrous Ether solution be used, 5 grs. to the oz. is enough (R.)- Lodoform, 
dusted over sores (R.). Linen, air-dried better than that which is ironed or 
mangled, by reason of its greater softness. 



BILIOUSNESS — BLADDER, IRRITABLE. 



533 



Biliousness. 

Podophyllum, acts as a cathartic (B.) ; corrects deficient secretion of bile, 
especially in children and infants ; gr. J to t 2 q, every 6 hours, to correct white 
or clayey stools; also in general hepatic derangement (P.)- Aconite, in occa- 
sional doses, improves the effect of Podophyllum (R.). Mercurial Cathartics, 
act only as purgatives, Calomel gr. j-x, or Pil. Hydrarg. gr. v-x ; Mercury 
restricted as purgative to cases where there is excess or deficiency of bile (B.). 
Frequent small doses of gray powder for deficiency (R.j ; Calomel gr. iij, fol- 
lowed by £ij each of Rochelle and Epsom Salts, when the tongue is heavily 
coated and furred (Gross). Yellow Oxide of Mercury, in doses of gr. -^ to -^, 
in trituration with sugar of milk, exceedingly efficient in many disordered con- 
ditions of the alimentary canal and its appendages (Schaffer). Bryonia, is 
worthy of commendation in the ordinary bilious headache with vomiting, 
and in general hepatic derangement known as sluggish liver (P.). Hydrastis, 
gtt. v-xv fl. ext. daily before meals, when with chronic gastric catarrh and 
dyspepsia (B.). Mineral Acids, before meals, Hydrochloric Acid and Pepsin 
after meals, in atonic dyspepsia (B.). Stillingia, when deficient biliary secre- 
tion (B.) ; may be used in place of Mercury (Br.). Ammonium Iodide, gr. j-iij 
in water each 2, 3, or 4 hours, when catarrh of duodenum and biliary ducts 
(B.). Ammonium Chloride, is much employed in Germany for hepatic de- 
rangements, and with good success. Euonymus, is considered very efficient 
by many practitioners in cases of hepatic dyspepsia, or " billious attacks," so 
called. Manganese, gouty subjects. Rhubarb, as a cholagogue, Aloes, with 
constipation. Angostura, is suitable to worst forms of bilious fevers LP.). Ca- 
lumba, is of benefit in many forms (P.). Alkalies, and their laxative salts, 
when bilious state, with uric acid diathesis (B.). Milk-cure, in obstinate 
cases; buttermilk or skimmed milk often agrees best (B.). [Compare Dys- 
pepsia, Hepatic Congestion, Duodenal Catarrh.] 

Prescriptions. 



R. Ext. Stillingia Fl., . . £v. 

Tinct. Aloes, . . . gij. 

Tinct. Nucis Vom., . . £j. 

M. Sig. — Twenty drops in water 

thrice daily. (B.) 



r. 



Ext. Euonymi, 

Ext. Hyoscyami, . 

Ext. Gentianse, 
Fiat massa, et div. in pil. xij. 
Sig. — One pill every other day 



gr. xv. 



R 



g r -J< 



Hydrarg. Oxidi Flavi, 

Sacch. Lactis, q. s. 
Triturat. et div. in chart, xlviij. 
Sig. — One powder dry on the tongue 
twice daily. 



R. Massae Hydrargyri, 

Ext. Colocynthidis Co., 

aa gr. iij. 
M. et div. in pil. ij. 
Sig. — Take at once, and follow in 
a few hours with a saline cathartic. 



Bladder, Irritable. 

Belladonna, in nocturnal incontinence, due to relaxation of sphincter, or 
irritable mucous membrane (B.) ; gtt. v-xx of tinct. every 3 or 4 hours give 
gradual but sure relief (P.). Cantharis, in women, without acute inflamma- 
tion (B.) ; on coughing (R.). Benzoic Acid, when from enlarged prostate, 
removes fetor of urine; also renders phosphatic or alkaline urine acid (P.). 
Ammonium Benzoate, may be used instead of Benzoic Acid (Br.). Cubebs, 



534 BLADDER, PARALYSIS OF — BLEPHARITIS BOILS. 

is often successful in women, but Cantharides generally better (Br.) ; is of 
especial value when vesical catarrh present (P.). Aqua-puncture, strange to 
say, has been used with considerable success (B.). Cannabis Indica, in 
spasm of the bladder, and in irritable conditions of that organ is generally 
useful. Eucalyptol, is often very efficient, but frequently fails, niij on sugar 
two or three times a day. [Compare Cystitis, Dysuria, Enuresis, Lithi- 
asis, Calculi, Urinary Disorders ] 

Bladder, Paralysis of* 

Cannabis Indica, in retention from spinal disease (R.). Ergot, in para- 
lytic dysuria, especially when sensation of bladder being only partially emp- 
tied (P.) ; when incontinence from paralytic sphincter, and in paralysis from 
overdistension (B., Wa.). Arnica, has proved curative (P.). Strychnine, 
gr. -^ to -g- 1 ^, useful (B.). Cantharides, often given with excellent effect, when 
bladder atonic (Wa.). Galvanism, may greatly benefit (B.); electro-mag- 
netic current from the bladder to the spine, of great use (Wa.). 

Blepharitis* 

Pulsatilla, internally and externally (P., B.). Mercury, after detaching 
crusts, rub in brown citrine ointment (B.) ; should be diluted with vaseline or 
simple ointment (Br.). Tannin, powdered, or tannic acid solution, gr. j-x 
to the ^ (B.). Alum, after acute symptoms subside (B.) ; a solution, gr. 
viij-^j aquae, every % or *4 hour, an excellent application (R.). Hydrastis, 
as lotion, very serviceable (P.). Bismuth, equal parts of the subnitrate and 
glycerin to the inflamed surface, in ciliary and glandular blepharitis (Wa.). 
Ergot, the fluid extract locally, gives excellent results (B.)T 

Prescriptions*. 

R. Unguent. Hydrarg. Nitrat., £j. 
Vaselinae Albae, . . ^iij. 
M. Sig. — Ointment for the margins 
of the eyelids. 

Boils. 

Belladonna, as plaster, to subdue inflammation, or use lint wetted with Atro- 
pine gr. iv, Aquae Rosae §j ( B.) ; with Glycerin locally, to allay pain ; inter- 
nally often successful (R., Wa.). Sulphides, in small doses (gr. -^ to \ of 
Calx Sulphurata) every hour or two, or Sulphurous Mineral Waters will abort 
or mature, and aid to expel pus (B., R.) ; of no use in the boils of diabetes 
(R.). Aromatic Sulphuric Acid, for the tendency, gtt. x-xv, in plenty of 
water thrice daily. Silver Nitrate, gr. v-J)j-Jj of nitrous ether, painted over 
adjacent part, to abort; specific if used early (B., R.). Arsenic, long-con- 
tinued, for succession of boils (B.); to lessen tendency to recurrence (Br.). 
Opium, a thick extract locally (R.). Camphorated Alcohol, smeared over 
boils in the earliest stage, then, when skin dry, smear with camphorated oil, 
to abort (R.). Sodium Phosphate, the best remedy for the systemic condition 
which produces boils (B.). Carbolic Acid, undiluted, on a thread passed 
through centre of boil while recent, will abort it. Counter-irritation, by blis- 
ters or Iodine around the boil (R.). Collodion, at papular or pustular stage 



R 


. Aluminis, 


. 


* 


gr. x. 




Aquae Rosae, . 


. 


. 


£j. 




M. Sig. — Lotion 


for 


the 


eve- 


lie 


Is. 






(B.) 



BONE, DISEASES OF — BRIGHT S DISEASE, ACUTE. 535 

(R.). Poultices •, to assist maturation and allay pain, maybe smeared over with 
Belladonna or Opium (R.). [Compare Acne, Carbuncle.] 

Prescriptions, 

R. Ac. Sulph. Aromat., . * 5;yj. 
Aquae, ... ad 5iv. 
M. Sig. — A teasp. in a winegl. of 
water 3 or 4 times daily. 



R. Calcis Sulphurat, . . gr. iij 
Sacch. Lactis, q. s. 
Triturat. et div. in chartas xxx. 
Sig. — One powder every 2 hours. 



Bone, Diseases of. 

Iodine, in scrofulous affections of bones, should be used locally, with the 
iodide of iron or cod-liver oil internally, nutritious diet, wine, out-door exer- 
cise (Wa.). Cod-liver Oil, in scrofulous affections, may be relied on if perse- 
veringly used, and accompanied by good hygienic conditions (Wa.). [Com- 
pare Caries, Exostosis, Nodes, Periostitis, Rachitis, Spina Bifida, etc.] 

Breath, Fetid. 

Potass. Permang., gr. j-gj aquae rosae, as awash for the mouth (B.). Chlo- 
rine, as solution of chlorinated lime, to remove fetor (B.). Carbolic Acid, a 
dilute solution, as wash for mouth (W.). Camphor, is used as a corrective 
(R.). Look for bad teeth, disordered digestion; in very offensive cases, gan- 
grenous lungs ; cleanliness of teeth and mouth are essential. 

Prescriptions. 



R. Calcis Chlorat., . , giij. 

Aquae Destillatae, 

Alcoholis, . . aa Jjij. 

Olei Rosae, . . . tnjv. 
M. Sig. — A teasp. in a glassful of 
water, as a lotion for the mouth. (B.) 



R. Acidi Salicylici, 

Liq. Ammonii Acet., 
Glycerini, 
Aquae, q. s. 
M. Sig. — A tablesp. every six hours. 
{Robinson. ) 




Bright's Disease, Acute. 

Aconite, should be given immediately on the appearance of the nephritis in 
scarlatina (R.) ; as a diuretic, advocated (P.). Cantharis, after subsidence of 
the acute stage, one-minim dose every 3 hours will stop the hematuria (R., 
B.). Digitalis, (infusion ^ss) the best remedy in renal dropsy from acute 
desquamative nephritis (B.) ; only diuretic as long as dropsy lasts (R.). Can- 
nabis Indica, as diuretic ; is especially useful when bloody urine (R.). Eu- 
calyptus, sometimes effective ; cautiously, or it will aggravate symptoms (B.). 
Hyoscyamus, in irritable kidneys (P.) ; may be substituted for Belladonna 
(Wa.). Jaborandi, is much used (Da Costa) ; large doses very depressant 
to the heart, but Titv-x of the fluid extract every half-hour or hour will pro- 
duce sweating. *It may be combined with tinct. of Digitalis (A. A. Smith) ; 
or the Nitrate of Pilocarpine, to excite skin when symptoms urgent, gr. -fa to £ 
for adult (B.). Turpentine, in drop or half-drop doses every 2 to 4 hours, 
controls the dropsy in a remarkable manner ( P. ) ; hot turpentine epithems are 
serviceable, but may increase the action of the kidneys (Wa.). Belladonna, 
has often proved useful (P.); may be used with benefit (Wa.). Jalap, the 
compound powder is the most generally useful purgative, used in the early 



536 



BRIGHT S DISEASE, CHRONIC. 



morning, to produce free watery evacuations, when uraemic symptoms super- 
vene (B.). Gallic Acid, checks albuminuria (B.). [See Albuminuria, for 
formula.] Juniper, as diuretic; often aggravates (P.). Poultices, large, of 
linseed meal, made light and soft as possible, beneficial (Wa.). Cupping, in 
lumbar region, ameliorates acute desq. nephritis, and congestion of the kid- 
ney (B.) ; cupping, or leeches over the loins, with opiates freely, diluents, and 
demulcents, with rest and an antiphlogistic regimen, often suffice (Wa.). Va- 
por-bath or Warm Pack, to increase the action of the skin (B.). Diluents, 
as milk, and cream-of-tartar in solution, should be used freely to relieve the 
congestion and remove obstructions from the tubules (B.). Iron, after the 
acute symptoms have subsided, as a tonic, the most suitable preparation being 
Basham's mixture, the now official Mist. Ferri et Ammonii Acetatis, in gss 
doses thrice daily (Da Costa). [Compare Albuminuria, Hematuria, 
Uremia.] 

Prescriptions. 



R. Potassii Acetatis, 

Infusi Digitalis, 

Infusi Juniperi, 
M. Sig. — A tablesp. every 2 
hours as a diuretic. 




R. Pulv. Jalapae Comp., . . giv. 

Div. in chartulas no. iv. 

Sig. — One in water before break- 
fast. 



R. Mist. Ferri et Ammonii Ace- 
tatis, .... gviij. 
Sig. — A tablesp. thrice daily, as soon 
as hematuria disappears. 



r. 



;ss. 



Ext. Pilocarpi Fl., . 
Vini Ipecac, . . . ^jss. 
Mucil. Acaciae, . . ^j. 
Aq. Cinnamomi, . ad ^ij. 
M. Sig. — A teasp. every four hours 
until free diaphoresis. 



Bright's Disease, Chronic. 

Milk-cure, has been very successful ; skim-milk alone for some time, then 
gradual addition of other diet (B.). Water, in large draughts, as diuretic, 
when excretion of solids is deficient (Br.) ; hot fomentations to lumbar region 
(B.). Lead, diminishes the albumen (R.). Gallic Acid, to lessen the albu- 
minuria. See under Albuminuria for formula (A.). Hydrastis, lessens ex- 
cretion of albumen (B.). Potassium Bitartrate, to prevent dangerous accu- 
mulations in cellular tissue or important cavities, also to draw off effete mat- 
ters ; care must be used, as it is a brisk purgative and is weakening (R.) ; in 
form of "cream-of-tartar lemonade," an agreeable diuretic (B.). Jalap, the 
compound powder occasionally, as derivative cathartic, to relieve the kidneys 
(Da Costa). Nitro-glycerin, 1U T ^ to dilate peripheral vessels, relieves the 
heart and the renal congestion, and diminishes albumen (B.). Tartrates, ex- 
cellent diuretics (R.). Cod-liver Oil, is very useful (R.). Baths, warm and 
Turkish, when uraemic symptoms and dropsy ; discretion needful, as baths 
may weaken (R.). Cannabis Indica, as diuretic when bloody urine (R.)« 
Turpentine, sometimes given in very small doses as a diuretic, and to check 
hematuria (R.) ; half-drop or drop doses every 2 to 4 hours very successful in 
dropsy with albuminous urine depending on non-desquamative disease of the 
kidneys. Jaborandi, in uraemia is very satisfactory (B.) ; large doses very 
depressant to the heart (A. A. Smith) ; tti xx of the fluid extract ter in die if 
the urine decreases much (Da Costa). Iron, to improve digestion and correct 
anaemia; the tinct. of the chloride or tinct. ferri acetatis preferred (B.) ; in 



BRONCHIECTASIS — BRONCHITIS, ACUTE. 537 

chronic tubular nephritis with cardiac hypertrophy the mist, ferri et ammonii 
acetatis, gss ter in die, with an occasional vapor-bath (Da Costa). Chimaphila, 
has power over various forms of nephritic disease, especially when albumi- 
nuria present (P.). Eucalyptus, in chronic desquamative nephritis, cautiously 
used will cause improvement (B.). Elaterium* for the dropsy, as a derivative 
cathartic; must be cautiously used (R.). Bromides, are useful in the convul- 
sions (R.). See Uraemia. Potassium Iodide, has improved some cases, 
which were possibly due to syphilis (R.). Aurum, the chloride in pill, gr. 
■5V to A * er i n die, persistently, in the chronic interstitial nephritis, to arrest 
hyperplasia of the connective tissue ; may be combined with Arsenic, which 
has a similar influence (B.). Mercuric Chloride, acts in the same manner, 
gr. 2V bis die (Da Costa). Food, should be nourishing, particularly suitable 
are milk, eggs and rare beef (Da Costa). Buffalo Lithia Water, of Virginia, 
has many advocates. [Compare Dropsy, Uraemia.] 

Prescriptions. 
(Compare those under Bright's Disease, Acute.) 

R. Strychninae Sulphatis, . gr. j£. 

Tinct. Ferri Chloridi, . gss. 

Acidi Acetici, . . 3jss. 

Curacoae, . . . ,lj- 

Liq. Ammonii Acetat., ad Jvj. 
M. Sig. — A tablesp. every 6 hours, 
followed by a glass of water. For the 
anaemia. 



R. Tinct. Nitro-glycerini, . gj. 

Sig. — One drop, gradually increased 
to five, four times daily on sugar. (B.) 



R. Auri et Sodii Chlor., . gr. jss. 
Aquae Destillatae, . . ]|iv. 
Solve. Sig. — A teasp. ter in die. 



Bronchiectasis. 

Quinine, the most useful remedy as a tonic (B.). Phosphates, are undoubt- 
edly useful, so also are the Hypophosphites (B.). Chlorine in solution as a 
stimulant and deodorizer, or as inhalation to lessen fetor (Br.). Palliation 
of the cough and expectoration, with care of the general health of the patient, 
is all that can be accomplished. [Compare Emphysema.] 

Bronchitis, Acute. 

Aconite, gtt. ss-j every hour (B.) ; in catarrh and bronchitis of measles (R.). 
Tartar Emetic, first stage, gr. ^ to ^, especially if cough is violent (B.) ; — 
gr. j to a quart of water, a teasp. of this every hour for the wheezing and cough 
of slight bronchitis in children (A. A. Smith); — gr. ^ to ^ every 2 or 3 
hours (R.). Ipecacuanha, as wine, when expectoration profuse, and difficult 
to expel (R.) ; dry stage (P.); see below, Opiuni. lobelia, as expectorant 
(B.) ; for paroxysmal dyspnoea (R.). Sanguinaria, after subsidence of acute 
symptoms, as expectorant (B.); very successful (P.). Quinine, to reduce 
temperature (R.). Colchicum, useful when gouty diathesis (P.). Ammo- 
nium Carbonate, expectoration profuse, and condition low (R.). Opiu?n. 
Morphine and quinine combined, or Dover's powder, to abort an attack ; also 
with expectorants to allay cough (B.). Frequent and violent coughs, without 
obstructed oxidation ; also to check excessive secretion (R.). As sudorific 
very useful, grs. x of Dover's powder (P.). Carbolic Acid, as spray, a 5 per 
cent, solution with steam atomizer, prompt and efficient. Apomorphine, the 
hydrochlorate in doses of gr. ^ every 3 hours, the best of all expectorants. 

45 



538 



BRONCHITIS, CAPILLARY. 



Cimicifuga, an excellent expectorant, and useful when acute symptoms have 
subsided (B.). Nitric Acid, ttix of dilute acid relieve (B.). Asafcetida or 
Anunoniacum, the last best, in bronchitis with wheezing of old people (R.). 
Cubebs, very useful, especially when secretion copious and system relaxed 
(P. ). Copaiba, after subsidence of the fever, the most serviceable expectorant, 
but nauseous (B.). Counter-irritants, mustard as poultice (large), with lin- 
seed or oatmeal, or both, very useful (R.). Iron, Lead, Zinc Oxide, to check 
profuse secretion (R.). Heat, to chest by linseed poultice, of great service. 
Diet should be light and in liquid form. Temperature of atmosphere in room 
about 8o° F., and the air moistened by steam. [Compare Cough.] 

Prescriptions. 



R. Antim. et Pot. Tart., 

Liq. Ammonii Acet., 

Spt. Etheris Nitrosi, 

Tinct. Aconiti, 

Syr. Simplicis, 
M. Sig. — A teasp. every 2 or 3 
hours. In first stage. 



. gr.y. 

. gss. 
ad 5vi. 



R. Tinct. Aconiti, . . iriviij. 

Aquae Cinnamomi, . . gj. 
M. Sig. — A teasp. every l / 2 hour for 
2 hours, then every hour. In acute 
inflammatory form. 



giv. 



R. Vini Ipecac, . 

Liq. Potassii Citratis, 
Tinct. Opii Camphorat., 
Syr. Acaciae, . . aa gj. 
M. Sig. — Tablesp. ter die. In first 
stage of ordinary acute bronchitis. 

(Da Costa.) 



R. Ext. Cimicifugse Fl.,. . gss. 
Tinct. Opii Deodorat., . gj. 
Syr. Tolutani, . . ad gij. 
M. Sig. — A teasp. every 4 hours. 
(B.) 

R. Tinct. Sanguinariae, 

Tinct. Lobeliae, . . aa gj. 
Vini Ipecac, . . . gij. 
Syrupi Tolutani, . . giv. 
M. Sig. — A teasp. every 3 hours. 

(B.) 



R. Apormorph. Hydrochlor., 

Ac Hydrochlor. Dil., 

Syrupi Senegae, 

Aquae Destillat., 
M. Sig. — A teasp. every 2 
For a child of 3 years as expectorant. 
Should be put up in a blue bottle. 



miij. 

Si- 

hours. 



R 



Ext. Eriodyctii FL, , 
Ext. Senegae Fl., 
Syr. Pruni Virginian., 
Aquae, q. s. 



JJVl. 

giv. 

ad giv. 



M. Sig. — Teasp. every 3 hours. 



Bronchitis, Capillary, 



Ipecacuanha, as emetic, preferred to tartar emetic in capillary bronchitis of 
very young or very old (B.) ; as wine, when expectoration profuse and diffi- 
cult to expel (R.). In very young infants should be used in place of antimony 
(M. & P.). Squill, as expectorant, may be used with benefit (Wa.). Anti- 
mony, sulphurated, gr. -fa in combination with Dover's powder, every 2 or 3 
hours, when the temperature very high, and pulse full and strong. Must be 
stopped as soon as nausea and vomiting begin (M. & P.). Lobelia, for par- 
oxysmal dyspnoea (R.). Ammonium Carbonate, when expectoration profuse 
and strength diminishing; in severe bronchitis or broncho-pneumonia of chil- 



BRONCHITIS, CHRONIC. 



539 



dren, especially when prostrate and livid (R.) ; has probably a specific action 
on the diseased tissue and its products (Clymer). Ammonium Iodide, in 
small, rapid doses, often gives great relief to the catarrhal process (Da Costa) ; 
often gives the most astonishing relief (B.). Ami?ionium Muriate, gr. ij every 
2 hours, either alone or with potassic chlorate (Clymer). Serpentaria, in 
capillary bronchitis of children gives excellent results (B.). Turpentine, one 
of the best stimulants when vital powers are depressed and peripheral circula- 
tion feeble (B.). Camphor, to allay cough and promote expectoration (B.-). 
Hydrocyanic Acid, for cough and tendency to spasm. Hydrarg. Sub sulph. 
effective as emetic (B.). Mustard, as poultice or bath, useful (R.) ; — the most 
important part of the treatment (M. & P.). Poultices, to encircle the whole 
chest in children (R.). A jacket of cotton- wool around the chest. Steam, by 
inhalation, may be impregnated with sedatives, or with carbolic acid ; — is of 
great importance (M. & P.). Quinine, in that form of capillary bronchitis 
occurring in tropical climates, and where marked debility (M. & P.). Stimu- 
lants, are often necessary, especially in the suffocative form, and where marked 
prostration (M. & P.). Emetics, are necessary when suffocative symptoms 
become prominent. [Compare Cough.] 



Prescriptions. 



R. Ext. Serpentariae Fl., . ^ss. 

Ammonii Carb., . . zij. 

Syr. Tolutani, . . . 3J SS » 
M. Sig. — A teasp. every 2, 3, or 4 
hours. (B.) 



R. Quininae Sulph., . . gr. vj. 

Ac. Sulph. Dil., . . tttxij. 

Syr. Simplicis, . . t ^ss. 

Aquas, . . . . ^ijss. 
M. Sig. — A teasp. every 2 hours to 
child of 2 or 3 years ; older children 
require more quinine. (M. & P.) 



R. Liq. Ammonii Acet, 
Syr. Ipecac, 
Liq. Morp. Sulph. 

Syr. Acacias, 

Aquae, 
M. Sig. — A teasp. 
for a child 2 years old 
pale and expression 
cool. 



gss. 
3J- 



. mxi. 

. ^jss. 

every 2 hours 

When surface 

languid, skin 

(M. & P.) 



R. Ammonii Iodidi, . . gj-ij* 
Ammonii Carb., . . 5£ij— iij. 

Syr. Glycyrrhizae, . . Jfij. 
Syr. Tolutani, . . Jij. 
M. Sig. — A teasp. every 2 or 3 hours, 



Bronchitis, Chronic, 

Antimony, when expectoration copious and difficult to expel (R.). Arsenic, 
where emphysema, in cigarettes (B.). [See ante, Asthma, for formula.] 
Sulphur, gr. v-x, in severe cases, with abundant discharge, especially where 
constitutional debility (R.). Sulphurous Acid Gas, inhalations, or the acid 
in form of spray, sometimes beneficial (B., R.). Lobelia, for paroxysmal dys- 
pncea (R.). Ammonium Chloride, combined with stimulating expectorants, 
such as Serpentaria, Sanguinaria, or Eucalyptus (B.) ; — when secretion is thick 
and abundant, may be applied by an atomizer (R.). Carbolic Acid, as inhala- 
tion of spray, 1 part to 100 of water; may be combined with tincture iodine 
(B., R.). A 5 per cent, solution in steam atomizer as inhalation. Hydrastis, 
fluid extract, locally and internally (B.) ; of great value internally and exter- 
nally in chronic coryza (P.). Senega, especially in the aged (R.). Iodine, by 
inhalation, sometimes used (R.) ; — the Iodides, especially the iodide of ammo- 



540 



BRONCHITIS, CHRONIC. 



nium, are very serviceable in combination with expectorants (B.). Colchicum, 
in gouty subjects (R.). Balsams of Peru, and Tolu, when copious secretion 
of pus (R.). Ammonia, inhalation, to lessen expectoration {R.). Oleum 
Anthemidis, in pulmonary catarrh with excessive secretion and difficult expec- 
toration, a very useful remedy, TUij-iv (P.). Ammoniacu7?i, the mistura, with 
chloride or carbonate of ammonium, efficient in the bronchitis of old people, 
with wheezing and abundant secretion (R.)- [See Bronchorrhgea, for form- 
ula.] Benzoin, zj of the compound tincture to boiling water, as inhalation ; 
eases cough and lessens expectoration (R.). Sometimes used by atomization 
(B.). Phosphates, for the resulting cachexia (B.). Phosphate of lime (R.i. 
Serpentaria, as stimulant. Alum, powdered, dusted over surface (B.). Silver 
Nitrate, locally (gr. v-Qj-^j) on sponge probang (B.). Camphor, to allay 
cough and promote expectoration (B.). Sumbul, has decided efficacy (P.). 
Opium, with expectorants, to allay cough (B.). When frequent and violent 
cough, without any signs of obstructed oxidation; also to check excessive 
secretion (R.). Codeine, gr. y^ every 3 to 6 hours, when other opiates are not 
w T ell borne (P.). Ethyl Iodide, by inhalation, is very valuable by reason of its 
local influence TUv-xx thrice daily (B.). Grindelia, an excellent expectorant, 
and especially when cough is troublesome (B.). Strychnine, as a respiratorv 
stimulant and to check the reflex vomiting ( B. ). The syrup of the phosphates 
of iron, quinine and strychnine. Squill, in chronic forms with tenacious sputa, 
but not when fever or acute inflammation (R.). Tar, diminishes the secre- 
tion and allays the cough (P.); gr. ij in pill every 3 or 4 hours in chronic 
paroxysmal winter cough (R.). Digitalis, when interstitial pneumonia and 
general anasarca ^B.). Eucalyptus, valuable in chronic cases of broncho- 
pulmonary catarrh (B.). Gallic Acid, useful in some forms of chronic broncho- 
pulmonary catarrh (B.). Iron, with free expectoration, mistura ferri com- 
posita ; or better, the phosphate of iron, quinine, and strychnine (B.). To check 
profuse bronchial secretion (R.). Myrtol, in fetid bronchitis, of great value 
(Gubler). Copaiba, when purulent secretion (R.) ; — for profuse secretion, the 
best of all expectorants, but nauseous (B.). Cubebs, when profuse expectora- 
tion, has similar remedial influence (B.). [See Bkonchorrhcea, for formulae.] 
ICoo miss -cure, possesess great value (B.). Cod-liver Oil, a teaspoonful ter die 
after meals, of great service, if continued (B.) ; to control expectoration (R. ). 
Poultices, made large, of hot linseed meal to cover the chest, when congestion 
of lungs. Olive Oil, inunctions to chest, has soothing and strengthening 
effects. Diet, nutritious, and stimulants necessary when great prostration. 
Koomiss is an excellent article of diet. [Compare Cough, Emphysema.] 

Prescriptions. 



ft. Ext. Eucalypti Fl., . 

Ammonii Chloridi, . 

Ext. Glycyrrhizse, . 

Syrupi Tolutani, 
M. Sig. — A teasp. 4 to 6 
daily. 



3J. 
times 



ss. 



ft. Ext. Eucalypti Fl., . 

Syr. Acacke, . . . ^j. 
Aq. Menth. Piperita?, . giij. 
M. Sig. — A teasp. every 3 hours. 



R 



. Ammonii Carbonat., . gr. xl. 

Infusi Serpentariae, . . giv. 
M. Sig. — A tablesp. every 3 hours. 



ft. Ammonii Chloridi, . . ziij. 

Syrupi Picis Liquidse, . }|vj. 

M. Sig. — Tablesp. 4 times daily. 



ft. Ammonii Chloridi, . . Z,iij. 
Syrupi Tolutani, 
Syr. Pruni Virg., . aa Jij. 
M. Sig. — Teasp. 3 or 4 times daily. 



BRONCHORRHOEA — BRUISES. 



541 



R. Tinct. Sanguinariae, 
Ammonii Chloridi, . 
Syrupi Tolutani, 
Spt. Etheris Nitrosi, 
Aquae, 
M. Sig. — Tablesp. p. r. n. 



• 3J. 


R. Syrupi Scillae, . . . §ss. 


. 35- 


Tinct. Opii Camph., . » 3 1 ]- 


• 3 1 * 


Ammoniaci, . . . £ss. 


• 3 SS - 


Syrupi Tolutani, . . £x. 


. giijss. 


M. Sig. — A teasp. p. r. n. 



Bronchorrhcea. 



Ammonium Iodide, often improves the condition, especially if used with 
arsenic (B.). Oil of Eucalyptus, of great utility (B.) ; m.ij ter die on sugar, 
or see formulae above. Sulphurous Acid Gas, as inhalations, or the sulphurous 
acid as spray, sometimes improve (B.). Lead Acetate, as astringent, to re- 
strain secretion (B). Petroleum, crude, in capsules, has been administered 
with rapid amelioration as the result (Blache). Grindelia, an efficient rem- 
edy (B.). Iodine, as liniment, over front and back of chest (R.). Spinal 
Ice-bag, to restrain excessive secretion (R.). Quinine \ and the Phosphates, 
also Cod-liver Oil, as restoratives (Wa.). Copaiba, the most serviceable ex- 
pectorant, but nauseous (B.); when copious secretion of pus (R.). Cubebs, 
has remedial effect in chronic bronchial affections with profuse expectoration 
(B.). Asafetida, is of great benefit (B.). Turpentine, an excellent remedy 
when fetid expectoration; maybe used internally ( 7T Lv) or by inhalation from 
atomizer. Carbolic Acid, internally, TUj, and by spray (gr. v ad 3J aquae), 
often of great utility (Da Costa). Benzoin, by inhalation, for its local in- 
fluence. Myrtol, is largely eliminated by the lungs, and is a most valuable 
agent in bronchorrhcea and fetid bronchitis, acting as a stimulant and anti- 
septic (Gublerj ; dose tnjj in capsules (Br.). [Compare Cough.] 



Presc7'iptions. 



aa 



R. Copaibae, 

Syrupi Tolutani, 

Spt. Etheris Nitrosi, . . 5j. 

Aquae Menth. Pip., . . 3 ij . 

M. Sig. — A teasp. every 4 hours. 



r. 



Copaibae, Bals. Tolutan., 
Pulv. Acaciae, . . aa 
Ac. Sulph. Aromat., . 
Aquae Destillat., . . gvi. 
M. Sig. — Tablesp. bis vel ter in die. 



t ^ss. 

Zss. 



R. Ammonii Chloridi, . 
Mist. Asafcetidae, 
Misce. Sig. — Tablesp. as required 



iv. 



R. Potassii Iodidi, 

Ac. Nitrici DiL, 

Tinct. Belladonnae, . 

Ac. Salicylici, . 

Aquae Camphorae, . ad 

M. Sig. — Dessertsp. in water 

4 times daily, for fetid bronchitis. 



3J. 

3 U J- 

giv. 
3 or 



Bruises. 

Arnica, the infusion very useful as an external application for bruises 
and cuts; also an excellent internal remedy for internal bruises, shake, falls, 
blows, or shock ; Tn_v-x every 2 or 3 hours (P.) ; in bruises, sprains, etc. ( Wa.). 
Aconite, the liniment locally to painful sprains and bruises (Wa.). Capsicum, 
a strong tinct. applied with gum, said to act like a charm on discolored bruises 
(R.). Sulphurous Acid, a solution, constantly applied (R.). Oil of Bay, as 



54 2 BUBO — BUNION — BURNS AND SCALDS. 

stimulating liniment (P.). Opium, the tincture with linimentum saponis (^j to 
3J) diligently rubbed in two or three times a day, affords great relief (Wa.). 

Bubo. 

Mercury, necessary in the indurated buboes diagnostic of syphilis (Ricord) : 
the powder of calomel locally applied for indolent buboes refusing to heal 
after opening (H.). Nitric Acid, indolent and broken bubo (R.). Sulphides, 
are less useful in maturating than in the case of ordinary boils or abscesses 
(R.) ; to check suppuration (St.). Iodoform, locally, has proved useful (Wa.). 
Iodine, applied to produce vesication around a bubo, relieves inflammation 
(R.) ; freely every day, with rest and compression, to cause absorption (St.). 
Silver Nitrate, lightly to surface, to stimulate indolent buboes ( Wa.). Potas- 
sio-tartrate of Iron, 30 parts to 250 aquae destil., three tablesp. daily ; also as 
lotion to sore (Ricord) ; phagedena (St.). Tartar Emetic, gr. j every two 
hours reduces inflammation in many cases (Wa.). Ice, greatly relieves (B.). 
Surgical. — Open freely with a bistoury when suppurating ; if pus is virulent, 
the open bubo is a chancroid, and must be treated as such (Keyes). Pressure, 
by compressed sponge under a spica bandage, or a shot-bag, the best local 
treatment for indolent bubo (Keyes) ; in all cases cleanliness, rest in recum- 
bent posture, emollient poultices. Diet, should be generous, with cod-liver 
oil, in phagedenic bubo. The treatment of Syphilitic Bubo is that of gen- 
eral syphilis, local measures are useless, and no treatment called for until a 
general eruption appears (Keyes). [Compare Chancroid, Syphilis.] 



Bunion* 

Iodine paint, or Emplastrum Hydrargyri, for indolent form, thick but not 
tender (D.). Rest, fomentations, and anti-arthritic remedies for thickened 
bunion ; burst it by pressure if recent and sac thin (D.). [Compare Bursitis.] 



Burns and Scalds. 

Carbolic Acid, I part to 30 of lin. calcis, or 1 part to 6 of olive oil ; the 
latter speedily relieves pain, and promotes healing without suppuration 
(Wa.); I part to 10 of olive oil, applied on layers of cotton batting, the best 
application for burns of all degrees. Boracic Acid, a saturated watery solu- 
tion, used with great success by Lister (B.). lead Carbonate, white lead 
paint, an excellent application to burns of small extent (B.). Salicylic Acid, 
^j-gviij ol. olivse is an efficient local application (B.). Collodion, flexible, to 
burns of first degree (B., R., P.). Phytolacca, relieves pain (B.). Lime, as 
lime-water and oil, equal parts (R.) ; or lime-water with linseed oil, a favorite 
application (P.). Rhus Toxicoden., externally 5 to the pint, in superficial but 
extensive burns (P.). Cantharis, the tincture diluted with 40 parts of water 
and applied on rags, is a most excellent application. Sodium Carbonate, in 
solution as lotion, immediately relieves pain and promotes rapid healing. Tur- 
pentine, in dangerous cases, where great constitutional depression (P.) ; as 
wash to severe burns, then locally basilicon ointment mixed with turpentine 
(B.). Cotton-wool, to allay pain and exclude air (P.). Warm Bath, immerse 
for some days (R.) ; exclusion of air the main indication (H.). 



BURSITIS — C ACH EX1JE. 



543 



Prescriptions. 



Lime and Linseed. 

R. Olei Lini, . . . 5vij. 
Aquae Calcis, . . . ^viij. 
M. Sig. — Apply on sheet lint, and 
cover with oiled silk. 



R. Sodii Carbonatis, . . §vj. 
Aquae, .... Oiij. 
M. Sig. — Apply freely for 3 days 
on old cloths or lint. 



R. Iodoformi, . . . gj. 

Cetacei, . . . . gj. 

Ext. Conii Alcohol., . gr. xl. 

Acidi Carbolici, . . gtt. x. 
M. Sig. — Spread on lint and cover 
the parts therewith. 



R. Pulv. Carbonis Ligni, . ^viij. 
• Sig. — To be dusted thickly over the 
burned parts. 



Bursitis. 

Iodine ; painted on outside, after removal of fluid with aspirator (D.) : after 
blistering (Wa.). Blisters, in rheumatic enlargement of bursae, are almost 
indispensable for a rapid cure (Wa.). Fomentations, with rest, to relieve 
pain and swelling. If unavailing, a crucial incision into the bursa, care being 
taken not to open the capsule of the knee (D.). Excision, when chronic, 
tumor hard, resisting other measures (C). 



Cachexiae. 

Lime, the phosphate, in scrofulous affections and anaemia (Wa.) ; in phthisis, 
and affections marked by mal-nutrition (B.). Iron, in splenic, syphilitic, and 
strumous, and especially in all anaemic states ; also in the malarial and phthis- 
ical ; chalybeate waters (B.). The ammonio-citrate the best tonic in the ca- 
chexia of gastric ulcers, especially in chlorotic females (Wa.). Arsenic, a 
prompt remedy in the malarial cachexia; also in cancerous of real value 
(Wa.). Hydrastine, in paludal and splenic cachexiae, stands in high esteem 
(B.). Nitric Acid, is adapted to the cachexia following acute disease or in- 
temperance ; also as alterative after long courses of mercury (Wa.). Potas- 
sium Iodide, in constitutional syphilis, and resulting affections of bones and 
skin (Wa.). Mercury, in the syphilitic ; but its utility much questioned (Wa.). 
Aurum, in cancerous, mercurial, and syphilitic cachexiae, especially when 
bones, glands, and oculo-nasal mucous membrane affected. Phosphates, in 
bone diseases, wasting, bronchitic, leucorrhoeic, etc. (B.). Arnica, in very 
developed cachexiae, has excitant action on nervous system (Wa.). Euca- 
lyptus, a serviceable tonic and stimulant in cachectic states generally (B.). 
Manganese, the syrup of the iodide of iron and manganese in anaemic, 
syphilitiCj, strumous, malarial, cancerous, etc. (B.). Grape-cure, often modifies 
most happily many conditions (P.). Air, in good condition, an important 
element (B.). Water, the Turkish bath and wet pack as aids to remedial 
action, in plumbic, mercurial and paludal (B.). Oils and Fats, to promote 
constructive metamorphosis in many cachexiae, especially cod-liver oil (B.); 
the latter a most valuable remedy in scrofula, phthisis, atrophy, tubercular 
and jail cachexiae, anaemia, etc. ( Wa.). Massage, has been productive of re- 
markable results in many forms of cachexiae (B.). Aliment, of prime im- 
portance (B.). [Compare the various titles, Anaemia, Scrofula, Syphilis, 
etc., and the formulae for tonics, on pages 520 and 525, ante.~\ 



544 CALCULI, BILIARY — CALCULI, RENAL AND VESICAL. 

Calculi, Biliary. 

Chloroform, is supposed by some to act as a solvent in 20- to 60-drop doses 
every 3 or 4 hours ; it cannot act as a solvent, but undoubtedly affords some 
relief (B.) ; as an inhalation it may be used to relieve the pain of the parox- 
ysm (Br.). Ether and Turpentine, equal parts of each, gj once daily for a 
year, is Durande's solvent remedy ; is not solvent, and as an anodyne inferior 
to morphine or chloral (B.). Morphine, gr. % with Atropine gr. T |^, hypo- 
dermically, the best anodyne for the pain and vomiting during the paroxysm 
(Br.). Chloral, sometimes relieves the pain (R.). Counter-irritants, as mus- 
tard poultices to relieve the pain during the paroxysm (Br.). Olive Oil, gij at 
night, followed next morning by 3 or 4 seidlitz powders an hour apart, efficient 
in facilitating the expulsion of accumulated gall-stones. Nitro-muriatic Acid, 
as bath, found useful in India to relieve the pain and promote expulsion of 
the calculus, Jjiij of the acid to a gallon of water (Scott). Sodium Phos- 
phate, in 3 doses before each meal for several months, to prevent recurrence 
(B.) ; should be given in plenty of water (Br.). Succinate of the Peroxide of 
Iron, hydrated, contains a large proportion of nascent oxygen, and is given 
in teaspoonful doses after meals for several months, and resumed at intervals 
afterwards, to prevent reformation of the calculi (Buckler). Diet, is impor- 
tant; withhold all starches, sugars and fats, also malt liquors and spirits ; mod- 
erate exercise out of doors, lean meats, eggs, fish, fruits and succulent veg- 
etables to be used freely. Mineral Waters, the alkaline are useful, especially 
Vichy, which is deemed of great benefit. [Compare Colic, Jaundice.] 

Prescriptions. 



R. Succinat. Hydrat. Ferri 

Peroxidi, . . . 5jss. 
Aquae, .... 3 v jss. 
M. Sig. — Teasp. after each meal for 
several months. 



R, Spt. Etheris Comp., . jij. 

Liquor. Magendie, . Tflxxx. 

Syr. Zingiberis, . ad t ^j. 
M. Sig. — Teasp. doses, an hour 
apart, until pain is relieved. 



Calculi, Renal and Vesical. 

Alkalies, especially potassium salts, if long continued will effect solution of 
uric acid calculi (R.); sodium salts should not be used (B.). Potassium 
Citrate, in large doses for bloody urine containing uric acid crystals (R.) ; the 
citrate and carbonate of potassium are the most desirable solvents for uric acid 
gravel (Sir H. Thompson). Potassium Tartra-borate, if long used, is very 
efficient as a solvent for uric acid calculi (B.). Potassium salts are much more 
efficient than those of Lithium as solvents for uric acid (Prof. Rogers). Alka- 
line Mineral Waters, those rich in potassium preferred, especially Vichy (B.). 
Ammonium Benzoate, long-continued will dissolve phosphatic calculi (B.). 
Magnesium B or 0- citrate, is a good solvent of uric acid calculi (Madsen). 
Lithium Citrate, to promote oxidation (Da Costa). Hydrangea, in decoc- 
tion, used by the Cherokees in all calculous affections with uniform success 
(Butler). Lead Acetate, gr. ^ to the 3 of distilled water, injected into the 
bladder to prevent formation of phosphatic calculi, or a solution of Dilute HCl 
Acid, TTLij— iij to the g (Sir H. Thompson). Nitric Acid, very dilute, as injec- 
tion for phosphatic calculi (R.); gtt. j to the ^, as injection into bladder in 
chronic cystitis and phosphatic deposits (B.). Cotton-root, in decoction, as a 



CANCER. 



545 



demulcent for strangury and gravel (P.)- Castor Oil, of value as a purgative 
(P.). Calumba, to relieve the vomiting (P.). Counter-irritants, as mustard- 
poultices, or turpentine stupes, to relieve pain of the paroxysm (R.). Ances- 
thetics, for the same purpose (B.). Morphine, hypodermically, as an anodyne 
and to relieve the vomiting (B.). Hot Fomentations , to alleviate spasm and 
pain while calculus is passing. Diet. Restrict the use of sugar in any form 
or combination, also fats and alcoholic beverages. Fresh, green vegetables 
may be used freely, also skimmed milk or buttermilk. Mineral waters, pre- 
ferably Vichy, Friedrichshalle and Carlsbad. Frequent abstinence from 
animal food. Lemon juice and soft water in large draughts, are useful. 
Surgical Measures. Lithotomy or Lithotrity for removal of stone from 
bladder. Solvents are of no use except for a very small calculus, and even 
then a considerable time must be occupied in the process. No operation in 
surgery more certainly safe, rapid and successful than lithotrity (Sir H. 
Thompson). [Compare Colic, Lithiasis, Oxaluria, etc.] 



Prescriptions. 



Magnesium Boro-citrate. 

R. Magnesii Carbonat., . £j. 

Sodii Biborat., 

Acidi Citrici, . aa 

Aquae Bullientis, 
M. Sig. — Tablesp. 3 or 4 
daily. 



Potassium Tartra-borate. 
R. Potassii Bitartratis, . partes iv. 
Ac. Borici, . . partem j. 

Aquse, . . . partes x. 
By heating the above together, the 
salt is obtained as a white powder, of 
which gr. xx in a large draught of 
water 3 or 4 times daily. 



Cancer. 

Arsenic, in cancer of stomach, diminishes pain and checks vomiting; also 
in scirrhus of stomach and epithelioma : is believed to retard the growth of 
uterine cancer (B.). Arsenious acid, pure or with starch, as a caustic; enough 
should be used to set up active inflammation (R.). Belladonna, locally and 
internally (TUv-x), of great benefit as palliative in severe pains of cancer (P.). 
Conium, as poultice, and internally to relieve pain (R.). Is particularly appli- 
cable to pain of cancer (P.). As palliative (Wa.). Hydrastis, has a renewed 
interest (Pf.). Carbolic Acid, undiluted, to sore, and injected beneath it, limits 
and retards (B.) ; pure, as anaesthetic, before applying caustics; with glycerin, 
as application to fetid cancers (R.). Mercuric Chloride, in small doses, long- 
continued, will retard the growth of gastric cancer (Da Costa). Citric Acid, 
Sjj-gviij aqua?, useful in allaying pain of cancerous ulcerations (Wa.). Acetic 
Acid, 1 to 3 aquae ; ""Ixxx injected into the tumors, has been used with varying 
success (Wa.). Chloral, in gr. x doses, 3 times a day, has relieved most 
severe pain of cancer (R.). Chloroform, as vapor to raw surface (R.). Hyos- 
cyamus, bruised leaves, locally (P.). Bismuth, relieves pain and vomiting of 
gastric cancer (B.). Glycerin of Tannin, with glycerin of carbolic acid, checks 
discharge and stench of uterine cancer (R.). Carbonic Acid, injected up va- 
gina in cancer of uterus, to relieve pain (R.). Iodoform, applied to diseased 
surface, relieves pain and removes fetid odor (B., P.). Resorcin, 15 parts to 
20 of Vaseline as an ointment twice daily after washing with a solution of pot. 
permanganate has successfully stopped epithelioma (Antonio). Potassium 
Chlorate, in impalpable powder, dusted on epithelioma, said to be curative 
(B.). Pepsin, injections into tumor (B.). Salicylic Acid, pure, applied in 

46 



546 CANCRUM ORIS CARBUNCLE. 

powder (B.). Zinc Chloride, the most efiFicient and safe escharotic. Parts j- 
ij -v flour, or •' caustic arrows" inserted at base of tumor (B.). Potassa Fusa, 
as escharotic (R.). Opium, to cancerous sores. Morphine, dissolved in gly- 
cerin and spread on lint, very useful where there is much pain. Opium is also 
used in cancer of the stomach (R.J. Codeine (gr. ^ to y 1 ^), a good hypnotic 
(P.). Zinc Sulphate, dusted over, dry. An excellent caustic. Remove the 
eschar by poultice (B. ,1. Bromine, for destruction of uterine cancer, is preferred 
by some (B.). Chromic Acid, a powerful escharotic (B ). Iron and Manga- 
nese, the syrup of the iodide, for resulting cachectic state (B. ). Poultices of 
starch, applied cold (R.) ; or poultices of bread, sprinkled with charcoal or 
freshly ground coffee, as deodorizers to open cancers. Warm Enemata, to 
relieve pain and straining in intestinal cancer (R.). 

Prescriptions. 
R . Bismuthi Subnit , . . £ij. R . Acidi Arseniosi, 1 . . Jjij. 
Morphinse Sulph , . gr. j. Mucil. Acaciae, . . . [jj. 

Fiant pulv. vj. Sig. — One thrice As paste on cancerous sore, followed 
daily in milk, when gastric pain and after 2 or 3 days by bread poultices 
vomiting. (B.) until slough separates. 



Cancrum Oris. 

Arsenic, in medicinal doses (R.i. Nitric Acid, to surface (R.); strong 
nitric acid the best caustic for worse forms of the disease Wa. . Potassic 
Chlorate, gr. xx-xl in 24 hours, has been strongly recommended (D.). Qui- 
nine, made into a syrup, or as enema, to support the strength (Wa.). [Com- 
pare Aphth.-e, Stomatitis.] 

Carbuncle, 

Belladonna, with glycerin, as local application to relieve pain (R., P., Wa.). 
Ammonium Acetate, to support the system (Cezard). Carbolic Acid, on lint, 
with glycerin or oil, into discharging sinuses (R.); or hypodermically into the 
sloughing tissues. Iodine, to produce vesication around carbuncle ; reduces 
inflammation 1R.1; part j of tincture to iij aquae, locally, has most striking 
effect (Wa.) ; maybe used with benefit internally or hypodermically (Cezard). 
Calcium Sulphide, gr. y 1 ^ hourly, or every two hours, of great service (R.). 
Opium, a thick extract, locally (R.j. Potassium Chlorate, highly recom- 
mended, also Quinine and Iron, freely to support the system and counteract 
the carbuncular poison. Poultices, the inflamed surface having been pre- 
viously smeared with belladonna and glycerin (R.j. Long-continued poul- 
ticing thought to create tendency to a fresh crop. Strapping, with plaster, 
concentrically from border inwards, leaving the centre free, will sometimes 
arre-t extension (R.). Collodion, as protective covering (P.); as zone 
around base, leaving the centre exposed Wa.). Collodium cum cantharide in 
a broad zone painted around the carbuncle, to relieve the tension ( Ag.j. Ice, 
or Ice-bags or iced-water on cloths in early stage, changing to warm fomenta- 
tions as soon as suppuration has begun (Hebrai. Galbanum and Opium as 
plaster to relieve pain, the separation of the core then proceeding painlessly 
(Hill). Crucial Incisions are not so frequently made now as formerly ; they 
relieve tension, but often give rise to severe hemorrhage. Diet should be very 
supporting, and stimulants may be used freely when the patient is debilitated. 



CARIES — CATALEPSY — CATARACT. 547 

Saline purges occasionally (Hill). Cauterization, with fuming nitric or 
carbolic acid, on top of a free, crucial incision, followed by dressing with 
carbolized oil, is the course to pursue in malignant pustule. Caustic Potash, 
applied before an opening occurs, or small pieces inserted into openings made 
by scalpel, to cause the rapid separation of the slough. The resulting ulcer 
should be treated on general principles. [Compare Boils.] 

Prescriptions. 



R. Calcis Sulphurat., . . gr. iij. 
Sacchari Lactis, . . q. s. 

Triturat. et div. in chart, xxx. 

Sig. — One powder every 2 hours, to 
be taken dry on the tongue. 



]£. Tinct. Ferri Chloridi, . gj. 
Potass. Chlorat., . . ziij. 

Liq. Ammonii Acetat., . t ^iij. 
Syrupi et Aquae, . q. s., ad^vW). 
M. Sig. — Dessertsp. every 2 hours. 



Caries. 

Aurum, in syphiloma of bones (B ). Calcium Chloride, where strumous 
cachexia (B.). Phosphoj'ic Acid, with 8 parts water, locally applied, has been 
of benefit (Wa.). Phosphates, best is syrup of lacto-phosphate of lime, or 
Parrish's phos. (B., R.). Vitiate 's Solution, to dissolve the carious bone, has 
cured many cases (B.) ; see formula below. Sarsaparilla, a very useful medi- 
cine (P.). Iodine, locally, with iron or cod-liver oil internally (Wa.) ; see 
Bone. Potassic Iodide, in syphilitic caries, holds the first place (Wa.). Cod- 
liver Oil, to promote constructive metamorphosis (B., R.). Mechanical Con- 
trivances, necessary in most cases ; Sayre's plaster jacket, Agnew's jacket of 
leather and steel, Taylor's apparatus, etc., are used in spinal caries to separate 
the diseased bones, and extend the spinal column. [Compare Necrosis.] 

Prescriptions. 

Vi Hate's Solution. 

&. Cupri Sulphat., 

Zinci Sulphat., aa partes xv. 

Liq. Plumbi Subacetat., p. xxx. 
Aceti, . . . . p. cc. 

To be injected through the sinuses. 



R. Syrupi Calcii Lacto-phos- 

phatis (U. S. P.), . . gviij. 
Sig. — A dessertsp. to a tablesp. 3 or 
4 times daily. 



Catalepsy. 

Turpentine, in enemas, and embrocations along the spine, affords the best 
chance of stopping the paroxysms (Wa.). Treatment must be essentially 
tonic and restorative (H.). No constant line can be stated (A.); external 
stimulation to arouse consciousness, by Ammonia, cold douches, Faradism, 
etc. Apomorphine, gr. ^ to T ^, in the paroxysm ; with the onset of nausea, 
consciousness returns and spasm ceases; in the intervals between the attacks 
the treatment should be that of hysteria (Gowers). 

Cataract. 

Phosphorus, with oil, by frictions to the forehead, and instillation of the 
same into the eye, may cause absorption of the lens or capsule (Wa.). Co- 
deine, in diabetic cases (Br.). Sodium Sulphate, a solution suggested as in- 



54^ CATARRH, ACUTE NASAL. 

jection into anterior chamber, in hope to dissolve the nebula (Wa.). Gal- 
vanism, has been successfully employed in incipient stage (Wa.). Mydri- 
atics, Atropine, Duboisine, etc., to secure full dilatation of pupil, as a means 
of ascertaining when the operation should be made, which is when the 
cataract is mature, there being no vision even with dilated pupil (Wa.). Diet 
and Regimen, may do much to retard degeneration of the lens, in cases due 
to diabetes, or malassimilation in gouty or rheumatic persons (C). Iridectomy, 
made early and effectually may postpone the progress of lenticular opacity, if 
due to increased intraocular tension (C). In partial cataracts, which have 
become stationary, iridectomy for artificial pupil may be done to expose clear 
portion of lens (Roosa). Medicine accomplishes nothing except to improve 
general health and so delay the progress of the opacity. Removal may be 
performed by one of several operations (Roosa). 

Catarrh, Acute Nasal. 

Aconite, in severe coryza with much chilliness, aching limbs, hot and dry 
skin, and quick pulse ; also in catarrhs of children and that accompanying 
measles (R.); In acute coryza (P.) ; with Belladonna in ordinary colds with 
sore throat and high fever (B.) ; in doses of ""l 1/3 every % hour, very useful 
for a commehcifig cold in the head (A. A. Smith). Belladonna, in acute 
nasal catarrh with profuse watery secretion, Tit v of tincture, then tix j each 
hour (B.). Nux Vomica, has great effect upon a dry cold in the head (P.). 
Euphrasia, is of decided utility in coryza (P.). Pulsatilla^ a warm lotion, ^j-ij 
in ^iv aquae, syringed into the nasal passages in subacute coryza with muco- 
purulent secretion (P.); acts similarly to Aconite, but is contraindicated if 
much gastric or intestinal irritation exists (B.). Iodine, by inhalation in daily 
attacks with itching nose (R.) ; -spj of the tincture with gj of carbolic acid 
inhaled from a sponge in the bottom of a wide-mouthed bottle placed in hot 
water (B.). Iodides, are unquestionably serviceable, their action being local 
and substitutive ; Ammonium Iodide, gr. j every two hours, the best mode of 
using them (B.). Sodium Iodide, gr. x ter die, with PH. Ferri Iodidi, in ca- 
tarrhs of specific origin (B.). Potassium Iodide, gr. x at bedtime at the on- 
set, to cut short an acute cold in the head; also useful in chronic colds (R.). 
Quinine and Morphine, gr. x with gr. j/£, at incipiency, will often abort (B.). 
Opium, at night, if taken early, will often abort an attack of coryza ; a glass 
of hot grog assists its action (R.) ; Dover's powder, in a full dose at the onset 
may abort (B.). Codeine, is useful in common colds, as a palliative (B t ). 
Ammonia, maybe inhaled in the early stage (R.). Potassium Chlorate, 8 or 
io lozenges a day will abort many a cold (R.). Camphor, as inhalation, the 
spirit in form of vapor (R.); with Opium and ammonium carbonate as 
powder (see formula below), to break up or modify a cold (Beard). Tartar 
Emetic, gr. ■£$ to T ^ in the first stage (B.) ; in acute catarrh of children often 
accompanied by vomiting and diarrhoea (R.). Arsenic, when sneezing, itch- 
ing of nostrils, frontal headache (R.) ; as cigarettes (B.) ; see under Asthma, 
for formula. Veratrum Viride, if arsenic fails (R.). Ipecacuanha, for acute 
nasal and bronchial catarrh, and ordinary colds in children (B ). Cimicifuga, 
when headache, stiff muscles, dull aches, bone-pains, etc. (R .); an excellent 
expectorant (B.) ; rheumatic colds, neuralgic pains in jaws (P.). Jaborandi, 
the fluid extract in doses of m_x to xxx, every half-hour until profuse dia- 
phoresis sets in, is one of the best modes of aborting a cold. Cocaine, a 4 or 
5 per cent, solution locally as spray, to empty the engorged venous sinuses of 



CATARRH, CHRONIC NASAL. 



549 



the nasal mucous membrane, by their contraction, which it induces. The 
fluid extract of Erythroxylon diluted with water is equally efficient if enough 
be used (Cohen). Cubed, or Ammonium Chloride, in the dry,*congestive 
stage of a cold in the head ; Cubeb cigarettes may be smoked as a temporary 
palliative with great relief. Sulphurous Acid, in coryza, by inhalation, spray 
or fumigation, is very efficient (R.). Oil Inunctions, daily to the whole body, 
in cases of undue susceptibility to taking cold, will prevent the frequency of 
the attacks (B.). Baths, a warm foot-bath before going to bed; Turkish 
bath, at onset in coryza, may prove abortive ; also useful later on. Cold sponge 
bath, in cases of extreme susceptibility, supplemented by occasional Turkish 
baths (R.). [Compare Cough, Hay-fever, Influenza.] 

Prescriptions. 



R. Camphorse, . . . gr. 1. 
^theris, . . . q. s. 

Dissolve to creamy consist- 
ence, then add — 

Ammonii Carbonat., . gr. xl. 
Pulv. Opii, . . . gr. x. 

Divide into thirty papers. 
One or two powders, according to 
age, twice or thrice daily. [Beard.) 



R. Acidi Carbolici, . . gr. lxxx. 
Alcoholis, . . . ^ss. 
Aq. Ammoniae, . . Tnjxxx. 
Aquae, . . . ^ijss. 

M. Sig. — A few drops as an inhala- 
tion from a cone of blotting-paper. 

(Brand.) 



R. Codeinae, . . . gr. ij. 

Syrupi Tolutam, 

Syr. Scillae Comp., . aa^j. 
M. Sig. — Teasp. occasionally for a 
common cold. (B.) 



R. Tinct. Aconiti, . . . ""I x. 

Tinct. Belladonnae, . . £ss. 

Syrupi Zingiberis, . ad ^ij. 
M. Sig. — Half to one teasp. accord- 
ing to age, every hour. 



R 



Ferrier's Snuff. 
Morph. Hydrochlor., 
Bismuthi Subnit., . 
Pulv. Acaciae, 
M. Sig. — Use as snuff, ) 
above in 24 hours. 



to 



g r - ij. 

3 V J- . 
3*1- 

r /the 



Catarrh, Chronic Nasal. 

Sanguinaria, the tincture in 10-drop doses thrice daily, or gr. T ^ of the 
alkaloid, internally, and the powder in small quantity locally to the mucous 
membrane, is successful treatment for chronic nasal catarrh (B.). Hydrastis, 
is of value in chronic coryza, also in ulceration of the septum or any other 
part of the nasal fossae, gtt. v of the tincture thrice daily internally, and gj to 
5viij of water locally with syringe (P.). Pulsatilla, is excellent in subacute 
inflammation of nasal passages, with offensive muco-purulent discharge. £J-ij 
ad Jiv of water, as wash (P.). Potassium Bichromate, is an excellent local 
application in a solution of gr. j-x to ^iv water (B.). Iodoform and Tannin, 
I of the former to 2 or 3 of the latter, carefully triturated, and applied by an 
insufflator every other day only, is the very best of all applications (B.). 
Sodium Chloride or Phosphate, a teasp. to the pint of warm water as cleansing 
solution, or the Bica7'bonate in the same proportion. A sea-water gargle in 
the naso-pharyngeal space, has been used with success (Mosler). Wei 
de Meyer's Catarrh Cure is simply bicarbonate of sodium and a little pink 
coloring matter (Robinson). Potassium Permanganate, gr. j-x to the pint of 
warm water, as a deodorant solution when necessary. Ammonia, by inhala- 



55° 



CATARRH, CHRONIC NASAL. 



tion, when painful inflammation of nasal mucous membrane and frontal bones 
(R.). Carbolic Acid, a I per cent, solution as spray, or inhalations of the 
vapor with that of iodine from a bottle in hot water, or vaporized by the 
warmth of the hand (B.). Salicylic Acid, in weak solution, I to 500 of water, 
as a disinfectant and astringent injection, used with a retro -pharyngeal syringe, 
and followed by applications of powdered Calomel, through a speculum, upon 
the ulcerated parts of the mucous membrane (Massei). Cubebs, finely pow- 
dered and blown into the nares by an insufflator (B.) ; have proven very useful 
(P.) ; may be smoked, and administered internally in teasp. doses (Wa.) ; in 
freshly ground powder, as a confection (see below for formula), very efficient 
in follicular disease of the naso-pharyngeal space (Robinson). Am??ionia- 
cum, in the same condition, very small doses, gr. j— iij, with ipecac, or carbonate 
of ammonium, will greatly lessen the amount of secretion (Robinson). 
Bismuth, in powder, with gum acaciae, as in Ferrier's snuff (see above for 
formula), or with tannin, calomel, iodoform, etc., used by insufflation, daily 
(Robinson). Aurum Chloride, in mercurialized and syphilitic subjects, with 
offensive discharge, depressed spirits, and soreness of the nasal bones. Iodides, 
of iron and sodium, in catarrh of specific origin (B.). Silver Nitrate, in pow- 
der, as alterative application, gr. x-xv to the ^ of menstruum, is often a useful 
adjunct to treatment, used once every 4 or 5 days (Robinson). Cod-liver Oil, 
should be used in strumous subjects (R.). Alum, in powder, dusted over the 
affected surface, is a useful application (B.). Eucalyptus, has been employed 
with benefit (Wa.). Bromine, the vapor may greatly benefit, but must be used 
with caution (B.). Senega has been found serviceable (Wa.). Douche is 
dangerous, being likely to cause extension of the catarrh to the Eustachian 
tube and the middle ear. It has been very generally abandoned. Sprays by 
hand-ball atomizers, or compressed-air apparatus, of warm watery solutions, 
vaseline, etc., are used with considerable success (Cohen). The Hank's 
atomizing tubes, with a 2-ball rubber syringe, are very serviceable for office 
use, and for the application of RumbolcTs hot vaseline spray, (See formula 
below.) Sulphur Waters, internally, of great benefit in follicular disease. 
(Robinson.) [Compare Oz^ENA.] 



Prescriptions. 



R 



Acidi Carbolici, . . "Nix. 

Glycerini, . . . ^ij. 

Vaselinae, . . . §ij. 

M. Sig. — Warm and use as a spray 

every 4 hours. (Rumbold.) 



R. Pulv. Argenti Nitrat., . gr. vij. 
Pulv. Acaciae, . . gj. 

Bismuthi Subnitrat., . ^iij. 
Triturat. Sig. — Apply with insuf- 
flator once in 4 or 5 days. 

(Robinson.) 

R . Bismuthi Subcarb , . £vj . 

Morph. Muriatis, . . gr. ij. 

P»lv. Amyli, . . . spj. 
Triturat. Sig. — Burness' modifica- 
tion of Ferrier's snuff. 



Taxi. 



R. Acidi Carbolici, 
Sodii Boratis, 
Sodii Bicarbonat., . aa ^ij. 
Glycerini, . . . £vij. 

Aquae, . . q. s. ad'^vu]. 

M. Sig. — Use daily as spray. 

(DobelL) 



R. Sodii Boro-benzoatis, 

Ext. Hydrastis Fl., . 

Glycerini, 

Ac. Carbolici, . 

Aquae Camphorae, . 

Aquae, . . q. s. ad ^xij. 
M. Sig. — Use with syringe or atom- 
izer thrice daily. (Chamberlain.) 



CEREBRAL ANEMIA CEREBRAL CONGESTION". 



SSI 



R . Bismuthi Subcarb., 

Pulv. Acacise, . aa. £ss. 

Zinci Sulphat., . . gr. x. 

Morph. Sulphat., . . gr. ij. 

M. Sig. — Snuff, to be used thrice 
daily. (Sajous.) 



R . Pulv. Cubebae, 
Syr. Aurantii, 
Aq. Menth. Pip.. 
Aquae, 
Ft. mistura. Sig, 

every 3 or 4 hours. 



q. s. ad%v\\y 

■A teaspoonful 



R. Sodii Salicylates, . . ^ij. 

Sodii Boratis, . . . gUJ. 

Glycerini, . . . 3ss. 

Aquae, . . q. s. ad $x). 

M. Sig. — Of this put a dessert- 
spoonful into a pint of warm water, 
and snuff it from the hollow of the 
hand thrice daily. [Sajous.) 



R. Sodii Iodidi, . 
Syrupi Picis Liq., 
M. Sig. — Dessertsp. 

with Pil. Ferri Iodidi 
thrice daily, in chronic 



[Robinson.) ■ of specific origin. 



. gss. 

thrice daily 
(U. S.) one 
nasal catarrh 



Cerebral Anaemia. 

Iron, the tincture of the chloride, or mild chalybeate waters, in chronic 
cases from general anaemia (B.). Amy I Nitrite, in vaso-motor spasm; affords 
relief in sudden attack (B.). Chloral, in small doses, with stimulants, warm 
baths ( Ros.). Camphor, or other cerebral excitants, as asafoetida, valerian, 
serpentaria (B.). The mono-bromide of camphor in one to five grain doses 
(Hammond). Glonoinum, mj of 1 per cent, soluticn (P.). Phosphorus, sup- 
plies the needed material for healthy brain-action (B.). Strychnine, stimu- 
lates the circulation generally; as a tonic with iron preparations. Galvanism, 
a mild current transversely through the head, gives excellent results in the 
confusion of mind, vertigo, etc., due to imperfect nutrition of the brain from 
atheroma of the cerebral vessels (B.). Arsenic, is highly efficient in some 
hypochondriacal cases (B.). Aurum, is of great utility in vertigo, melan- 
cholia, etc., when due to or accompanied by cerebral anaemia (B.). [Com- 
pare Insomnia.] 

Cerebral Concussion. 

Arnica, when from a fall, cannot be too highly spoken of (P.). Warmth, 
to extremities, rest, expectant treatment, will suffice in mild cases (Ag.). The 
indications are: (1) to recover from insensibility and collapse; (2) to prevent 
inflammation; (3) to restore impaired faculties (D.). Stimulants, or Venesec- 
tion, cannot be too strongly reprobated (Ag.). 



Cerebral Congestion. 

Aconite, in active form, renders important service (B.). Is much the best 
remedy in this condition (P.). Belladonna, one of the best remedies in all 
hypersemic conditions of the brain or spinal cord (P.). Gelsemium, v\y of the 
fluid extract every 2 hours, very useful ( B.). Bromides, are very useful (B.) ; 
must be used in full doses. Colocynth, as counter-irritant, appears to act well 
I P. !. Cathartics, lessen blood-pressure (B.). Colchicum, in plethoric subjects 
(B. 1. Galvanism, of brain and cervical sympathetica ( B. ). Chloral, when tem- 
perature high iB.'i. Arsenic, sluggish venous circulation, torpor iB. 1. 
Hydrocyanic Acid, Htfj-v of Scheele's dilute acid (B.) Venesection, will 



552 CEREBRAL SOFTENING — CHANCRE CHANCROID. 

prevent injury to brain. Not to be adopted as a matter of course. It is con- 
traindicated when anaemia, aortic valvular disease, or in cases commencing 
with syncope (A.). Water, cold douche to head, feet in warm water : ice and 
hot water alternately to head and nape of neck, often more effective than ice 
alone (B.). Hot water to head on flannels: mustard and hot-water packing, 
for 20 to 30 minutes, around legs, when active congestion. Protect bowels well 
(R.). Diet, should be low, but not too low, until all fear of relapse past. Full 
animal diet should be avoided, also undiluted wines (A.). [Compare Apo- 
plexy, Coma.] 

Cerebral Softening. 

Vensection, and antiphlogistic treatment generally, most beneficial in red 
softening, result of inflammation. Require wise discretion, and should be 
used early. Not to be thought of in the yellow form, from want of nutrition : 
where restoratives and food, perhaps wine (A.). Phosphorus, in threatened 
softening of the brain; is the only drug which affects the nerve-centres (W.). 

Chancre. 

Mercury, small doses steadily, ptyalism must not be induced. Black-wash 
(calomel gr. viij, aq. calcis ^j), or yellow-wash (hydr. chlor. corr. gr. j, aq. 
calcis ^j), on lint, to erosions and ulcerated indurations (B.). Calomel alone 
as dry dressing. Internal use of mercury best postponed until secondary 
symptoms appear (St.). Carbolic Acid, as wet dressing, gr. ij of crystals to 
^iv aquae ter die (St.). Iodoform, heads the list of dry dressings ; with lyco- 
podium, equal parts, or 1 to 2 zinci oxidi ; 2 to 1 hydr. chlor. mite (St.). Hy- 
drogen Peroxide, said to destroy the specific character. Wash lesion ter die, 
and apply lint soaked in it (R.). Caustics, should never be used unless chan- 
cre attacked by phagedena (St.). Caustic Alkalies, to hard edges (R.). Bro- 
mine, Chromic Acid, best escharotics (B.). Dressings, are effective as far as 
the local trouble is concerned in the majority of cases ; sometimes a piece of 
lint on the erosion will suffice. Never cauterize an initial lesion unless it is 
attacked by phagedena (St.). Cleanliness, of great importance; tepid water 
locally frequently suffices for the outward treatment of infecting chancre. 
[Compare Syphilis.] 

Chancroid. 

Mercury, the acid nitrate one of the best caustics ; apply with a glass rod 
(B.). Nitric Acid, fuming, as caustic (B., R.) ; ^j to 5viij aquae is an excel- 
lent dressing (St.). Carbolic Acid, injected into sore (B.) ; ^ij-v to Oj aquae 
locally in phagedena (St.). Ferri et Potas. Tartras, the "born enemy of 
phagedena" (Ricord) ; gj to gvj aquae, internally, teasp. doses thrice daily; 
also locally (St.). Ferric Iodide, in sloughing phagedena, or simple c. in de- 
bilitated constitutions (B.). Iodoform, powdered and dusted over the sore, 
allays pain, changes morbid action, and is antiseptic (B., R.) ; 1 part to 2 of 
lycopodium, or one of tannic acid; as stimulant and alterative (St.). Does 
no good except to relieve pain (Gross). Potassium Chlorate, in impalpable 
powder, is better than iodoform (B). Chloral, gr. iij ad ^j aquae, the best 
local application to relieve pain (Gross). Caustics, in severe cases; the 
white iron, strong sulphuric acid, pure nitric acid, pure carbolic acid, are ef- 
fective in the order named (St.). [Compare Bubo.] 



CHAPPED HANDS AND LIPS — CHILBLAINS. 



553 



Chapped Hands and Lips. 

Sulphurous Acid, as solution, or by fumigation, will speedily cure (R.). 
Glycerin, diluted, or better still, glycerin of starch, or with y^ the quantity of 
eau de cologne (R.). Benzoin, the comp. tinct., I part to 4 of glycerin; an 
admirable application (P.). Hydrastis, on compress, as lotion (P.). Collodion, 
is usefully employed (P.). Carbolic Acid, I to 2 of glycerin, locally ; one ap- 
plication is generally sufficient. Unguentum Aquce Rosce alone, is often 
efficient ; may be combined with oxide of zinc. 



Prescriptions. 



a 



Resinae, . 
Cerae Albae, 
Adipis, . 
Zinci Oxidi, 



3- 

Si- 

£ V1 J- 



R. Cetacei, 
Glycerini, 
Cerae Albae, . 
Ol. Ajnygd. Amarae, 



3J- 

gr. xv. 
Ittfij. 



Chest-pains. 

Belladonna, as ointment, when tenderness is in skin (pleurodynia) (R.). 
Iodine, oint ; pain in muscles (myalgia) of chest, they being tender on pres- 
sure, while the skin may be pinched without pain (R.). Strychnine, affords 
relief in functional irritability of the nervous system, manifested by wander- 
ing neuralgic pains (B.). Arnica, for a " stitch " in the side. Bryonia, when 
painful catching of breath. Cimicifuga, for intercostal rheumatism and pains 
under the breasts in women. 

Chicken-pox. 

Aconite, is of great value (B.). Water, hot and cold baths and packs are 
of great utility; cold, if hyperpyrexia; cold compress if sore-throat; hot or 
warm pack when free diaphoresis required (B.). Treatment, precautionary 
only required. Avoid exposure to cold and wet ; maintain the action of skin 
and bowels (H.). Acetate of Ammonium, in diaphoretic and antifebrile mix- 
ture. See Fever, Simple, for formula. Inunction, with camphorated oil, or 
thin starch, to relieve itching and allay inflammation (P.). 



Chilblains. 

Arnica, a useful application (Wa.). Iodine, ointment, the best application 
(R.). Carbolic Acid, an efficient application is an ointment of carbolic acid and 
iodine (B). Benzoin, the tincture in glycerin, applied after thorough wash- 
ing in soap and water and drying, the best application. Sulphurous Acid, 
an efficient application; giij-gj each of water and glycerin (B.); as solution 
or fumigation (R.). Balsam of Peru, in ointment for broken chilblains (R.). 
Capsicum, tinct. painted over unbroken chilblains (R.). Cajuput Oil, applied 
locally (R.) Turpentine, as wash, then apply basilicon ointment mixed with 
turpentine (B.). 

Prescriptions. 

r. 



. Acidi Carbolici, 


• 3h 


R. Tinct. Benzoini, 


- 3fr 


Tinct. Iodi, 


• 8JJ- 


Olei Lini, 


• 3 1V - 


Ac. Tannici, . 




Cerae Flavae, . 


. m- 


Cerati Simplicis, 


• 3 lw - 


Glycerini, 


. q.s. 


M. Sig. — Ointment. 


(B.) 


M. Sig. — Ointment. 


(Reveil.) 



554 



CHLOROSIS — CHOKING CHOLERA ASIATICA, 



Chlorosis. 

Iron, combined with arsenic or strychnine. Occasional purgation and ac- 
tive exercise. Also chalybeate waters for blood deficiencies (B., R.) ; is not 
a specific in chlorosis, and acts best in the purest types (Tr.) ; the iodide, 
when much torpor of the system, is often speedily efficacious (Wa.). Arsenic, 
if iron fails, or disagrees (B.). Ergot, in chlorotic amenorrhcea (P.). Man- 
ganese, the saccharated carbonate of manganese and iron (B.). Nux Vomica, 
stimulates the bloodmaking organs, and may be combined with iron. A very 
generally useful preparation is the syrup or elixir of iron, quinine and strych- 
nine (B.). Cocculus Indicus, with amenorrhoea and exhausting leucorrhcea 
(P.). Hypophosphites, of lime or sodium (R.). Benzoin, has been used with 
advantage (P.). Pepsin, benefits, especially where digestive derangement 
(B.). Oils and Fats, as inunctions after baths, of great benefit (B.). Gal- 
vanization, central ; will aid the action of the remedies (B.). [Compare 
Anaemia, Amenorrhcea.] 



Prescriptions. 



R. Ferri Arseniatis, . . gr. ij. 
Extracti Cinchonae, . gr. xij. 
Fiant pil. xij. Sig. — One after each 
meal. (B.) 

R. Ferri Sulph. Exsiccat., . gr. xl. 
Quininae Sulphatis, . gr. xx. 
Strychninae Sulphat., . gr. ss. 
Ft. pil. xx. Sig. — One thrice daily. 



gr- 
g r - 



v. 

XV. 



R. Pulv. Aloes. Socot., . 
Ferri Sulph. Exsiccat., 
Ol. Tanaceti vet 
Ol. Sabinae, . . gtt. xxx. 

Myrrhae, Croci, 

Cantharidis, . aa gr. xxx. 
Ft. pil. lx. Sig. — Two thrice daily, 
gradually increased to four. 

( Wallace.) 



Choking. 

Potassic Bromide, benefits a curious affection, sometimes found in children, 
who from their birth can swallow solids with ease but choke at drinks (B.). 
Oil of Cajuput, in one case of persistent "choking " sensation in the throat, 
a few doses removed the symptoms which had lasted several weeks (Hale). 



Cholera Asiatica. 

Camphor, a drop or two of the saturated tincture, or v-x drops of the spirit's 
with a little opium every half-hour (B.) ; gtt. iv-vj of strong spirits every ten 
minutes until symptoms abate, then hourly (R.). Arsenic, in epidemic chol- 
era: some cases of arsenic poisoning not distinguishable from cholera (B.) ; 
for the vomiting and in collapse (R.). Copper salts have been given (R.). 
Turpentine, Titx-xx every two hours promises to be a remedy of value (Wa.). 
Chloral, as injection, the most efficient treatment, especially when morphine 
and atropine are given coincidently (B.). Chloroform, a few drops frequently 
repeated, or x-xxx drops of chlorodyne, of great value (B.). Opium, fo to 
\ gr. morph. hypodermically in preliminary diarrhoea (B., P.) ; % to }( gr. of 
the greatest value, even in collapse (R.); dangerous if kidney complications 
exist (P.). Lead, the acetate in early stages (R.). Carbolic Acid, with iodine, 
has given good results (B.). Sulphuric Acid, the aromatic, with opium, is 
very effective (B.); two parts of the former with one of laudanum, of this 5 
to 30 drops as per age, is one of the best prophylactics (McClellan). Strych- 



CHOLERA INFANTUM. 



555 



nine, as prophylactic during the preliminary diarrhoea, and in epidemic when 
nearing collapse (B.). Alcohol, small doses of iced brandy for vomiting (B.). 
Spinal Ice-bag, for cramps (R.). Saline Injections, into the veins, have 
been successful in the collapse (B.). Transfusion, of milk, in collapse (B.). 
Absolute Rest, recumbent posture, no food, ice ad libitum ; enemata of warm 
milk ; fresh air, friction and heat to abdomen, legs and feet ; stimulants worse 
than useless. 

Prescriptions. 



K. Chloralis Hydrat., . 

Morphinae Sulph., . 

Aquae Laurocerasi, . 
M. Sig. — Fifteen to twenty 
as injection hypodermically. 



R. 



3 u h 

gr. lv. 

drops 
(B.) 



&)> 



M 



Chloroform i, , 
Tinct. Opii, 
Spt. Camphorae, 

Tinct. Capsici, . aa £vss, 

Alcoholis, . . . §j. 
. Sig. — 30 to 60 drops in water. 
(Squibb' s Cholera Mixture.) 



R . Acidi Carbolici, . 

Tinct. Iodi, 

Aq. Menth. Pip., . 
M. Sig.— A tablesp. 
oftener. 



every 



gr. iv. 
gtt. xvj. 
giv. 
hour or 
(B.) 



R. Acidi Carbolici, . . gr. viij. 

Bismuthi Subnit., . . %i). 

Mucil. Acacia?, 

Aquae Laurocerasi, aa Jj* 
M. Sig. — Teasp, every hour or two 
for vomiting and diarrhoea. 



Cholera Infantum, 



Ipecacuanha, greenish stools with mucus and often blood (B.). Arsenic, 
for vomiting and collapse (R.). Mercury, gr. ]/$ of gray powder hourly of 
great service in infantile cholera with incessant sickness, profuse almost con- 
tinuous diarrhoea, offensive and nearly colorless stools. A starch injection, with 
a minute quantity of laudanum, assists the gray powder, and should be given 
in urgent cases (R.). Zinc Oxide, with bismuth and pepsin, is very useful 
(B.). Camphor, ^j-^iv of milk, very serviceable (B.) ; an admirable remedy 
for summer and choleraic diarrhoea (R.). Opium, generally necessary. Ene- 
mata of starch and laudanum (see above under Mercury). Morphine, hypo- 
dermically, in doses of gr. ^j^ to -fa according to age, the latter dose for a 
child of one year, with 5 or 6 drops of ether, to be repeated in an hour, the 
most efficient treatment (E. Smith). Copper Sulphate, often very successful 
(B.). Carbolic Acid, with Bismuth, may arrest the disorder promptly (Br.). 
Lead Acetate, is one of the most useful astringents in this complaint (Br.). 
Potassium Bromide, when due to nervous irritation or cerebral congestion 
(B.). Silver Nitrate, is beneficial after the acute symptoms have passed (B.). 
Caffeine, when due to nervous irritation (R.) Coto Bark, the tinct. gtt. j-iij 
is highly recommended by Rohrer for choleraic diarrhoeas of children. Alcohol, 
in grave cases, with tendency to collapse, gtt. x-xx of brandy with milk every 
30 to 60 minutes. Diet. Farinaceous food a common cause. Cow's milk O^ 
with sacch. lactis gj to O^ aquae-bul., or cold milk with lime-water (R.) ; 
milk, animal broths; no starches or fats (B.). Drinks, as water, weak tea, 
etc., freely, to keep vessels filled and prevent paralysis of the heart (Meinert). 
Spice Poultice, to abdomen, composed of cloves, ginger and cinnamon, mixed 
with brandy or whiskey. Mustard Bath, in stage of collapse, with mustard 
over the heart, and ether hypodermically (Smith). 



556 



CHOLERA SIMPLEX CHORDEE. 



R. Acidi Carbolici, 

Bismuthi Subnit., . 
Mucil. Acaciae, 
Aquae Menth. Pip., 
M. Sig. — Teasp. every 2, 

hours. 



Prescriptions. 



j' 



gr. iv. 

or 4 
(B.) 



R 



. Acidi Carbolici, 
Spt. Vini Gallici, 
Aquae Menth. Pip., 
Mucil. Acaciae, . 
Syr. Papaveris, . 
Tinct. Opii Deod., 

M. Sig. — A teasp. every 



gr. xxiv. 
gtt. xxiv. 

o v J- 
gtt. x. 

2 hours. 



R. Cupri Sulphat , . . gr. j. 

Tinct Opii Deod., . gtt. viij. 

Aquae Destil., . . ^iv. 

M. Sig. — Teasp. every 2, 3, or 4 

hours for a child of one to two vears 

old. '(B.) 



R 



. Plumbi Acetat., . . gr. xxiv. 

Pulv. Opii, . . gr. xij. 

Pulv. Camphorae, . Jss. 

Sacch. Lactis, . . q. s. 
Triturat. et div. in chart, xij. 
Sig. — One even- hour. (B.) 



R 



gr-^To- 



R . Hydrarg. Chlor. Mitis, gr. A. 
Bismuthi Subnitrat., . gr. ij-v 
In powder every half-hour for the hour or hour for the acute gastric 

vomiting and purging. symptoms. 



Hydrarg. Chlor. Mitis, gr. \ 
Plumbi Acetatis, . gr. \ 
Opii, 
Ft. pulv. no. j. Repeat every half 



Cholera Simplex. 

Camphor, an admirable remedy (R., B.). Ve rat rum Album, for the vom- 
iting (R.). Copper Salts, have been given (R.). Arsenic, for vomiting; also 
for collapse in latter stages (R). Chloral, by injection, the most efficient 
treatment (B.). [See C. Asiatica for formula.] For the cramps Chloral 5j, 
in Lin. Saponis giv-vj, applied with friction to the abdomen (Da Costa). 
Carbolic Acid, with bismuth, very effective (B.). [See above, C. Infantum.] 
Lead, the acetate, in early stages (R.). Opium, gr. %-% morphine, hypo- 
dermically ; very useful (B.). Gr. *£, Jf , or ]/ 2 opii, every 2, 4, or 6 hours, in 
early stage (P.)- Calumba 9 as anti-emetic, of great value (P.). Ipecacuanha, 
has been used with much advantage (Wa. ). Sumbul, said to have proved 
successful (P.)- Mustard, as an emetic in collapse, to stimulate a failing 
heart (P.). Cajuput Oil, much used in India for choleraic affections | P. }. 
Alcohol. Iced brandy in small doses for vomiting ( B.). The value of stimu- 
lants justly doubted; if given, should be largely diluted (Wa.). [Compare 
Cholera Asiatica and Infantum, above.] 



Chordee. 

Aconite, gtt. j hourly, will relieve (R., P.). Belladonna, combined with cam- 
phor or opium, gives the best results of remedies administered internally (St). 
Camphor, gj doses of the spirit will relieve (R.). Cant harts, gtt. j ter die, 
will prevent (B., R.). Cannabis Indica or Cannabis Sativa (P.). Lupulin, 
valuable (P.) ; said to prevent (B.). Morphine, hypodermically, the one sure 
remedy; should be injected into the perineum at bedtime (St.). Diet should 



CHOREA — CHOROIDITIS. 557 

be plain, even low, no stimulants ; copious draughts of barley-water or lin- 
seed tea. 

Prescriptions. 



R. Liq. Morph. (Magendie), . ^iv. 

Atropinae Sulphat., . . gr. j. 

Acidi Acetici, . . . q. s. 

Aquae Destillat., . ad gj. 

M. Sig. — "niv-viij hypodermically 
at bedtime. (St.) 



R . Pulv. Opii, . . . gr. xij. 
Pulv. Camphorae, . gr. xxiv. 

Sacch. Alb., . . q. s. 

Fiant capsulae xij. 

Sig. — One at bedtime, to be repeated 
in 2 hours if required. (St.) 



Chorea. 

Cimicifuga, in cases due to menstrual derangement, is very useful (B., P.) ; 
when rheumatic history (R.); a very valuable remedy (P.). Strychnine, in 
doses gradually increasing to toxic (Tr.) ; minute doses (gr. fa to fa) have 
been of much use when from fright or commencing puberty (B.) ; Arsenic, 
large doses required, "lUv ter die, when non-anaemic (B.); very successful in 
uncomplicated cases (R.). Zinc, the Sulphate has similar action to Arsenic, 
but is inferior (B.). In large and increasing doses it is very useful (R.). Iron, 
large doses of the Subcarbonate in anaemic cases, about the time of puberty 
(B.). Chalybeate waters often relieve or cure. Arsenic generally better, 
unless anaemia coexists (R.). Hyoscyamine, gr. ^J 7 ter die, gradually in- 
creased, has cured cases which resisted all other remedies (Da Costa). The 
mydriatics are very suitable in nervous, delicate children. Copper. Cupr. 
Ammoniatum has been used successfully (B.). Veratrum Viride, has been 
employed (R.). Cocculus, picrotoxine, large doses (B., P.). Conium, in large 
doses, to quiet muscular agitation (B.); is only palliative (R.); evidence con- 
tradictory as to its value (P.). Valerian, said to restrain the movements (R.). 
Useful when from worms (P.). Chloral, contributes to a cure by inducing 
quiet sleep (B., R.). Chloroform, inhalations, often of great service in severe 
cases (R.). Morphine, -with Chloral, hypodermically in large doses, for severe 
cases (Tr.) ; when the movements prevent sleep (R-). Physostigma, is 
recommended (R.) ; — of doubtful benefit (B.). Musk, has been given (R.). 
Cod-liver Oil, in low nutrition (B., R.). Water. Cold affusion to head and 
spine, and cold baths, important (B.); not to be used if rheumatism, fever, or 
pain in joints. Tepid water first (R.). Galvanism, the constant current, used 
by Benedict in twenty cases, all recovering. Galvanic chain around neck and 
down the back. 

Prescriptions. 



R. Tinct. Ferri Chloridi, . Jj. 

Liq. Acidi Arseniosi, . . # ^ij. 

Syr. Limonis, . . . ^ss. 

Syr. Simplicis, 

Aquae, . . aa q. s. ad giv. 
M. Sig. — Half a teaspoonful thrice 
daily, after meals, gradually increased, 
and effects carefully watched. 



R. Chloralis Hydrat., . . Ziv. 

Tinct. Hyoscyami, . . ^j. 

Syr. Limonis, . . . # 5j. 

Aquae Cinnamomi, . . ^iv. 

M. Sig. — A teasp. 3 or 4 times 
daily, according to age. 



Choroiditis. 

Mercury, as in iritis ; cannot be borne to the same extent as in latter dis- 
ease (A.). Opiates, necessary externally and internally to overcome pain 



558 CLIMACTERIC DISORDERS COLIC, INTESTINAL. 

(A.). Treatment i is generally the same as in corresponding forms of iritis, 
but when atrophic spots appear on the choroid, no treatment can repair the 
damage (A.). Rest of eyes and protection from light by blue glasses. In 
suppurative form (panophthalmitis) use Atropine in strong solution, with ice 
compresses and leeches in early stage. Paracentesis repeatedly to relieve ten- 
sion and give exit to pus. Canthoplasty of outer canthus to relieve the pres- 
sure of the lids (Roosa). 

Climacteric Disorders* 

Aconite, for nervous palpitations, and restlessness or " fidgets ;" gtt. j hourly 
(R.). Cimicifuga, for distressing headache (R.). Nitrite of Amyl y in small 
doses when the "heats'' predominate, followed by cold, clammy, pale skin 
(R.). Ergot, for the flooding, gr. ij of Squibb's extract in fresh pill every hour 
until relieved. Cannabis Indica may be well combined with it. Cannabis 
Indica, is used in the headaches of the menopause with uniformly good results. 
[See Headache, for formula.] Nux Vomica, Opium, and Bella donna, when 
symptoms described under Iron are limited to head and face (R.). Iron, for 
flutterings of the heart, with fullness of head, heat and weight on the vertex, 
frequent flushings, and hot and cold perspirations. Large doses of Sesqui- 
chloride ter die (R.). Ammonia, Raspail's sedative lotion to painful part of 
head, in headaches (R.). Potassium Bromide, for despondency, with sleep- 
lessness and irritability, often also with heats, flushings, perspirations (R.). 
Physostigma, the extract, gr. -^ every l / 2 hour for 7 or 8 doses for flatulence 
and a sensation of fluttering at the pit of the stomach (A. A. Smith). Cam- 
phor, for drowsiness and headache. Eau-de-cologne saturated with camphor 
rubbed to head (R.). Zinc Valei'ianate, hysterical symptoms (R.). Change 
of air and scene, where other treatment only partially successful (R.). Warm 
Bath, to promote free perspiration. 90 to 95 Fah. for an hour once a week, 
will obviate many of the symptoms (R.). [Compare Metrorrhagia.] 

Coccyodynia. 

Chloroform, injected as deeply as possible about seat of greatest pain (B.). 
Electricity, has cured one severe case of 12 years' standing,'and helped others. 
Surgical treatment the only resource in rebellious and painful cases (Ros.). 
Nott extirpated the coccyx ; Simpson performed subcutaneous section of 
muscles and ligaments. Goodell removes the bone, after first treating the 
case as a local expression of a general neurosis. 

Coldness. 

Strychnine, for cold hands and feet (R.)- Cold Baths, with friction to the 
skin, nightly for cold feet (R.). Spinal Ice-bag, is often efficiently employed 
in general coldness of the surface, and persistent coldness of the hands and 
feet (R.). 

Colic, Intestinal. 

Nux Vomica, quickly subdues abdominal cramps and spasms (P.). Bella- 
donna, especially in children (R.). Chamomile Oil, Tnjv-vj, in colicky 
attacks of hysterical women (P.). Cocculus, of great value, especially during 
pregnancy (P.). Chloral, sometimes relieves (R.). Chloroform, effective in 



COLIC, LEAD. 559 

flatulent colic ; also useful in hepatic and saturnine (B.). Often used combined 
wilh Opium (D.). Potassium Bromide, in a peculiar form in young children 
(R.). Given in anise or peppermint water is of greater efficacy for the colic of 
infants than the opium preparations in general use, and perfectly safe (B.). 
Asafoetida, no better remedy in flatulent colic of infants. Teasp. doses of the 
mistura asafcetidse (B.) Morphine, gr. ]/%-% hypodermically, repeated in i$ 
minutes, gives more relief than any other remedy, in all forms of colic (B.). 
Frequent small doses R., P.). Arsenic, will cure in a surprising manner when 
enteralgia is idiopathic (B.). Essential Oils, especially those of Cloves and 
Cinnamon (R.), Anise, Cardamom, etc. Oil of Rue in flatulent colic of 
children (P.). Magnesia, the carbonate with Opium and Asafetida, as in 
Dewees's Carminative, now ofHcial as Mistura Magnesias et Asafcetidae, the dose 
being ^Ixx for an infant of 2 to 4 weeks old. Tobacco, as enema ; dangerous ! 
(B.); as clyster, or by stomach (R.). Ammonia, in spasm of intestinal canal 
and in colic of children or infants from bad feeding (R.). Lime Water, for 
young children who eject milk in lumpy masses, with colic and flatulence 
(R.). Water. Hot fomentations to ease pain (R.j. A copious enema of 
warm water often gives immediate relief. 

Prescriptions. 
R . Spiritus Chloroformi, R . Ext. Gentianae, 

Tinct. Cardamomi Co., . aa §ij. Pulv. Rhei, . . . aa gj« 

M. Sig. — Teasp. in water every 1, Ft. pil. xx. Sig. — One or two thrice 
hour. (B.) daily for tendency to colic. 



R. Atropine Sulph., . . gr. j. 

Zinci Sulphatis, . . gr. xxx. R . Pulv. Camphorae, 

Aquae Destil., . . 5J. Pulv. Capsici, 

If. Sig. — 3 to 5 drops 2 or 3 times Pulv Zingiberis, . aa gr. ij. 

daily. (B.) i Ft. pil. xij. Sig. — One as required. 

Colic, Lead. 

Alum, singularly is the best remedy (B.) ; gr. x hourly (R.) ; converts the 
poisonous salt of lead in the system into a comparatively innocuous sulphate ; 
3Jss-ij daily with TUxl-1 Tinct. Opii, and an occasional dose of castor or croton 
oil to procure one or two motions daily (\Va.). Opium, gives more relief 
than any other remedy, gr. ^ to ^f of morphine hypodermically (B.) ; gr. ij 
-iv of opium, with a moderate dose of castor oil (P.). Sulphuric Acid, diluted 
well, as a prophylactic, and is useful in the treatment of the disease (B.) ; con- 
sidered remarkably efficient when used in association with repeated sulphur 
baths (Wa.). Calomel, a full dose, with or without opium, followed in a few 
hours by castor oil and a turpentine enema, often affords speedy and marked 
relief (Wa.). Tobacco, may control, but is dangerous (B.). Croton Oil, in 
half-drop doses, with sufficient opium to relieve the pain, repeated every 3 or 
4 hours until free evacuations are produced ; proves effectual when other rem- 
edies fail (Wa.). Magnesium Sulphate, for the constipation, and to remove 
the poison from the system; should be combined with Iodide of Potassium, 
£j of the former given ter in die and about two hours after gr. v-x of the 
icdide. This treatment dissolves the lead in the tissues, causes its elimination 
by the intestinal mucus, renders it insoluble after it has entered the intestinal 
canal, and quickly removes it from the body (Br.). [Compare the treatment 
of Lead-poisoning, ante, page 305.] 



560 



CONJUNCTIVITIS, CATARRHAL. 



R . Aluminis, 

Ac. Sulph. Dil., 
Syr. Limonis, . 
Aquae, 
M. Sig.— Tablesp. 

two for colic. 



Prescriptions. 

R 



every 



;iij. 
hour or 
(B.) 



Magnesii Sulphatis, . . gj. 

Ac. Sulph. Dil., . . jrj. 

Aquae, . ^iv. 

M. Sig. — Tablesp. every 3 hours 
(B.) ; or thrice daily, each time pre- 
ceded by a 5 to 10 grain dose of Po- 
tassium Iodide. (Br.) 



Colic, Renal and Hepatic. 

Ether, inhaled in paroxysms of hepatic colic (R.). Chloroform, inhalation 
in renal and biliary colic, inferior only to morphia injection, superior to opium, 
warm baths, etc.; two or three administrations may be required (R.). [See 
also Colic, Intestinal.] Counter-irritation, flying blisters for renal colic 
(R.). Opium, small doses with spt. chloroformLevery five or ten minutes 
until the pain gives way, or morphia hypoderm. (R). Turpentine, has been 
given with benefit in biliary colic (R.). Dioscorea, is used successfully in 
so-called bilious colic, ni xv-xxx of the fluid extract. -Water, warm baths to 
ease the pain (R.). Aliment. Withhold all starches and fats. Alkaline mineral 
waters are useful (B.). [Compare Calculi.] 

Coma. 

Blisters, in a comatose condition, large blisters or mustard poultices should 
be applied in quick succession to different parts of the body — chest, abdomen, 
thighs and calves ; often very valuable in the critical condition near the end 
of an acute illness (R.) Cold Douche, for stupor of drunkenness or of opium 
poisoning. May have to be repeated if relapses occur. It should be kept up 
for a long time if pulse and breathing improve, or no worse (R.). Croton 
Oil, as purgative, ^\.% or y^ every hour (R.). Potassium Bitartrate, as 
purgative when blood is poisoned (R.). Mustard, as poultice to the feet 
and ankles in the coma of narcotic poisoning (P.). Exercise. In coma from 
poisoning the patient should be persistently walked about. [Compare Cere- 
bral Congestion, Uraemia, and the treatment of Narcotic Poisoning, ante, 
page 281.] 

Condylomata. 

Nitric Acid, §j to Oj aquae, as wash, frequently used (B 4 , R.). Thuja, 
locally a strong tinct. with gtt. v in water, night and morning, internally, for 
warts with narrow base and pendulous body. Warts about anus or pudenda 
of either sex, whether syphilitic or not, often rapidly cured by Thuja (P.). 
In non-syphilitic warts of penis or vulva, I have employed it with satisfaction 
(Pf.). Mercury, Calomel dusted over, after washing with a solution of chlo- 
rinated soda (Ricord, R., B.) ; the nitrate locally or a 20 per cent, oleate 
(R.). Zinc, the chloride, iodide or nitrate as local applications (R.). Ar- 
senic, arsenious acid as a caustic (R.). Carbolic Acid, as a mild escharotic 
(B.). Chromic Acid, gr. c-^j aquae dest. ; a good local application (B.). [Com- 
pare Syphilis, Warts.] 

Conjunctivitis, Catarrhal. 

Zinc, a weak solution of the sulphate or acetate as astringent collyrium 
(B.) ; gr. ij ad ^j aquae destil. as mild astringent lotion every few hours, 



CONJUNCTIVITIS, CATARRHAL. 



561 



with ice locally in the earlier stage (Roosa). Borate of Sodium , gr. v. ad t ^j 
aquae dest. a good and mild astringent for ordinary cases. Boric Acid, gr. 
vj ad gj each of aq. camph. and aq. destil., as collyrium (Fox). Boro-gly- 
ceride, £ss ad ^j of aq. camph. and aq. dest. a very efficient application. See 
ante, page 20. Carbolic Acid, a 5 per cent, solution applied every two hours 
by spray of steam atomizer, which dilutes it one-half, an extremely efficient 
application, relieving the pain and contracting the vessels. Cocaine, the hy- 
drochlorate in 3 to 5 per cent, solution or oleate, applied to the palpebral 
conjunctiva, is a very efficient palliative, especially where much pain and pho- 
tophobia (Koller). Alum, potassa alum after acute symptoms subside (Br.); 
gr. iij-v ad gij aq. destil. brushed over the conjunctiva twice daily. Pulsa- 
tilla, ^j-ij of tincture to ^iv aquae as wash several times daily, also TnJ-x 
internally every 3 or 4 hours (P.). Opiu?n, the wine dropped into the eye 
relieves pain and improves the condition of the conjunctiva (R.); Morphine, 
gr. j-ij ad Jj, is often used in collyria with zinc salts or alum. Mercury, 
Calomel dusted over the palpebral conjunctiva, in severe cases; should be 
finely levigated and dusted from a camel's-hair brush (B.); the oleate of 
mercury and morphine to the outside of the lids in palpebral conjunctivitis 
(R.); the red oxide as ointment, gr. x ad £j vaseline (Bader); the yellow 
oxide, gr. viij-x ad gj vaseline (Seely). Cadmium, as collyrium, gr. ij of 
the sulphate to ^j aquae rosae (B.). Tannin, in glycerin, %] ad 5j, every 
second day in chronic catarrhal conjunctivitis, presenting diffused injection 
of vessels with oedema (Hansell). Silver Nitrate, solutions of strength gr. 
j-iv ad ^j applied by physician to conjunctiva (R.); should not be given to 
patient. Zinc and copper salts are preferred (B.). Copper, the sulphate 
crystal in chronic cases where great swelling or hypertrophy of the papillary 
layer. Is too irritating to be entrusted to the patient. Lead salts should 
never be used lest deposits occur in slight abrasions or ulcerations of the cornea. 
Sulphates, of zinc, copper and iron with alum, aa gr. j to gj of aq. destil. as 
collyrium, extremely efficient; in severe cases may be used in saturated solu- 
tion by the physician (Holmes). Castor Oil, a drop placed in the eye often 
allays the pain and photophobia caused by an irritant (R.). Belladonna, lo- 
cally and internally (B.) ; Atropine in strong solution, gr. iv to 3J, is one of 
the best local applications where mydriasis is not objectionable. Euphrasia, 
as a mild astringent (P.). Blisters, behind the ears in bad cases (R.). Ergot, 
the fluid extract locally gives excellent results in acute conjunctivitis (B.). 
Staphisagria, especially in tarsal ophthalmia (P.). Colchicu??i, when gouty 
diathesis (A). Spigelia, in rheumatic form (P.). 



B . Zinci Sulphatis, 
Morphinae Sulph., 
Atropine Sulph., 
Aquae Rosae, . 
M. Sig. — Eye-water 



Prescriptions. 



g r - U- 

gr. ss. 

3- 



R. Liq. Plumbi Subacetat., . £j. 
Aquae Destillatae, . . giij. 
M. Sig. — For local use. To be 
brushed over conjunctiva of everted 
lids by the surgeon and washed off 
with water. (Buller ) 



R . Hydrarg. Oxidi Rub., . gr. x. 

Atropinae Sulph., . . gr. j. 

Vaselini, . . . ^j. 

M. Sig. — A minute portion as an 
ointment for the eye. [Bader.) 



R . Ung. Hydrarg. Nitrat., . gr. xx. 

Cocainae Hydrochlorat., gr. v. 

Vaselini Albi, . . £ij . 
Use a fresh ointment, triturate 
thoroughly, and label " Ointment for 
the eye." 



47 



562 CONJUNCTIVITIS, PHLYCTENULAR. 

Conjunctivitis, Diphtheritic. 

Zinc Chloride, gr. ij-iv ad 3Jj, as collyrium, has succeeded admirably 
(Wa.). Atropine \ locally, throughout the disease. Treatment not very effectual 
(Roosa); is, for severe cases, powerless; cornea sure to be attacked, and 
liable to slough (Noyes). Boric Acid, 4 per cent, solution, as antiseptic, the 
best application, with Quinine, internally in full doses (Noyes). Iron, the 
pyrophosphate for children, jj in ^iij of simple syrup, of which a teasp. thrice 
daily after meals, with quinine in 1 to 3-grain doses thrice daily, and good 
food (Derby). Cold by compresses, as in purulent ophthalmia, in early 
stages. Silver Nitrate vt\ solution locally, a 10-grain solution or the mitigated 
stick in the second stage. Tannin, gr. xx to the ^ of glycerin, later on, 
applied every day, with hot water lotions if corneal complications. 

Conjunctivitis, Gonorrhceal. 

Zinc Chloride, gr. j-ij ad 5j aquae, as collyrium, with marked benefit (Wa.). 
Silver Nitrate, a 2-gr. to the ^ solution, after syringing out the eye with 
warm water, followed by ice compresses, in hope to abort the attack, if seen 
early (Roosa). Cold, by ice or wet compresses, essential in the early stage 
(C). Atropine, may be used from the beginning, as corneal complications 
begin very early. Treatment, generally the same as for Purulent Conjuncti- 
vitis. Isolation and cleanliness are of prime importance. 

Conjunctivitis, Granular. 

Silver Nitrate, the diluted stick (see page 80) applied lightly and quickly 
(C.) ; strong solutions to granular lids, gr. xx ad ^j cautiously when corneal 
ulcers exist (B.); mild solutions better, gr. v ad ^j, daily in the papillary 
form ; in miliary trachoma it should not be stronger than gr. ij ad ^j (Noyes). 
Applications lose their effect after a time and should be changed (Roosa). 
Copper Sulphate, the solid crystal lightly touched to the membrane once a day, 
the favorite astringent and caustic in all forms of trachoma (Roosa); when 
membrane torpid to other stimulation and when lymphoid substance is 
predominant. As ointment gr. v-x ad ^j vaseline, when for use by patient 
(Noyes). Alum, a smooth crystal is a useful daily application (Noyes). 
Tannin, gr. x-xxx ad glycerini ^j, an application to change to from others 
(Roosa). Bismuth is one of the numerous applications in chronic conjuncti- 
vitis and granular lids (B.). Phytolacca internally, is undoubtedly efficient in 
granular conjunctivitis ( W.). yeriquity, to excite substitutive inflammation. 
See ante, page 17. Atropi?ie, gr. ij ad ^j aquae, thrice daily, is often advisable, 
where moderate irritation and haziness of the cornea (Noyes). Hygienic Meas- 
ures of great value. Protection by blue or smoked glasses. Rest of eyes, best 
secured by using atropine collyria. Hot or cold water as local bath fre- 
quently. Tobacco must be avoided, also all locations contaminated by impure 
air. Canthoplasty of outer commissure when lids press on globe. 

Conjunctivitis, Phlyctenular. 

Mercury. Calomel finely levigated and dusted from a camel's-hair pencil 
over the membrane in phlyctenular ophthalmia, an excellent local applica- 



CONJUNCTIVITIS, PURULENT. 563 

tion ; which should never be used when iodine is being taken. In more obsti- 
nate cases a small bit of Pagenstecker's ointment, the size of a pin-head 
(Hydrarg. Ox. Flav. gr. j-iij, Vaselini, ^j), placed between the lids (Noyes). 
Ergot, the fluid extract, applied undiluted, gives excellent results in the 
phlyctenular ophthalmia of children (B.). Antimony. Tartar emetic gr. -£-% to 
•j 1 ^ 3 or 4 times daily in strumous ophthalmia, with sharp purgation at the 
outset (R.). Belladonna, or Atropine, locally in strumous ophthalmia, of 
great service in relieving pain ; constitutional treatment also required (Wa.). 
Arsenic, invaluable in inveterate cases of strumous ophthalmia, especially 
when complicated with cutaneous eruptions (Wa.). Tannin, finely powdered 
and dusted over the everted lid, gives remarkably good results in this and 
other forms of conjunctivitis, causing very little pain and no inflammatory reac- 
tion (B.). Carbonic Acid Gas, applied to the eye is said to relieve the pain 
and photophobia of strumous ophthalmia (R.). Hydrastis, as lotion, is serv- 
iceable when meibomian follicles are implicated, causing adhesion of lids 
in the morning (P.). Eserine. locally, to reduce the pupil and shut out the 
light (P.). Iodine, is employed locally in strumous ophthalmia, for its alter- 
ative stimulation (W.). Zinc Chloride, gr. ij-iv ad gj, as collyrium, has suc- 
ceeded admirably in pustular ophthalmia (Wa.). Zinc Sulphate, gr. j-iv ad 
3j, is very serviceable; the addition of liquor plumbi improves its efficacy 
(Wa.). Rhubarb, the mistura rhei et sodae where much disturbance of diges- 
tion present. Tonics, may be given later, preparations of Cinchona and Iron. 
Cod-liver Oil, in strumous subjects, tends to remove the manifestations of the 
disease (R.). 

Conjunctivitis, Purulent. 

Alum, gr. ij ad gj aquae, a sufficient astringent application in ophthalmia 
neonatorum (Roosa) ; gr. viij ad ^j aquae, applied every X or H nour m the 
purulent ophthalmia of children, its success depending on the frequency of 
the application (R.). Copper Sulphate ', gr. j ad ^j aquae camph. as collyrium 
in purulent ophthalmia of infants (Wa.). Silver Nitrate, gr. iij-x ad gj aquae 
destil. rarely so strong as gr. x,once daily applied by brush to everted lids in 
purulent ophthalmia of infants (Noyes) ; solution gr. ^ ad gj twice daily 
under lids (Meigs) — by many it is considered needless and injurious 
(Roosa). Boric Acid, a 4 per cent, solution, as antiseptiCj is all that is neces- 
sary in mild cases; in others it is the proper fluid for cleansing the eye 
(Noyes). Atropine, when the cornea becomes invaded, and shows haziness, 
a solution gr. ij ad gj, must be instilled every 3 hours (R.). Cold, by ice or 
wet compresses, essential in the early stage of acute purulent ophthalmia (C). 
Cleanliness, a matter of great importance. As the discharge is infectious the 
patient should be isolated and care taken to prevent inoculation of the other 
eye therewith. 

Prescriptions. 



R. Sodii Boratis, . . gr. xij. 

Zinci Sulphatis, . . gr. j. 
Aquae Camph., . . £j. 
Aquae Destillat , . . gj. 

M. Sig. — Apply to lids 2 or 3 
times daily in oph. neonatorum, with 
solution of Silver Nitrate, gr. 3^ ad 
^j injected under lids twice daily. 

(Meigs.) 



R. Sodii feoratis, ■„ . . gr. iij. 

Aquae Rosae, 

Aquae, . . . aa gj. 
M. Sig. — Apply beneath lids three 
or four times daily after cleansing. 



R . Atropinae Sulph.* . . gr. j. 
Glycerini .^ss, Aquae, . 31J. 
M. Sig. — Two drops into the eye. 



5 6 4 



CONSTIPATION. 



Constipation. 

Nnx Vomica, gtt. j-ij of tincture bis vel ter in die (R ) ; gtt. v-x in a glass 
of cold water before breakfast and dinner, often overcomes the most obstinate 
constipation (P.); especially useful when great fecal accumulations from 
torpor of bowel (B.). Sulphur, gr. x with confection sennae, often succeeds 
after other remedies fail (R.). Sulphurous mineral waters (B.) ; or sulphates 
in purgative waters; frequent small doses (R.). Podophyllum, the most gen- 
erally used cathartic when deficient secretion (B.). Gr. j 1 ^ to */£ night and 
morning, when constipation with nervous and bilious headaches (P.). Senna, 
as in the pulvis glycyrrhizae compos. U. S., which may be taken in doses of a 
teasp. to a tablesp. as required, and kept up for months (Godell). Mercury, 
Calomel or gray powder as cathartic (R.). Hydrastis, very valuable, when 
constipation referable to a sluggish liver (P.). Magnesium, the bi-carbonate, 
a useful and mild aperient (R.). Alum, cheap and serviceable laxative (B. ). 
Jpecacuanha, gr. j every morning, fasting, when great torpor of bowels (R ). 
Locculus, flatus, hard, lumpy motions (P.)- Turpentine, in purely atonic 
constipaiion, with gaseous distension of colon, has triumphed when all other 
remedies failed (P.). Physostigma, very effective in intestinal torpor (B.). 
Stillingia, th.x of fluid extract in habitual constipation (B.). Castor Oil, a 
mild, efficient cathartic (B.). Ammonium Chloride, in the so-called bilious 
state, with constipation (B.). Arsenic, small doses ("Hlij) of Fowler's solution 
often overcome constipation (R.). Belladonna,^. ^ of the extract at night, 
in habitual constipation (B.) ; gr. ]/&-% once a day, especially when dyspepsia 
(R.). Acts directly on the bowel as a stimulant (P.). Croton Oil, the most 
efficient cathartic, when simple impaction without inflammation. Gtt. j-ij 
(B.); when evacuation of blackened feces (R.). Cascara Sagrada, the 
fluid extract in doses of £j, produces large, soft evacuations without griping, 
and leaves behind it a laxative influence. Frangula, in similar doses, is 
equally efficient, but if from a fresh bark may produce griping. Cathartics, 
especially confectio sennae, pil. rhei compos., pil. aloes, the comp. cathartic 
pill, as well as those above (B.). Purgation as usually practiced denounced 
by editor of the Lancet, October I, 1870. Saline Waters, are useful (B.). 
Pullna, Friedrichshall, or Hunyadi ; the first two with milk, are good for chil- 
dren (R.). Pnemata, of soap-suds and salt, or a pint of cold water (B.) ; or 
turpentine, castor oil, aa ^ss,to Oss-j of gruel (P.). The habitual use of warm 
enemata increases torpor of the bowels (R.). Tamar-dndien, a favorite mild 
aperient, is proprietary, and supposed to contain cocculus, Glauber's salts, 
etc. Aliment, important in habitual constipation ; corn bread, cracked wheat, 
oatmeal, bread of unbolted flour, fruits, green corn, tomatoes, and celery. ^ 
dozen each of almonds and raisins daily. A glass of cold water before break- 
fast may overcome habitual constipation (B.). An orange or a smoke after 
breakfast (R.). Tobacco habitues rarely suffer from constipation. [Compare 
Intestinal Obstruction.] 

Prescriptions. 

Castor Oil Emulsion. 



R. Ext. Colocynth Co,- . gr. xij. 

Ext Belladonnae, . . gr. ij. 

Ext. Gentianae, . . gr. vj. 

Olei Cari, . . . gtt. iij. 
Ft. pil. vj. Sig.- — One pill at bed- 
time. (GoodelL) 



R, 01. Ricini, 

Glycerini, . . aa £j. 
Tinct. Aurantii, . . ttixx. 
Tinct. Senegae, , . ni v. 
Aq. Cinnamomi, . ad ^ss. 
M. ft. emulsio. Sig. — One dose. 



CONVALESCENCE CONVULSIONS, INFANTILE. 



565 



R . Podophylli Resinae, 

Quininae Sulphatis, 

Est. Aloes Aquosi, 

Feliis Bovini, 

Ft. pil. no. xvj. Sig. 

at bedtime. 



. gr. ij. 

aa gr. viij. 
gr. xvj, 



•One or two j as required. 
(Goodell.) 



B . Aloes Socot., 
Extracti Bellad., 
wSaponis, 
Ft. pil. no. xxiv. Sig.- 



R 



Ext. Cascarae Sag. Fl., . gj. 
Ext. Belladonnae Fl., . £j. 

Tinct. Nucis Vom., . . £ij. 
Syrupi et Aquae, . aa ad ^iv. 

M. Sig. — Teasp. thrice daily in ob- 
stinate constipation. (Clarke.) 



. gr. xij. 

• g r il 3- 
. q. s 
-One or two 
(Wallace.) 



R . Aloes Socot., . . gr. vij. 
Rhei Pulv., . . gr. xxiv. 

Ext. Belladon., . . gr. j. 
M. Ft. pil. no. xij. 
Sig. — One or two pills as required. 
(Da Costa.) 



Convalescence. 

Lime, as lime-water, or the carbonate, in convalescence from serious dis- 
eases (R.). Quinine or Hydrastine, to promote digestion and appetite (B.). 
Fats, especially cod-liver oil (R.). Alcohol, before or during meals (R.). 
Koumiss, possesses great value (B.). Bitters, especially gentian and calumba 
(B) ; the latter especially when stomach weak (R.). Eucalyptus, a serviceable 
tonic (B.), Coca, ^ss-ij of the fluid extract as a dose (B.). Guarana, gr. xv- 
£j may be given (B.). Opium, as laudanum, injected per rectum, for insomnia 
of convalescents ^R.). Sea-Baths, valuable in many cases (R.). Diet, requires 
the most careful attention ; the prevalent error of giving food of difficult diges- 
tion too early must be guarded against, especially in intestinal or gastric dis- 
orders. The strictest moderation should be enjoined. The symptoms must 
te watched closely, and combated by appropriate medication. [Compare 
Adynamia for Tonic Prescriptions.] 



Convulsions. 

General Directions. — In all cases, horizontal posture, fresh air, loosen the 
clothing; insert a plug of soft wood, or a cork, between the teeth, to prevent 
biting the tongue ; sprinkle the face and chest with cold water. Epileptic. — 
The general directions above will usually suffice. [See also Epilepsy.] 
Hysterical.— -The diagnostic peculiarities are: pupils not dilated, but are sensi- 
tive to light ; no wounding of tongue ; face not livid ; pulse usually normal. 
[See also Hysteria.] Infantile. — Administer some anti-spasmodic, as Ether, 
alone or combined with Musk or Belladonna ; then search for any mechanical 
cause, as a pin in the dress, etc. Lance gums, if dentition the cause (A). 
[See Convulsions, Infantile.] Urcemic. — [See Uraemia; Puerperal 
Convulsions.] 

Convulsions, Infantile. 

Belladonna, is of the highest value in certain congestive forms, as in fits 
due to the irritation of teething, or those referable to whooping-cough (P.). 
Ignatia, is efficient in convulsions of children from intestinal irritation, no 
cerebral congestion being present (P.). Valerian, has been successfully used 



566 



CORNEAL OPACITIES. 



when from worms, to which parasites it is fatal (P.)- Potassium Bromide, 
in all forms of convulsions in children (R.); children bear it in large doses, 
gr. v thrice daily or oftener for a child a year old in convulsions from teeth- 
ing (Br.). Chloral, in large doses, gr. v, by mouth or rectum (Br.) ; best 
used as a suppository rather than by liquid injection, and often very useful 
(R.). It gives better results than any other agent. Chloroform inhalations 
of great service (R.) ; useful in all forms (B.) ; should be used to arrest the 
convulsion and prevent recurrence (A. A. Smith). Alcohol, has remarkable 
power in arresting convulsions of dentition ; small doses of wine or brandy 
(Wa.). Asafetida, in the convulsions of teething, a small portion in enema, 
appears to mitigate them (Wa.). Opium, efficient, but dangerous in young 
children. Veratrum Viride, has been employed successfully (R.). Amyl 
Nitrite, gtt. v. with gr. ^ of morphine used in one case as a last resort, after 
five hours convulsions in a child of 1 8 months, which resulted in producing 
quiet sleep (Engel). Hot Baths, are important, with cold affusions or ice 
to the head (B.). Spinal Ice-bag, may be very efficient (R.). 



Prescriptions. 



R 



Chloralis Hydratis, . gr v. 

Lactis, . . . • S» 
M. Sig. — As rectal injection. Or 
the dose may be made into a supposi- 
tory with cacao-butter and inserted 
well up into the rectum. 



R . Sodii Bromidi, 

Chloralis Hydratis, 

Sodii Bicarb., . aa gr. viij. 

Aquae, . . . . |j. 

M. Sig. — A teaspoonful every hour 
to a child under four months old. 



Corneal Opacities. 

Cadmium, is said to promote their absorption ; gr. ij of the sulphate to ^j 
of rose-water as collyrium (R., Wa.). Mercury, Calomel by insufflation, or 
the red iodide gr. ij, cerate gr. xl, oil gtt. xx, as ointment, successfully used 
(Wa.); weak solutions of the bichloride, or ointments of the oxides, gr. %( 
ad gj, as remedies among many others to hasten their absorption in recent 
cases (Arlt). Oils, eel-liver and cod-liver oils, ox-gall, juniper oil, oil of 
turpentine combined with olive oil, and others, dropped into the eye once or 
twice daily for the same purpose (Arlt). Opium, the wine at first, then in- 
sufflations of calomel and red precipitate or yellow oxide of mercury oint- 
ment, most frequently used by me in recent cases (Arlt). Potassium Iodide, 
as ointment with carbonate of potassium after cod-liver oil or oil of turpen- 
tine with olive oil, in cases of longer standing (Arlt). Silver Nitrate, gr. 
v-x ad ^j aquae, as lotion (C). Iodine, internally and as collyria, has been 
efficacious, especially in strumous cases (Wa.). Sodium Chloride, gr. x ad £] 
aquae destil.,of which rriv-x injected subconjunctivally, to hasten disappear- 
ance of turbidity (C). Operative Aleasures, only in case of incrustations, as 
of lead and lime, situated superficially, by removal of epithelium and ante- 
rior elastic layer. Deeper interference may lead to suppurative keratitis. Ex- 
cision of opaque cornea and transplanting of one from an animal's or a re- 
cently enucleated human eye (keratoplasty), has always failed. Artificial 
pupil by iridectomy, for central opacities which are unremovable. Tattooing 
to relieve deformity of disfiguring leucomata (Arlt). Pannus and leucoma 
are best let alone (D.). Stenopaic Spectacles, for semitransparent opacities 
in pupillary region (Donders). [Compare Keratitis.] 



CORNS — COUGH, 



$6? 



Corns. 

Silver Nitrate solid, after soaking and paring (Wa.) ; the best application 
for soft corns, and very irritable ones (D.). Acetic Acid, strong, to remove 
corns (Wa.). Mercury, corrosive sublimate in alcoholic solution locally to 
remove corns (Wa.). Iodine, gr. xl, ad gj alcoholis, locally (Wa.). Poultices 
are useful ; or a plaster of soft material with hole in centre (D.). Water, hot 
and cold, alternately applied to inflamed corns. Keep a corn thin by frequent 
washing and paring. In performing the latter operation, the knife should 
work downwards to the apex of the corn, so as to remove pressure from its 
centre. 

Prescription. 



R. Acidi Salicylici, . gr. xv. 
Extract. Cannabis Ind., gr. vijss. 
Alcoholis, 90 , . . TUxv. 
Athens, 62 , . . TTtxxxvij, 
Collodii Flexilis, . "ntlxxv. 



Mix, and keep in closely-corked 
vial. Paint the corn every other day 
for a week, then it can be easily 
squeezed out. 

( Vigier.) 



Cough. 

Opium, in some form, is much used in cough-mixtures; morphine and gly- 
cerin to fauces (B.) ; moderate doses only are useful in irritative affections of 
the air-psssages, to allay irritation and , hypersecretion, but it may do even 
fatal mischief in cases where secretion is copious and expulsory power feeble 
(P.); opiates inadmissible when with copious expectoration there is any in- 
dication of bronchial congestion (Wa.) ; very useful in violent and frequent 
cough with little rhonchus and no signs of obstructed oxidation ; also, when 
cough is due to red, inflamed and ulcerated throat ; opium or morphine given 
so as to cling for some time in contact with the pharyngeal structures (R.). 
Codeine is often efficient in cough when morphine cannot be borne (Br.). 
Aconite, irritable, tickling throat-cough; short, dry cough of asthmatics, with 
anxious look, full, strong pulse (P.). Belladonna, often useful. No indica- 
tions (R.). Internally and externally as plaster to the chest,' very serviceable 
in spasmodic and nervous coughs (Wa.). Hyoscyamus, very useful in spas- 
modic, tickling night coughs (P.). Hydrocyanic Acid, for nervous, irritable 
cough, and cough of phthisis and mother's sympathetic cough (B.) ; no more 
certain palliative for simple nervous cough due to irritable state of the system 
(Stille) ; a valuable adjunct to ordinary remedies in cough of phthisis (W r a.). 
Prunus Virginiana, has some influence due to its hydrocyanic acid; is much 
used in cough-mixtures (B., P.). Laurocerasus, used as substitute for hydro- 
cyanic acid in spasmodic coughs (B.). Conium, supposed to be useful (R.) ; 
is very useful in spasmodic cough (Wa.). Ipecacuanha, the fl. ext. for trouble- 
some night-cough (B); in obstinate winter-cough, with wheezing, the wine 
as spray to fauces efficacious (R.) ; in coughs of childhood ipecac is one of 
the most generally serviceable expectorants we can use (Wa.). Lobelia, dry 
cough, continued tickling sensation, even in sleep (P.). Sanguinaria, com- 
bined with hyoscyamus, in nervous, spasmodic cough (P.). Senega, as a stimu- 
lant expectorant in the cough of chronic bronchitis and subacute chest affec- 
tions. Gelsemium, excessive irritability of the respiratory centre (R.) ; often 
remarkably relieves convulsive or spasmodic, reflex, nervous coughs (B.). 
Pulsatilla, as anemonine, y 2 gr. and gr. doses, very useful in irritative cough, 



568 



COUGH. 



asthma, whooping-cough (P.) Iodine, by inhalation for children in hoarse, 
hollow cough, wheezing (R.). Alum, internally in spasmodic cough, gr. x to 
£j aq. as spray, in chronic cough (R.). Potassium Bromide, serviceable in 
various reflex coughs (uterine, renal, etc.), and in cough of phthisis occasion- 
ally ameliorative as a gargle (B.). Cubebs, gss-j of the tinct. in half-glass 
of linseed tea thrice daily, often cures like a charm the coughs of chronic ca- 
tarrh, of emphysema, or acute catarrh, or following an attack of influenza (R.). 
Asafcetida, Garrod ascribes its value to the sulphur oil in it (P.). Very ser- 
viceable in after-cough from habit, and in mother's sympathetic whooping- 
cough (B.). Carbolic Acid, as spray, a 5 per cent, solution in a steam atom- 
izer will often prevent as well as cure a cough from cold. Valerian, in asth- 
matical and hysterical coughs (P.). Chloroform, with morphine and molasses 
in paroxysmal dry cough. May be painted on throat also (R.); in irritable 
reflex cough the vapor of a teaspoonful of the spirit may be inhaled from the 
surface of hot water and repeated every five minutes for four or five times 
(B.). Chloral, in convulsive coughs, ameliorates symptoms after hypnotic 
effect (Wa.). Camphor, equal parts of camphor and chloral triturated 
together are said to allay spasmodic cough when painted over larynx (B.). 
Glyce?'in of Tannin, applied to throat when chronically inflamed and so pro- 
ducing cough; often the case with children (R.). Grindelia, useful in cough 
of habit and spasmodic cough (B.). Squill, in catarrhal cough, should not 
be employed until active inflammation has subsided (Wa.) ; the syrup or 
vinegar of squill is the best preparation for cough with tickling in the throat 
(P.). Cod-liver Oil, in chronic coughs (R., Wa.). Lactucarium, the syrup 
as vehicle in cough-mixtures (B.). Chamomile Oil, gtt. ij-viij, in coughs due 
to heightened reflex irritability, especially in hysterical women (P.). Fix, Tar- 
water, in winter cough, especially when paroxysmal (R-). Allays the cough 
of bronchitis and phthisis (P.). Emplastrum Picis, as rubefacient and counter- 
irritant in chronic coughs (Wa.). The frequency and violence of nervous 
coughs may be controlled by a determined effort of the patient's will. [Com- 
pare Bronchitis, Pertussis, Phthisis.] 



Prescriptions for Cough Mixtures. 



R 



Adults. 
Spiritus Etheris Nitrosi, , 
Vini Ipecac, . 
Tinct. Opii Deodorat., 
Syrupi Tolutani, . ad ^ij. 
M. Sig. — A teaspoonful twice or 
thrice daily. (Bowditch.) 



;ss. 



R. Liq. Morph. (Magendie), . 5jj. 

Syr. Scillae Comp., 

Syr. Tolutani, . . aa ^j. 

Syr. Ipecac, 

Spt. Lavand. Co., . aa ,^ss. 

Spt. Limonis, . . • jj. 

Syr. Pruni Virgin., . ad §vj. 
M. Sig. — A teasp. as required. 
Each dose has of Morph. gr. ^ 5 . 



R. 



Children. 

Mist. Glycyrrh. Co., . 

Syr. Pruni Virginian., 

Syr. Tolutan., . 

M. Sig. — Half teaspoonful 3 or 4 

times daily for infants, teasp. doses at 

I to 2 years, larger doses for older 

children. {Potter.) 



aagj. 



R . Tinct. Opii Deodorat., 

Vini Antimonii, . aa gss. 

Ext. Valerianae Fl., 

Syr. Simplicis, . . aa^j- 

Aquae, .... 3JSS. 

M. Sig. — A teasp. every hour or two 

until cough controlled. For those 4 

years and upwards. (Meigs 6° Pepper.) 



COXALGIA — CROUP. 



569 



Coxalgia. 

Barium Chloride, in considerable doses (gr. j-ij) persevered in for a month, 
thought to be a most valuable remedy in scrofulous diseases of joints (Wa.). 
Sulphuric Acid, £) ad ^j adipis, as ointment, persevered in, has resulted in 
great benefit. A powerful irritant (Wa.). Counter-irritation, by blisters 
around the hip, with perfect rest in the straight posture, cod-liver oil, etc. (D.). 
Iodide of Iron, in scrofulous disease of the joints, with cod-liver oil and nu- 
tritious diet (Wa.). Iodoform, very successfully used by many continental 
practitioners in scrofulous diseases of the joints (Wa.). Cod-liver Oil, the 
remedy on which most reliance is to be placed (R.). [Compare Abscess, 
Caries, Suppuration, Synovitis.] 



Croup, Catarrhal. 

Aconite, valuable (R., Wa.) ; has been employed witn the best results (P.) ; 
from gtt. ^ to j every half-hour, until an impression is made on the fever- 
movement, then every hour or two (B.). Hot Water, applications beneath the 
chin and along the whole course of the larynx (Wa.). Hot fomentations or 
turpentine stupe to throat (El.) ; hot bath (95°-io2°) in the paroxysm a good 
method (M. & P.). Potassium Bromide, locally, a solution by atomization 
has proven highly efficient in spasmodic croup (Wa.). Lobelia, has been used 
with occasional success (P.). Ipecacuanha, the syrup or fluid extract as an 
emetic at the outset (El.) ; is a slower emetic than tartar emetic (P.); the 
syrup to vomiting during the paroxysm, and nnv-x every 2 or 3 hours next 
day (M. & P.). [Compare Laryngismus Stridulus.] 



R. 





Prescriptions. 




. Potassii Citratis, . 


• 3J- 


R. Tinct. Belladon., . 


gtt. iv. 


Syr. Ipecac, 


■ 3'j. 


Tinct. Opii Camph., 


gtt. 1. 


Tr. Opii Deodorat., 


. gtt. Xlj. 


Pulv. Aluminis, 


■ g r V J. 


Syr. Simplicis, 


• &*' 


Syr. Acacise, . 


, 5ss. 


Aquae, . 


. 3JSS. 


Aquae, . 


gjss. 


M. Sig. — Teasp. every 


two hours at 


M. Sig. — Teasp. every 2 01 


r 3 hours 


years of age. In severe form of 


at 6 months old when cough 


frequent 



spasmodic laryngitis. 



(M. & P.) [ and harassing. 



(M.&P.) 



Croup, Membranous. 

Mercury, a remedy of established value, gr. ss-j of calomel, with gr. %-% 
of ipecac, according to age, every 2 hours, with local and other general measures, 
especially the use of a hot (70°-75°) and moist atmosphere ( Wa.). The sub- 
sulphate, given early, is the best emetic, gr. iij-v. ; calomel is strongly urged as 
a laryngeal sedative and aplastic agent, allaying laryngeal spasm and preventing 
formation of membrane (B.). Alum, one of the best emetics in this disease, 
a teasp. in honey or syrup, repeated every 10 or 15 minutes until it operates 
(M. & P.); a very useful and non-depressant emetic (B.). Sanguinaria, by 
many considered specific, is undoubtedly the best emetic for this disease (P.) ; 
is too harsh and too uncertain in action (B.). lartar Emetic, as an emetic, 
has established value in croup (Wa.). Is injurious; too depressant (B.). 
Potassium Chlorate, as alkali, after emetics, the most reliable internal remedy, 
gr. ij-iij every 2 hours to a child of 4 years (M. & P.). Chloride of Iron, may 

48 



570 CYANOSIS — CYSTITIS, ACUTE. 

be combined with the preceding, in doses of 3-5 drops of the tincture, at the 
same age (M. & P.). Emetics, besides the above: Copper Sulphate, in small 
frequent doses (R.) ; Ipecacuanha, inferior to mercury (B.). In severe cases, 
vomiting should be caused 3 or 4 times a day, and should be commenced 
early (R.). Apomorphine, effective, but highly dangerous (B.). Senega, is 
considered a valuable auxiliary (P.), has been employed (R.). Quinine, in 
full doses is highly useful (B.). Sulphurous Acid, as spray, hourly or more 
frequently (R.). Tannin, a 5 per cent, spray, several times a day for 15 or 20 
minutes (R.). Lactic Acid, as solvent of membrane (B.). Iodine, the tinc- 
ture, externally, affords great relief, and tends to prevent formation of false 
membranes (Wa.). Water. — Warm bath, hot fomentations or compress to 
throat. Watery vapor in room. Steam inhalations, with a few drops of Iodine 
or Bromine. Diet. — Water only in small quantities during attack. Supporting 
diet may be required afterwards. Lime-water, by vaporization, or inhalations 
of the vapor of slaking lime for a few minutes in every hour, or some other 
alkaline solution duriag the whole treatment (M. & P.). Tracheotomy , fully 
justifiable, 2\ x / 2 per cent., recovered, out of 1024 operations; should be done 
when paroxysms become very frequent, and dyspnoea is rather persistent than 
paroxysmal (M. & P.). [Compare Laryngitis, Diphtheria.] 

Prescriptions. 

R. Acidi Lactici, . . . giijss. 
Aq. Destillat., . . 3X. 

M. Sig. — To be used as a spray, 
or applied by a mop. 

{London Throat Hospital?) 



Cyanosis. 

A my l Nitrite, by inhalation, often gives marked relief (P.). Quebracho, in 
that from asthmatic attacks of consumptives, lessened the cyanosis or entirely 
relieved it (Rohrer). Leeching is of service, in a manner not easily under- 
stood (P.). Treatment must depend on the nature of the lesion or disease 
giving rise to the cyanotic condition (A.). 

Cystitis, Acute. 

Belladonna, is a good remedy in almost every form of vesical irritation 
(G.) ; when the vesical mucous membrane is irritable (B.); very useful in 
recent catarrh from chill, with pain (P.). Cantharis, in large doses causes 
inflammation of the urinary tract, but gtt. j of the tincture every hour will often 
relieve vesical catarrh (A. A. Smith) ; in small doses continued, very efficient 
(B.) ; gtt. j-v of the tincture thrice daily, when bladder is irritable, its sphincter 
weak, and pain along the urethra (P.) ; may be employed in cystitis with ben- 
efit (R.) ; the best remedy in small doses for acute cystitis. Aconite, for febrile 
symptoms (R., P.). Quinine, often useful for acute symptoms (B.). Iodoform, 
in suppository for painful cystitis (R.). Opium, a rectal injection of starch 
and laudanum will subdue pain and prevent the frequent micturition (R.) ; 
opium is dangerous if kidneys are diseased (P.). Alkalies, the citrates and 
bicarbonates if urine is highly acid; stop when it becomes alkaline (R.). 
Liquor potassae in barley-water or in a docoction of Triticum repens, preferred 



R . Pulv. Sanguinarise, 


. gr. xx. 


Pulv. Ipecac, 


• gr. v. 


Syr. Ipecac, . 


• »j- 


M. Sig. — A teasp. every % hour 


until emesis, then ]/ 2 


teasp. every 


hour. 


(p-) 



CYSTITIS, CHRONIC. 571 

to all other alkalies ; urine must be maintained at a neutral or very slightly 
acid reaction (Thompson). Cannabis Indica, an excellent anodyne in all 
bladder cases, having specific effect on that organ. Rest in horizontal posture, 
mucilaginous drinks, hot fomentations and hip-baths, from ioo° to no°, laxa- 
tives for the bowels, light food. Milk-diet often necessary, especially in chil- 
dren. [Compare Bladder Irritable, Calculus, Dysuria, Enuresis, 
Hematuria.] 

Prescriptions. 

U. Atropinae Sulphatis, . gr. j. R. Pulv. Opii, . . . gr. xij. 

Acidi Acetici, . . gtt. xx. Camphorae, . . . gr. xxx. 

Alcoholis, Ext. Belladon., . . gr. iij. 

Aquae, . . . aa ^ss. Ol. Theobrom., q. s. 

M. Sig. — Four drops in a winegl. M. et div. in supposit. no. vj. 
of water before each meal. (G.) I Sig. — One at bed-time. 



Cystitis, Chronic. 

Benzoic Acid, and the benzoates, in chronic cystitis from any cause, when 
urine is alkaline (B.); has some balsamic character, and is useful in some 
cases of chronic cystitis : gr. xxiv at least in the day, in pills made with gly- 
cerin (Thompson). Alkalies, when urine is acid ; the liquor potassae, with 
hyoscyamus as an anodyne, preferred notwithstanding its chemical incompati- 
bility, to control painful and frequent micturition (Thompson) ; bicarbonates 
or citrates better, as the strong reaction of liq. potassae unfits it to be given in 
doses sufficiently large to affect in any great degree the reaction of the urine 
(R.). Triticum, is very efficient as an internal remedy, jf ij-iv of the rhizome 
boiled in a quart of water until reduced to a pint, this strained to be taken in 
four doses in the 24 hours (Thompson) ; a very useful remedy (Pancoast). 
Buchu, is probably the most efficient of the urino-genital remedies, the fluid 
extract in doses of rrtx-^j (B.) ; the best drug in chronic cystitis, especially 
when the catarrh implicates the ureters or the kidneys themselves, producing 
considerable muco-purulent discharge (P.). Uva Ursi, is decidedly effective 
(P.); is less so than Buchu (B.). Stigmata Maydis, an infusion, gij ad Oj, 
wineglassful every 3 or 4 hours, has been used internally with considerable 
success (Dessein). Pareira, considered superior to Uva-Ursi (Brodie) ; often 
very successful (P.). Chi?naphila, is often very efficient, but is more actively 
diuretic than the preceding named remedies (B.) ; by many practitioners it is 
considered the best remedy for chronic cystitis. Copaiba, is very useful by 
virtue of its local action on the mucous membrane, but objctionable for its 
nauseous taste and resulting gastric disturbance (B.). Cubeb, is often useful, 
from its stimulating effect (P.). Turpentine, has been useful in many cases 
(R., P.) ; when cystitis due to urethral inflammation or prostatic disease (B.). 
yuniper, the oil is indicated under the same conditions as is turpentine (B.). 
Eucalyptus, there is no more efficient remedy in chronic cystitis than this (B.) ; 
the oxygenated oil of Merck is best in doses of 3 drops on sugar every 6 or 8 
hours. Salicylic Acid, in large doses, either internally or by injection into the 
bladder, is most efficient (B.) ; the acid or salicylates often useful to prevent 
decomposition (P.). Carbolic Acid and sulpho-carbolates to preserve the 
urine sweet (R.). Stdphites will accomplish the same object (B.). Silver 
Nitrate, by intra-vesical injection, gr. j ad giv to begin with, increased grad- 
ually to gr. ^ ad gj at most (Thompson). Stronger solutions are advocated 



572 



CYSTS. 



by Professor Richardson of New Orleans, and Professor Gardner of McGill 
College, Montreal. In the writer's experience a 5 per cent, solution, used 
as a vesical wash, has been promptly efficient in curing many cases which 
resisted other treatment for months. It sometimes produces serious symptoms, 
and it is therefore well to have a neutralizing solution of sodium chloride on 
hand for use if required. Other Injections which may be used to wash out 
the bladder, are — Lead Acetate, gr. j to ^iv of warm water, once daily ; Nitric 
Acid, dilute, ^l-j-ij to the ^j of water ; Tannic Acid, gr. j to ^j ; Borax, t ^j in £ij 
of glycerin and ^ij of water, of which t ^ss to ^iv of warm water for one injec- 
tion ; Quinine, gr. j-ij to the J of water, with a drop of acetic acid. All injec- 
tions must be used with great care, not more than ^ij forced in at once, and 
that very slowly. Use flexible catheter, warm solutions, and a rubber injecting- 
bottle with long nozzle and stop-cock (Thompson). Washing the bladder is 
of great value (R.). Evacuation of the urine, some of which is often retained 
in the bladder, is a matter of great importance. Ergotin, hypodermically, 
increases the contractile power of the bladder, and enables it to empty itself 
more perfectly (Langenbeck). [Compare Bladder Irritable, Calculus, 
Dysuria, Enuresis, Hematuria.] 

Prescriptions. 



B . Uva-Ursae Fol., 

Pareirae Radicis, . aa 3 j-ij. 

Sig. — Boil in 3 pints of water, until 

reduced to a quart, then strain, and 

take I or 2 winegl. 3 or 4 times daily. 

( Thompson.) 



B . Ext. Tritici Fluidi, . . ^ij. 

Syr. Amygdalae, . . . 31J. 

M. Sig. — A dessertsp. in water 5 or 

6 times daily. {Pan coast.) 



B. Ol. Terebinth., . . gss. 

Camphorae, . . . gr. xv. 

Ext. Hyoscyami, . . gr. ss. 

Fiat massa. Sig. — Take a piece the 

size of a cherry-stone morning and 

evening. [Chauvel.) 



B . Quininae Sulphatis, . ^ss. 

Acaciae, . . ^ij. 

Morphinae Sulphatis, . gr. jss. 

Aquae, . . q. s. ad ^iij. 

M. Sig. — A tablesp. to 3^ ounces 
of warm water, which inject in 3 parts, 
daily. 



R 



3). 



Sodii Boratis, 
Glycerini, 
Aquae, . 
M. Sig. — Tablesp. in four ounces 
of warm water as an injection. 



aa ,5'j- 



B . Argenti Nitratis, . . gr. vij. 

Aquae Destillat., . . ^iijss. 

M. Sig. — Injection every third or 

fourth day after washing the bladder 

out with warm water. (Picord.) 



Cysts. 

Iodine, injection very effective in cysts of neck, and sometimes in unilocular 
ovarian (B.) ; §x after tapping ^R.). Silver Nitrate, gtt. v-x of solution, ^j- 
ij as injection, will cure after setting up inflammation (B.). Galvano-puncture , 
will permanently occlude cysts of neck ( B.). Aurum Chlo?-ide y may sometimes 
cure ovarian dropsy (B.). Remedies internally have all been proved worth- 
less (E.). 



DEAFNESS DELIRIUM — DELIRIUM TREMENS. 573 

Deafness. 

Quinine, cures some forms, and often causes deafness (Brown-Sequard). 
Glycerin, for dryness of meatus; also to form a film to ruptured tympanum 
(R.) ; either alone or in combination with olive oil (P.) ; effects are temporary 
(Wa.). Tannin, the glycerite as application for throat deafness (R., Wa.). 
Colchicum, when from gout in ear (A.). Cantharides, as ointment; gr. xxx 
ad gj adipis, below and behind the ear bis die, with alterative mercurial treat- 
ment, in deafness from thickened tympanum (Wa.). Gargles, in throat-deaf- 
ness, are of great value ; potassium nitrate, borax, etc., in sthenic ; tincture of 
capsicum added in nervous forms ; hydrargyrum perchloride, when from sec- 
ondary syphilis (Wa.). Water, washing in warm water, in deafness from gen- 
eral debility (Toynbee). Faradization, of the ear in nervous deafness, in 
which slight results only to be expected from the treatment (R.). Demands 
the utmost caution (Wa.). Collodion, contractile, applied to the membrana 
tympani, in deafness from relaxation of the membrane, has exerted a perma- 
nently beneficial influence, even in cases of long standing (Wa.). Turpentine, 
gtt. xl in Jss glycerin, a few drops into the meatus, in deafness depending on 
deficient secretion of cerumen, results in much benefit (Wa.). Morphine, 
gr. ss sprinkled on surface behind the ear denuded by a small blister, has 
proved curative in chronic deafness, after all other remedies had failed (Wa.). 

Delirium. 

Belladonna, delirium of typhus and other fevers (R.) ; severe forms of de- 
lirium (P.). Hyoscyamus, delirium of typhus; mild, less inflammatory form, 
hallucinations, nervous excitement, little cerebral congestion (P.). Stramo- 
nium, in wild and furious delirium of puerperal mania, with general restless- 
ness and suicidal or destructive tendency (Wa.) ; no drug deserving of more 
confidence in the greater number of maniacal cases (Cullen). Opuim, in 
traumatic delirium, as a rectal injection, combined with tartar emetic in 
fevers, or, better still, morphine hypoder. Laudanum in low, muttering de- 
lirium (R.); is regarded with suspicion (P.). Cannabis Indica, the extract, 
in doses of gr. X~X m nocturnal delirium occurring in softening of the brain 
(Wa.). Potassium Bromide, in delirium resembling delirium tremens (R.). 
Camphor Monobromide, useful in rambling delirium (Wa.). Camphor, in 
20-gr. doses, every 2 or 3 hours, especially in low muttering delirium (R.). 
Chloral, in violent delirium of fevers (R.). Antimony , delirium of fevers 
(R.). [See Fevers.] Water, the cold douche in maniacal delirium ; place 
patient in warm bath during application (R.). [Compare Cerebral Con- 
gestion, Fever, Mania.] 

Delirium Tremens. 

Belladonna, of proven efficacy when congestion of the brain (P.) ; useful 
for the insomnia when coma vigil, cold surface, cyanosis (B.). Stramonium 
can do all that Bell, can do, and is more powerful (Tr.). Hyoscyamus, in 
some forms admirable (P.). Opium, cautiously, if at all (B.); as rectal in- 
jection, hypodermically, or with spirits. If patient strong, delirium boisterous, 
and pulse full, add Tartar Emetic or Aconite (R.). Bromides, in the "hor- 
rors " preceding the delirium, ^j every 4 to 6 hours. Are of less value in 
the delirium and in subsequent attacks (B., R.). Ammonium Bromide has 



574 DEMENTIA AND INSANITY. 

been used with very good results (Wsl). Chloral, ax outset (R.); ver >" we- 
ll, but dangerous to old drunkards, or when heart disease exists B. . 
If long continued to produce sleep chloral will produce a condition of in- 
somnia. Chloroform, inhalations to procure sleep (R.). Anaesthetics dan- 
gerous (B.). Cannabis Indie a, gr. ss-j of extract, one of the least dangerous 
and most useful hypnotics (P.). Tartar Emetic* as hypnotic B. : combined 
with opium to control mania and insomnia {R.). Capsicum, to induce sleep 
in early stages, gr. xx-xxx in a bolus with honey, repeated after three hours 
(R.). In 20-30-gr. doses has remarkable success (P.). The tincture in Zss- 
doses every three hours of great benefit Wa. . Xux Vomica, or Strychnine, 
should be more freely used than it is in alcoholism, and in delirium tremens 
may be used hypodermically almost to the commencement of tetanic action 
(Luton 1. Arnica, the tincture is exceptionally serviceable in cases where 
there is depression (B.). Coffee, often exceedingly useful 7 Digitalis. Jss 
of tinct. repeated in 4 to 6 hours R. ; a tablesp. of the infusion every 4 hours 
in pale subjects, anaemia of brain, with effusion and oedera ::as cured 

many cases promptly without producing any unfavorable symptoms. Its 
safety and efficacy are alike questionable Wa. . Cimicifuga, an excellent 
tonic for the nervous system, very successful (P.). Quinine, with a mineral 
acid to restore digestion, in the " horrors,'' and in adynamic states B. ; gr. j 
two or three times daily as a tonic, the best to produce nervous tranquillity 
( Anstie). Sumbul, very efficient for insomnia (P.). Zinc Phosphide, gr. jss 
. in divided doses, for many weeks, is used with decided benefit. Zinc 
Oxide, is of essential benefit as a nerve tonic and sedative, gr. ij-viij, twice 
daily, gradually increased to the higher dose named Wa. . Lupulin, the 
tinct. or oleo-resin, useful in mild cases as stomachic tonic and cerebral seda- 
tive B. . Ammonium Carbonate, when anaemia of brain and feeble heart- 
action iB.). Conium, combined with opium, useful 1 P. '). Alcohol, of un- 
doubted use where failure of stomach to appropriate food (B.). Water, about 
6cr with ice to head, to reduce temperature in the hyperpyrexia (B., R.). 
: r nent, should tend to nourishment, and establishing of digestion B. . 
Concentrated liquid nourishment, with moderate use of stimulants H. . Diet 
:enc. The immediate source of danger is exhaustion, hence ani- 
malized and nutritious, digestible diet in fluid form, small quantities frequently 
repeated ; beet-tea, soups, yolk of eggs, warm milk, cocoa, cayenne pepper 
or stimulants in soups: coffee, tc still nervous excitement; hot baths and wet 
:o eliminate the poison. A quiet dark room, sleep a necessity, often in- 
duced by Belladonna. [Compare Alcoholism.] 

Prescriptions. 

U. Tinct. Capsiei, R,. Chloralis Hydrat., . " , 

Ext. Lupulini Fl., . aa ij- E x t- Conii FL, . . . ijiij. 

Mucil. Acacia?, . . gss. Ext. Hyoscyami Fl., . giv. 

Aquae Cinnamomi, . . ^jss. Mucil. Acaciae, . . ^ij. 

M. Sig. — Dessertsp. as required for Aquae Menth. Virid., ad 51J. 

the wakefulness and excitement which ML Sig. — Teaspoonful in water after 

precedes an attack. | each meal. 

Dementia and Insanity. 

Moral or Mental Treatment in recent times, is confided in greatly. With 
correct management from the start, nearly all cases of insanity unattended by 



DEMENTIA PARALYTICA DENGUE. 575 

paralysis or physical decay may be cured (Savage) This can be best admin- 
istered in a well-conducted asylum or hospital for the insane, where security 
and the prospect of recovery will be better than in the best home. The total 
abolition of any one plan of treatment in favor of another would be a great 
mistake. More than half of first attacks of insanity are recovered from under 
good management, which is best attained under the direction of persons 
trained in this specialty (H.). Recently, efforts have been made at the im- 
provement of the insane condition by requiring them to attend school daily, 
with remarkably good results. Tonics and Hypnotics, should be used in cases 
requiring them. Food, of good quality is at the basis of treatment. Opium, mor- 
phine the best form, especially for melancholies, climacteric and senile cases, 
which improve under its use ; is hurtful in mania. Chloral dots, as much harm as 
good, is best suited to wildly maniacal and erotic patients. Potassium Bro- 
mide, is almost discarded, except for epileptic cases. Conium, is useful, spar- 
ingly, for noisy patients, so also is Hyoscyamine. Colchicum, for gouty cases, 
which are numerous. Cure the gout and you may cure the insanity. Shower- 
bath, suitable for cases due to self-abuse, and the wet pack in the mania of 
hystero-epilepsy. Stimulants rank high, next to quiet and absence from home. 
Koumiss, a good food in hysterical dyspepsia and anorexia, being easily di- 
gested and preventing waste [Dr. Savage, Bethlehem Asylum). [Compare 
Delirium, Hypochondriasis, Mania, Melancholia.] 

Dementia Paralytica. 

Physostigma, has seemed to retard the progress of the disease in some few 
cases (B.). Paraldehyde, in 1 or 2 drachm doses as a calmative and hypnotic 
is as efficient as chloral and without danger (B.). Tonics, maybe used, though 
treatment is only palliative. Lacto-phosphate of Calcium, Cod-liver Oil, etc. 
No remedies have hitherto been of any avail (B.). 

Dengue. 

Emetics and Purgatives are indicated at the outset, also free diaphoresis. 
Treatment is entirely symptomatic. Quinine, in five-grain doses every four or 
five hours for the fever (Da Costa) ; should be given more for its tonic than 
for its antiperiodic effects (Fayrer). Opium, in some form for the pains and 
nocturnal restlessness. Salicylic Acid or salicylates for the pains in joints and 
muscles. Carbolic Acid, as lotion, a 5 per cent, solution, for the itching, or 
camphorated oil. Belladonna confers great relief in this disease, ni x-xv of 
the tincture may be given every hour for two or three doses (Fayrer). Aconite, 
with salines and nitric ether, during the pyrexia, which may go so high that 
cold sponging or the cold bath may be required. Bitter Tonics, as gentian 
and calumba, with quinine and a mineral acid or strychnine during convales- 
cence. 

Prescriptions. 



R. Tinct. Colchici Sem., . 5pj. 

Spt. ^Etheris Nitrosi, . ^iv. 

Potassii Nitratis, . . gr. xl. 

Aquae, . . . ad gvj. 

M. Sig. — Tablesp. well diluted 
every hour or two until profuse dia- 
phoresis occurs. For relief of the 
violent pains. 



R. Tinct. Aconiti, . . trixvj. 

Morph. Acetatis, . . gr. ij. 

Spt. ^Etheris Nitrosi, . giv. 

Liq. Amnion. Acetat, . %i\). 

Aquae Camphorae, . ad giv. 

M. Sig. — Teasp. to dessertsp. ac- 
cording to age, every hour for three 
hours, then every two hours. 



576 



DENTITION — DIABETES. 



Dentition. 

Belladonna, in convulsions of dentition rarely fails to relieve (P.). Hyos- 
cyamus, to alleviate pain and subdue irritation; better than opium for children 
(P.). Chamomilla, rnj of the tincture every j£ hour, an excellent sedative 
for children (A. A. Smith). Potassium Bromide, for irritability and convul- 
sions in teething (R.)- Dulcamara, the infusion, in diarrhoea of dentition 
quickly checks symptoms (P.). Calumba, excellent for the accompanying 
vomiting and diarrhoea (P.). Hypophosphites, of lime or sodium, as a general 
tonic, are highly recommended (R.). Rhubarb, with soda, internally for the 
aphthae, with perfect cleanliness of the mouth and a wash of Borax or Potas- 
sium Chlorate in glycerin, gr. x ad l|j (E. Smith). Castor Oil, for the diarrhoea 
of dentition to clear out the bowels, then a mixture of Chalk and Catechu, or 
Oxide of Zinc, gr. j to the dose, with gtt. j of Laudanum if required to reduce 
peristalsis (E. Smith). Lancing the Gums to relieve tension when gum is 
actually swollen : should not be indulged in indiscriminately. 







Prescriptions. 




R. Potassii Bromidi, 


. 


• 3J- 


R . Sodii Bromidi, 




Olei Anisi, 


. 


• ™jj. 


Sodii Bicarbonat , 




Mucil. Acaciae, 






Chloralis, 


aa gr. xx 


Aq. Menth. Pip., 


. 


aa^j. 


Aq. Menth. Viridis, 


. |jss. 


M. Sig. — Teasp. 


every 


half-hour 


Syr. Zingiberis, 


• 3 SS - 


until relieved. 




(B-) 


M. Sig. — Half-teasp. 
according to age. 


to dessertsp 



Diabetes Insipidus. 

Opium, large doses necessary, gr. yj-xij a day (B.); combined with gallic 
acid the most generally useful remedy (W.). Ergot has cured many cases, 
the fluid extract in doses of ^ss-j thrice daily (Da Costa); one of the most 
efficient remedies (B.); is the most useful remedy (R.). Iron and Strych- 
nine are very useful for tonic effects (Da C). Valerian restrains the flow of 
urine but does not cure (B.). Muscarine has been used with apparent suc- 
cess (R.). Potassium Iodide is curative in many cases of syphilitic origin 
(B.). Alum has produced good results (B.). Jaborandi, used successfully 
to reduce the quantity of urine (B.). Valerian, large, increasing doses (R.). 
Krameria lessens quantity of urine (P.). Diet, a dry diet beneficial (B.). 



Prescriptions. 



R. Ext. Ergotae FL, . . giij\ 
Sig. — Half-teasp. thrice daily, grad- 
ually increased to a dessertspoonful. 



R. AcidiGallici, . 
Div. in chartulas xij. 
Sig. — One thrice daily. 



3")' 



Diabetes Mellitus. 



Phosphoric Acid, largely diluted, assuages the inordinate thirst. In one 
case it seemed to act as a curative agent (Wa.). Arsenic, when from faulty 



DIARRHCEA. 



577 



assimilation, in diabetes of hepatic origin, and in thin subjects (B.). Opium, 
in large doses (gr, vj-xij a day), ameliorative. Codeine, is especially service- 
able (B.). Abates thirst and controls appetite (R.). Its value much disputed 
(P.) ; is of great value in many cases (W.). Codeine gr. X"~X one °f tne 
best remedies (Da Costa). Sodium Salicylate has cured when all other drugs 
have failed (R.) ; gr. x-xv in compound spirit of lavender and water, thrice 
daily, is my favorite remedy (Da Costa). Ergot is one of the useful drugs 
( Da C. ) : decreases the quantity of sugar and the volume of urine. Potassium 
Bromide, gr. xx ter die, cured two cases in six weeks (Begbie, R.) ; useless 
(Da C.). Krameria lessens quantity of urine (P.). Phosphates, to avert 
failure of nutrition (B.). Glycerin has produced good results (B.). Used in 
place of sugar (W.). Aurum Chloride is one of the promising remedies (B.). 
Uranium Nitrate, gr. i-iij, thrice daily has caused decided improvement in 
several cases (Hughes). Alkalies are used on theoretical grounds, but have 
not produced much benefit. One case apparently cured by the diligent use 
of Ammonium Carbonate (B.); are serviceable (Da Costa). Alkaline min- 
eral waters for diabetes of hepatic origin and in obese subjects, are extremely 
useful (B. ). Salines, a warm solution of phosphate and chloride of sodium, 
by intravenous injection, in diabetic coma, produced astonishing results in one 
case (B.). Aloin, for the accompanying constipation (DaC.). Nux Vomica, 
or Strychnine, is generally beneficial. Calcium Lactophosphate benefits the 
thin nervous type of diabetes remarkably (B.). Aliment. All saccharine 
and farinaceous foods forbidden. Use fats, animal food, and gluten or almond 
bread. Milk-cure, buttermilk best, to be the only food until cessation of symp- 
toms. Alkaline Waters, when of hepatic origin and in obese subjects. Tepid 
drinks in the intense thirst (B. >. Diet and Hygiene are of the utmost im- 
portance. Avoid amylaceous food, and everything containing sugar, especially 
ordinary bread. Use fresh, nutritious animal food, with bread of bran or 
almonds. Warm baths, Warm climate, flannel underclothing. Milk-cure, by 
skimmed milk, very successful, 6 to io pints daily. No other food for six 
weeks, then animal food alone. Caution, — the urine of patients taking sali- 
cylic acid gives the reaction of sugar with Trommer's test (R.j. 



Prescriptions. 



R . Liq. Potassii Arsenitis, . gjss. 
Tinct. Opii Deodorat., . Zv. 
Syrupi Zingiberis, . • %}• 
Aquae Cinnamomi, . ad ^iv. 
M. Sig. — Teasp. thrice daily. 



R . Codeinae, . . . gr. viij. 
Syrupi, et Aquae, . . ^ij. 
M. Sig. — Half-teasp. thrice daily, 
gradually increased up to two tea- 
spoonfuls. (Pavy.) 



Diarrhoea. 



Aconite, when from chill, high fever, cutting abdominal pains (P.). Mer- 
cury. Calomel for infantile diarrhoea (ileo-colitis), gr. -^ to T \ every half- 
hour (B.). The bichloride, gr. j in t ^x aquae, a teasp. frequently in acute or 
chronic diarrhoea of adults or children with slimy, bloody stools, pain and 
straining. Gr. */£ of gray powder hourly, or gr. T ^ of corrosive sublimate 
every two or three hours (R.j ; gr. j of the bichloride to the quart of water, 
of this a teasp. every hour in mucous diarrhoea (A. A. Smith). Camphor, in 



573 



DIARRHOEA. 



summer diarrhoea and the preliminary diarrhoea of Cholera Asiatica (B.); 
when from effluvia of drains or exposure to cold (R.) ; useful in many forms 
(P.). Ipecacuanha, in summer diarrhoea and dysentery of children with 
greenish stools (B.); hourly drop-doses of the wine especially if vomiting 
(R.) ; when from nervous irritation, especially young children (P.). Dul- 
camara, in diarrhoea of children from damp, or with dentition (P.). Pulsa- 
tilla, dyspeptic diarrhoea, mucous discharges, active piles (P.). Quinine, in 
periodic diarrhoea, with dysentery and jaundice (B.). Veratrum Album, 
in the vomiting and purging of summer diarrhoea (R.). Podophyllum, in 
chronic, with high-colored motions and cutting pains, also, in morning diar- 
rhoea (R.). Gr. ■£$ to T ^, with occasional doses of aconite, for vomiting and 
diarrhoea of gastro-enteritis and prolapse of rectum (P.). Chamomile, an 
infusion in summer diarrhoea of adults, or in that of dentition (R.)» The 
oil in diarrhoea of children, especially from worms (P.). Arsenic, for evacua- 
tion of undigested food (B.) ; gtt. j of liq. arsen. before meals when diarrhoea 
excited by food ; also in chronic and membranous forms (R.). Nux Vomica, 
a very useful adjunct to other remedies (B.); often of much service in epi- 
demic diarrhoea (P.). Sulphuric Acid, in summer and choleraic diarrhoea. 
Small doses in chronic form and in the straining diarrhoea of children (R.). 
Iron, sol. of pernitrate in army diarrhoea (B.). Lime Carbonate, in later 
stages, as chalk mixture in diarrhoea of typhoid or phthisis (R.). Zinc Salts, 
very efficient in summer diarrhoea of children (B.). Rhubarb, in early stages 
to get rid of irritant, afterwards to check the diarrhoea (R.); when torrefied 
it has no purgative power, but its astringency is retained. (See page 440.) 
Rumex, in morning diarrhoea (R.). Arnica checks exhausting diarrhoea with 
great certainty (P.). Silver Nitrate, in diarrhoea of children. White, pasty 
and offensive stools. Combined with opium the most effective remedy for 
that of phthisis or typhoid (B.). Mineral Acids, in painless, watery stools, 
light color and alkaline (B.). Alkalies, mistura cretae in sour-smelling stools 
(B.). Sodium, potassium or magnesium bicarbonates when acid canal (R.), 
Lead Acetate is excellent in all forms (B.) ; with opium as an injection (R.)» 
Bismuth is effective, requires large doses. Gr. xxx-lx every three or four 
hours ; is especially indicated when desire for stool is felt immediately after 
eating (B.). Gr. j hourly with milk, sometimes with gr. y^ gray powder, in 
various forms of infantile diarrhoea ( R.). Opium, commonly used, but is best 
in watery evacuations, combined with mineral acids or acetate of lead (B.). 
As injection with starch in severe cases (R.). Calumba, when not inflamma- 
tory (B.). Coto Bark, the fluid ext. or Cotoin is one of the new remedies for 
atonic diarrhoea. Purgatives, Saline, a teasp. of Epsom salts (magnes. sulph.) 
in a wineglass of water every three hours when intestinal inflam'n (B.). Cop- 
per Sulphate, the most effective astringent in chronic diarrhoea and that of 
phthisis (B.). Ergot, in persistent chronic diarrhoea (B.). Iodine, one or two 
drops of tinct. in diarrhoea from atony of mucous membrane (B.). Tannic 
Acid, very useful in profuse and chronic diarrhoea. Stille advises tannic acid 
and milk diet for chronic diarrhoea and dysentery (B.). Diet. Cool or cold, 
light, bland food. Gruel, rice, arrow-root, whey, barley-water, in recent cases. 
In chronic cases the most digestible but nutritious food, as fresh fi>h, game, raw 
eggs, rice, mucilaginous drinks. Milk-and-lime-water or soda-water very 
useful. Also raw meat pulp. Avoid beef, pork, veal, and much starchy food. 
[Compare Dysentery, Cholera.] 



DIARRHCEA DIPHTHERIA. 



579 



Prescriptions. 



R. Bismuthi Subnit., . gj-ij. 
Pepsini Saccharat., . gss. 
Zinci Oxidi, . . gr. vj-xij. 
Trit. et div. in chartulas xij. 
Sig. — One every four hours in sum- 
mer diarrhoea of children. 



R. Zinci Sulphatis, 

Pulv. Opii, 

Pulv. Ipecac., . . aa gr. xij. 
M. Fiant pil. no. xij. Sig. — One 3 
or 4 times daily in chronic diarrhoea of 
adults. 



R. Tinct. Opii Camph., 

Tinct. Catechu, . aa giij. 

Mist. Cretae, . . . ^x. 
M. Sig. — A teasp. four or five times 
daily for children. 



b. 



Tinct. Opii Camph., 
Syr. Rhei Aromat., •. aa^ 
Aquae Calcis, . . ad 
M. Sig. — A teasp. for children. 



R. Sodii Bromidi, . . gss. 

Mucil. Acaciae, 

Aquae Purse, . aa q.s. ad ^ij. 
M. Sig. — Teasp. every three hours 
in the diarrhoea of dentition, for 
child less than a year old. 

(A. A. Smith.) 



R. Tinct. Opii Deod., . 

Tinct. Calumbae, . ad 

M. Sig. — Teasp. in a winegl. 
water before meals. 



of 



R . Cupri Sulphat., . 
Morph. Sulphat., 
Quininae Sulph., . 
Fiant pil. no. xij. Sig.— 

thrice daily. 


gr.j. 
gr.ij. . 
gr. xxiv. 

-One pill 


R . Zinci Oxidi, 
Sodii Bicarb., 
M. et div. in chartulas iv. 
Sig. — One every 6 hours. 


gr. xvij. 
gr. viij. 


R. Plumbi Acetat., . 
Pulv. Opii, . 
Fiat massa, et div. in pil. ■> 
Sig. — One twice daily. 


. gr. xx. 
. gr. x. 


R. Ac. Nitrici Diluti, . . gij. 

Tinct. Camphorae, 

Tinct. Opii, . . aa gj. 

Syr. Zingiberis, . . ziv. 

Aq. Menthae Pip., . ad£v}. 
M. Sig. — Tablesp. doses to be used 
after a cathartic. {Hope's Mixture 
modified by Thompson.) 



R. Spt. Athens Co., 

Tinct. Opii Camph., . aa jf j. 

Syr. Simplicis, . . . Jij. 

M. Sig. — Dessertsp. after each 
movement. 



Diphtheria. 

Belladonna, an excellent remedy ; if given early will abort the exudation 
and later is useful to sustain the heart (B.) ; especially when throat and ton- 
sils acutely inflamed and much swollen (R.)- Corrosive Sublimate, gr. -}§-\ 
every 2 or 3 hours, has given me most success, with Thymol or Boric Acid 
gargle ; and Potassium Chlorate, Iron and Quinine together, where the mem- 
brane is not spreading (Da Costa). Merc. Cyanide, in solution of gr. -^ to 
the ^, of which a teasp. every *4 hour day and night to older children and 



58o 



DIPHTHERIA. 



adults, with a gargle of the same solution (Sellden) ; gr. ^V"tV» according to age 
every hour or two (Erichsen). Calomel is next in importance to quinine and 
iron, has proved successful in cases where other means failed, gr. %-% every 
3 hours, with a little Dover's powder (Da Costa). Chlorine- Water, tablesp. 
doses internally and as gargle, highly efficient. Calomel, checks plastic exu- 
dation; its use limited to children of good constitutions, with sthenic symp- 
toms. Gr. ]/ 2 to j every 2 or 3 hours with or without Dover's powder (gr. j) 
or ipecac, (gr. j) till bowels become relaxed, with greenish stools (Wa.). Gr. 
v repeated boldly every hour to ^iv, for a child of 3 years, until the stools 
appear like polyps in water-troughs, gelatinous, and of a bright, dark-green 
hue. Then a dose of castor oil if salivation is feared (Reiter's Monograph, 
1878). Calcium Chlorate, solution locally as lotion for the mouth. Consid- 
ered almost specific by some ; its chief utility is in removing fetor ; may influ- 
ence germs (R., B.). Potassium Chlorate, grain-doses every y£ hour (A. A. 
Smith) ; is more largely used than any remedy, both internally and locally (B.) ; 
in full doses with Liq. Cinchona, seems to be of service in some cases (Wa.). 
Pilocarpine, used in 80 cases without a single death ; produces free salivary 
discharge but is depressant to the heart (Guttmann) ; many opinions for and 
against it. Is decidedly injurious in adynamic cases (B.). Quinine in tonic 
doses recommended from my experience (Da C.) ; when headache with high 
temperature, vomiting, and symptoms of septic poisoning, then in full doses 
(Wa.) ; is most useful after serious symptoms have abated, then with Iron and 
a mineral acid (Mackenzie). Carbolic Acid, in spray, locally to the fauces, to 
remove fetor and destroy disease-germs (B. ). As caustic, the concentrated 
acid in glycerin on a mop or brush (W. ). With iodine to prevent systemic 
infection (B,). Arsenic, in medicinal doses, when sloughing of throat, or ma- 
lignant diph. (R.)- Salicylic Acid, locally and internally (gr. x) has produced 
good results (B.). Sulphurous Acid Gas, recommended by a royal commis- 
sion in Victoria, as a means of arresting the disease. Crude sulphur burned 
in the room, ail apertures being closed (R.) Sodium Sulphite, ^j-^j aquae, 
locally, an easily managed application (B.); an injection for nares in nasal 
diphtheria (Da C). See formula below. Sodium Benzoate,is highly effi- 
cient, 75 to 100 grains daily, according to age, also used locally (B ). Sodium 
Sulpho-Carbolate, has been found useful in lieu of carbolic acid ( Wa.). Li?ne 
Water, dissolves false membrane. The vapors of slacking lime inhaled ; or 
better, lime-water by atomizer to back of fauces while patient respires deeply 
( W.). Ferric Chloride, as solution painted on or applied by spray to the throat 
(R.). Of no advantage locally, internally may serve by supporting the or- 
ganism (B.) ; the tinct. of the chloride, gtt. xx every 2 or 3 hours; or better 
the perchloride, gr. x / 2 to j every 2 hours in syrup and water, is easier to take 
and doesn't hurt the throat ( Da C). Strychnine, hypodermically, for the sub- 
sequent paralysis (R.). Tartaric Acid, locally, converts membrane into a gela- 
tinous mass, easily expelled (Vidal). Thymol, gr. xx to the 3 of water, with 
a little glycerin, is the best gargle; may need weakening (Da C). Boracic 
Acid in solution, is next best as gargle (Da C). Alum and Sulphur, equal 
parts, powdered and blown into the throat at moment of deep inspiration, as 
often as asphyxia is threatened, has been found efficient (Jones). Trypsin, 
is a good solvent of the false membrane. Chinolin, a 5 per cent, solution 
painted over the affected parts with great advantage ( Seifert) ; the tartrate in 
10-grain doses internally (B ). Bromine, the vapor by inhalation, is useful 
( Wa.) ; a T J ¥ solution in distilled water, of which gtt. j-iij every y z hour in 
a teasp. of sweetened water, using a glass spoon ; and a saucer full of bromine 
water in the room, renewed every 12 hours, has seemed to be extremely effi- 



DIPHTHERIA. 



581 



cient in a number of cases. Iodine, as inhalation frequently (see formula 
below) : with use the solution maybe increased to ^ss at each inhalation (R.). 
Potassium Permanganate \ gr. y z in distilled water, internally, and also used 
locally, is of undoubted benefit (B.) : is credited with brilliant results even in 
malignant cases. Sanguinaria, the best emetic, and by many is considered 
specific in this disease (P.). See formula below. Lactic Acid, ^rijss to gx 
of distilled water, as gargle, on mop or by spray, to dissolve membrane (B.). 
Tannin, sl 5 per cent, solution, as spray (R.). Alcohol, is probably as good 
a local antiseptic as any : diluted with equal parts of water, by hand-ball 
atomizer every l / 2 hour. Cubebs, are very efficient in the catarrhal forms of 
diphtheria (B. Robinson) : the freshly ground berries in large doses in early 
stages of the disease, a very successful treatment (Trideau). Water. Ice in 
the mouth, and the wet pack to the throat are extremely serviceable (B.). Ice 
sucked, especially at commencement, and continued until the disease declines 
(R.). Ice packed in bladders or thin india-rubber bags, to the throat (W.). 
Aliment. Good foods, wines or brandy necessary from the start to maintain 
the patient's strength (RJ. A teasp. of glycerin every 3 or 4 hours, plenty of 
good soup and wine, nutritive enemata, are necessary to sustain system. Moist 
inhalations. Temp, of room 68° Fah. Removal from the house wherein 
attacked is advisable. Ice very grateful to the patient. Stimulation, freely, 
the essential part of the treatment; infants are not injuriously affected by even 
teasp. doses of whiskey every x / 2 hour. Stimulate for effect and not by dose; 
those cases do best which are stimulated freely and early (Da C). There is 
more danger from giving too little alcohol than from too much. A three year 
old child can comfortably take from Jj-§v of Cognac, or gr. xv of Musk or 
Camphor, or gr. xv-^j of Ammonium Carbonate in 24 hours. In the septic 
form especially, the intoxicating action of alcohol is out of the question. 
Young children with general sepsis began to improve when their Jiv of brandy 
were increased to §xvj daily (Jacobi). Tracheotomy, only in extremis (R.) : 
is not successful in this disease, though very much so in membranous croup 
(Da C). 

Prescriptions. 



S 



R . Tinct. Ferri Chloridi, 

Syrupi Tolutani, . aa. 

Liq. Potassii Citratis, . ^iv. 

M. Sig. — Teasp. to dessertsp. ac- 
cording to age, every 3 hours. gz=Tt\x. 

{Anderson.) 

R. Hydrarg. Chlor. Corros., gr. j, 
may be added to the above formula, 
which should then be given in teasp. 
doses. 



R . Potassii Chloratis, . . gr. xl. 

Syrupi Simplicis, calid., . gijss. 
Solve, et adde — 
Ac. Sulphur. Aromat., 
Tinct. Ferri Chloridi, aa. ^j. 
M. Sig. — Teasp. doses for adults, 
every 2 to 4 hours, reduced as im- 
provement advances, but kept up 
throughout disease. 



R . Acidi Lactici, 

vel Tartarici, . . ^ijss. 
Glycerini, . . . giv. 
Aq. Menth. Pip., . . .^vij. 
M. Sig. — Locally to patches every 
3 hours. 



R. Thymol, . 
Glycerini, . 
Aquae, 
M. Sig. — Gargle. 


{Da Costa.) 


R . Sodii Sulphit., . 
Glycerini, . 
Aquae, 
M. Sig. — Nasal inj 


q. s. ad Jiv. 
ection. 

{Da Costa.) 



5 82 



DROPSY. 



R. Tinct. Ferri Chloridi, . ,^jss. 
Glycerini, Aq. Destil., aa §j. 
M. Sig. — Teasp. of this and the 
next R . alternately every y 2 hour. 



R. Potassii Chloratis, . . £ss. 

Glycerini, . . . Jfss. 

Aquae Calcis, . . . Jijss. 

M. Sig. — Teasp. of this and the 
preceding R . alternately every ]/ 2 
hour. 



R . Pilocarpine Muriatis, gr. %-%. 

Pepsini, . . . gr. x-xx. 

Acidi Hydrochlor., . gtt. ij. 

Aquae Destill., . . ^viij. 
M. Sig. — Teasp. every hour for a 
child. 



R. Pulv. Potass. Chlorat., . gj. 
Ac. Hydrochlor., . . ^ij. 

Mix in a strong pint bottle, cork 
until effervescence ceases. Add §xvj 
of Water, §j at a time, shaking at each 
time. Cork tightly. Paint the bottle. 

Sig. — Chlorine-water. A tablesp. 
or two to be taken frequently, accord- 
ing to age. 



R . Pulv. Sanguinariae, 

Pulv. Ipecac, 

Syrupi Ipecac, 

M. Sig. — Teasp. every 

until vomiting; afterwards, y 2 teasp. 

every hour. [Phillips.) 



gr. xx. 
gr. v. 

l hour 



B 



. Tinct. Ferri Chloridi, 

Potassii Chloratis, . aa ^ss. 

Glycerini, . . . £vj. 

Aquae, . . q. s. ad §viij, 

M. Sig. — Gargle, every 3 hours. 



R. Iodi, . . . . gr. iv. 

Potassii Iodidi, . . gr. iv. 

Alcoholis, . . . £iv. 

Aquae, ad ^iv. 

M. Sig. — Teasp. on boiling water 
as inhalation. ( Waring- Currati .) 



R. Bromi, 

Potass. Iodidi, . 

Aquae, 
M. Sig. — Inhale from a 
solvent of membrane. 



• 26- 

cone, as 



R . Acidi Carbolici, 
Aquae Calcis, . 
M. Sig. — Spray. 
a hand-ball atomizer several times 
daily, for 5 minutes each lime. 



. ntxv. 
To be used with 



R. Ac Tartarici, . . . Jp. 

Glycerini, . . . .?jss. 

Aquae Menth. Pip., . ad §iv. 
M. Sig. — Gargle frequently. 

( Vidal.) 

R . Ac Salicylici, 

Sodii Boratis, . . aa gtj. 
Ac Carbolici, . . . £j. 
Aquae, .... §iv. 
M. Sig. — Use as gargle or wash. 



Dropsy. 

Arsenic, in dropsy from feebleness of heart, and in old age (B.); swelled 
feet from debility (R.). Digitalis, one of the best remedies, esp. in renal 
dropsy from acute desquamative nephritis. The infusion in doses of j|ss (B.). 
The fresh infusion best for heart disease, esp. when tricuspid regurgitation (R.). 
Induces striking effects in cardiac dropsy, when scanty urine and venous en- 
gorgement. Has high rank as a diuretic (P.)- Apocynum Cannabinum, 
actively diuretic (P.). Bryonia, as a drastic purgative and diuretic, care 
necessary as it depresses the heart. The infusion best (P.). Hellebore, the. 
tinct. in doses of gtt. v-xv, every 2 or 3 hours, very successful in dropsical 



DROPSY. 



583 



effusions, especially in general anasarca after scarlatina (P.). Senega, as a 
diuretic when dependent on kidney disease; has been praised (P.). Chima- 
phila, is useful as diuretic in renal dropsy esp. when with loss of appetite and 
debility (P); maybe substituted for Scoparius (B.). Juniper, largely used as 
a diuretic in cardiac and renal dropsy (B.) ; esteemed in post-scarlatinal dropsy 
(R.). Iron, purgative chalybeate waters (B.) ; the Mistura Ferri et Ammonii 
Acetatis (Basham's Mixture), in anaemic dropsy (Da C). Pilocarpus, very 
valuable in renal dropsy when secretion of urine is much reduced or sup- 
pressed (B.). Jalap, the compound jalap powder, gr. xv-xx, with giij of potas. 
bitart. and a little ginger, early in the morning, 2 or 3 times a week ; no hydra- 
gogue superior, in dropsy from Bright' s disease (Wa.). Turpentine, controls 
dropsy with albuminous urine, from non-desq. renal disease. Gtt. ss every 2 
to 4 hours (P.). Colchicum, as a hydragogue in hepatic and cardiac dropsy 
when patient is vigorous, also in post-scarlatinal dropsy (B.). Scoparhis, 
esteemed by English physicians (B.) ; is most useful in cardiac dropsy. Cullen 
found it the most certain diuretic. Diluents should be freely used with it (P.). 
Squill, in cardiac dropsy ; cautiously if from kidney-disease. If anaemic add 
iron (B., R.). Taraxacum, is occasionally used as a diuretic, with limited 
utility (B.). Copaiba, gives good results, especially in Ascites, which see for 
formula (B.). Potassium Bitartrate and Acetate, are very certain as diuretics 
when largely diluted with water. " Cream-of-tartar lemonade." Indicated 
in desquamative nephritis, and general dropsy from valvular disease of the 
heart (B., R.). Elaterium, of unquestionable value as derivative in many 
passive forms of dropsy; though many fear it (P.). Acupuncture, or better 
still, incisions from fy to an inch long, one over each external malleolus gen- 
erally sufficient. A hot sponge, moist with weak carbolic acid solution kept 
to incisions (R.)- Aliment, dry diet is of advantage in dropsy of serous cavi- 
ties 'B.). Diet. Should be light in acute dropsies; in chronic, nourishing. 
Water not injurious but beneficial as drink. Warm baths, Hollands gin in 
small doses, tapping, for alleviation in incurable cases. A moderately warm, 
dry atmosphere. Skim-milk diet said to be of very great value in renal 
dropsy. [Compare Ascites, Hydrocele, Hydrocephalus, Hydrothorax, 
etc.] 

Prescriptions. 



R . Vini Colchici Seminis, . ^ss. 

Liq. Ammonii Acetat., . ,^ijss. 

Infusi Petroselini, . . ^v. 
M. Sig. — Teasp. every 4 hours. 
An excellent diuretic, esp. adapted to j 
dropsy of scarlatina. (B. 



R. Eiaterii, . 

Spt. Etheris Nitrosi,. 

Tinct. Scillae, 

Tinct. Colchici, 

Syr. Simplicis, . 
M. Sig. — Teasp. 3 or 4 times daily, 
in hepatic and cardiac dropsy in 
sthenic subjects. 



• g r -J- 
aa ^ss. 

% 



R. Aceti Scillae, . . . £ss. 

Infusi Digitalis, . ad Jjiv. 

M. Sig. — A tablesp. 2 or 3 times 
daily. 



R . Potassii Acetatis, . . gvss. 

Spt. Etheris Nitrosi, . £ij. 

Aquae, . . q. s. ad £v\i}. 

M. Sig. — Tablesp. every 3 or 4 
hours. 



R . Potassii Bitartrat., . . %}. 

Ext. Taraxaci, . . £ss. 

Decocti Taraxaci, . . ,?viij. 
M. Sig. — y 2 winegl. twice or thrice 
daily. 



5 8 4 



DUODENAL CATARRH — DYSENTERY. 



R. Pulv. Scillae, 

Pulv. Digitalis, . aa^ss. 

Potassii Nitratis, . . gj. 
M. Fiat massa, et div. in pil. xxx. 
Sig. — One pill thrice daily. 



R . Mist. Ferri et Ammonii 

Acetatis (U. S. P.), . 5vj. 

Sig. — Teasp. or two three or four 

times daily. (Basham's Mixt.) 



Duodenal Catarrh. 

Sodium Phosphate, ^j four times daily, extremely efficient in catarrhal con- 
ditions of the duodenum and bile-ducts, resulting in jaundice, hepatic colic, 
etc. (B.). Vichy Water, in similar conditions, probably owes its efficacy to 
the phosphate of sodium contained in it (B.). Potassium Bichromate, in doses 
°f S r * To~5» two or tnree times a day, is an excellent remedy in so-called duo- 
denal dyspepsia, manifested by a bitter taste, coated tongue, pale stools, vom- 
iting of glairy fluid and dull pain in right hypochondrium. Arsenic, has been 
used with success in jaundice from catarrh of bile-ducts after duodenal ca- 
tarrh (B.). Podophyllum, in catarrhal and malarial duodenitis. Nitro-muriatic 
Acid, in mucous duodenitis ; also as bath to right hypochondrium (giij-gall. j), 
temp, of bath 96 (B.). Aliment. No starches or fats; milk, eggs, oysters, 
beef-broth, broiled or raw beefsteak, whitefish (B.). Diet should be exclu- 
sively animal, in order to let the stomach deal with it. [Compare Jaundice, 
Biliousness.] 

Dysentery. 



Aconite, fever and cutting pains (P.). Mercury, in minute doses for the 
ileo-colitis of children. Gr. ^ to T ^ of calomel or hydrargyrum cum creta every 
half hour (B.). Gr. T ^ of the bichloride hourly or every 2 hours, in acute 
or chronic dysentery if stools are slimy or bloody (R.). Ipecacuanha, is par 
excellence the remedy for acute dysentery of the ordinary type ; large doses, 
gr. xxv-xxx (P.); gr. xv in milk (B.). Valuable in acute or epidemic, also 
in summer dysentery of children, with greenish stools, mucus and blood. Gr. 
ii-v every 2 hours in milk (B.). Dysenteric diarrhoea of children, especially 
with vomiting, will often yield to hourly drop doses of ipecacuanha wine (R.). 
Hama?nelis, when the discharges contain much blood (R.). Nux Vomica, in 
epidemic dysentery (P.); prune-juice stools, much gas, vital depression (B.). 
Arsenic, Fowler's solution gtt. ij with gtt. v of opium often benefits (B.). 
Quinine, when periodic (B.); in malarial subjects is as successful as ipecacu- 
anha in dysentery of the ordinary type (P.). Gamboge, gr. ^ in 24 hours, 
exceedingly valuable, especially in young persons (P.). Castor- Oil, as a mild 
cathartic, is very valuable in appropriate cases (Wa. ) ; gtt. v every hour, in 
water with sugar and gum, is excellent for dysenteric diarrhoea of children 
(A. A. Smith). Arnica, when vital powers are greatly depressed, is highly 
extolled (Wa.). Saline Purgatives, Epsom salts the best treatment for acute 
dysentery, especially when fever, pain, tenesmus and stools of mucus and 
blood (B.). Silver Nitrate, in pill, gr. %-), with opium, in acute dysentery 
after subsidence of acute symptoms. Also as enema beyond the sigmoid flexure 
(gr. x-xx ad Oj aquae). Also as escharotic through speculum to ulcer of rectum 
(B.). Opium, as enema, with starch and milk, after canal is emptied by salines. 
Indispensable in chronic dysentery (B.). For the purging (R.). A remedy of 
great value, and applicable to every stage and every form of the disease, allaying 
pain and vascular excitement, moderating peristalsis, promoting the cutaneous 
secretion. Is inferior to ipecac, in acute dysentery, and is most valuable in the 



DYSENTERY. 



585 



chronic form (Wa.). Glycerin, with infusion of flaxseed (i to 4^, to allay 
tenesmus (B.). Lead Acetate, as enemata in acute and chronic dysentery, 
to allay tenesmus (B.); with ipecac, and opium in pill, for acute form, see 
formula (Da C). Sulphuric Acid, with saline purgatives (B.). Copper Sul- 
phate, useful in acute dysentery; in chronic the most valuable astringent (B.). 
Gr. x-xx ad Oj aquae (R.). Ergot, in chronic, after acute; and also in the 
acute form (R.). Grape-cure, is used successfully in the chronic form (P.). 
Iron Pernitrate, sometimes in chronic (army) dysentery (B.). Calumba, is 
of great value in chronic, with ulceration of colon (P.). Injections of muci- 
laginous enemata (as flaxseed) are of great value (R.). Diet is of prime 
importance (B.). Avoid animal food and stimulants. Liquid foods best; all 
cold (R.). [Compare Diarrhcea, Enteritis.] 



R . Plumbi Acetat. 

Ipecacuanhae, 

Pulv. Opii, . 
Fiant pil. no. xij. 
2 hours until blood ceases, then at 
longer intervals. {Da Costa.) 



Prescriptions. 

gr. xxiv. R . Magnesii Sulph., . 

gr. iij. Ac. Sulph. Dil., 

gr. iij. Aquae, .... ^viij. 

Sig. — One every M. Sig. — Tablesp. in a winegl. of 
water every hour or two until it ope- 
rates. (B.) 



R . Plumbi Acetat., . . gr. iv. 
Morph. Acetat., . . gr. ss. 
Aq. Fervid., . . Jjj. 
M. Sig. — Enema to allay tenesmus. 



R. Morphinae Sulph., . gr. ij. 

Strychninae Sulph., . gr. %. 

Ac. Sulphurici Dil., . ?ss. 

Aquae Camphorae, . ^iijss. 
M. Sig. — Teasp. well diluted, every 
hour or two. In epidemic dysentery 
with prune-juice stools and marked 
depression. 



R. Bismuthi Subnit., . spj. 

Spt. Ammon. Aromat., £j. 

Tinct. Opii, . . gtt. xvj. 

Syrupi Simplicis, . t ^ss. 

Misturse Cretae, . . §jss. 
M. Sig. — Dessertsp. to child over 
one year; tablesp. or more to an adult, 
every 2 or 3 hours, after emptying 
bowels by a laxative. 



R 



. Ext. Ergotae Fl., . . Jfiijss. 

Tinct. Opii Deodor., . Jss. 
M. Sig. — Teasp. thrice daily. 

[Andrew.) 



R . Ferri Subsulphatis, . gr. xl. 

Pulv. Opii, . . . gr. xx. 

Fiant pil. no. xx. Sig. — One thrice 
daily. Chronic dysentery. 



R. Ergotini, 

Ext. Nucis Vom., . 

Ext. Opii, 
Fiant pil. no. xx. 
every 6 hours. 



. gr. xx. 
. gr. v. 
. gr. x. 
Sig. — One 
{King.) 



R . Liq. Ferri Nitratis, 

Ac. Nitrici Dil., . aa ^ss. 

Syr. Zingiberis, . . 5j. 

Aquae, . . q. s. adgn]. 

M. Sig. — Teasp. thrice daily for 

child of 2 years. Tonic to follow 

palliative treatment. [Starr.) 



49 



586 



DYSMENORRHEA. 



Dysmenorrhea. 



Pulsatilla, in the functional form, is of much benefit when discharge is 
scanty or profuse, black and clotted ; should be persevered in for 2 months or 
more (P.) ; gtt. ij every hour is most effective when the affection is not of 
membranous, obstructive or neuralgic character (A. A. Smith). Belladonna, 
in neuralgic or spasmodic forms, dark and fetid discharge, crampy pains and 
cold chills, a suppository or mild injection, together with internal administra- 
tion, will relieve (P.) ; in neuralgic dysmenorrhea it will permanently relieve 
(B.). Aconite, a valuable remedy when commenced early (P.) ; for the con- 
gestive form in plethoric subjects (B.). Cimicifuga, relieves the pain in conges- 
tive variety, and is decidedly useful (P.) ; is said to be very efficient (R.); is 
valuable (Wa.). Opium, necessary when pain is very severe; one hypodermic 
of morphine at each period is often sufficient (Wa.). Codeine, when morphine is 
not well borne, has given very complete satisfaction in several cases; gr. ^ 
moaning and evening ( Oliver). Gelsemium, relieves pain in the neuralgic form, 
TT|.v-x of the fluid extract every 2 hours (B.). Chloroform^ as the liniment on a 
flannel wrung out of hot water, or by inhalation as anaesthetic when pains very 
severe ; sometimes exerts a permanent influence (Wa.). Ergot, given when 
the molimen begins, is useful in the congestive form (B.). Amyl Nitrite, 
may be inhaled with benefit in the neuralgic variety, especially in chlorotic 
girls (Wa). Sodium Borate, in the membranous form, has been used with 
great benefit combined with ext. belladonna (Wa.). Ammonium Acetate, has 
remarkable power over many forms of dysmenorrhea. The liq. ammonii 
acetatis, in ^ss doses, with gr. y£ of ipecac, every 2 or 3 hours, to keep up the 
action of the skin until the flow is well established (E.). Camphor, is my 
favorite remedy, gr. x in mucilage and cinnamon- water; repeat the dose in 
an hour or two if necessary (Dewees). Guaiacum, is very useful (P.) ; drachm 
doses of the ammoniated tincture in the neuralgic or rheumatic forms (B.). 
Caulophyllum, is by many considered the best curative remedy for spasmodic 
dysmenorrhcea, if given in the intervals. Viburnum Opulus, the fluid extract, 
in half-drachm doses, has considerable reputation in some sections for uterine 
pains of various kinds, and is useful in the spasmodic variety of this affection ; 
may be used in combination with cannabis indica (Thomas). Arsenic, gtt. iij-x 
of Fowler's sol. with gtt. x of tinct. digitalis, ter die between the periods, gives 
excellent results (Athill) ; indicated when copious membranous discharge from 
bowels and uterus (R.). Cannabis Indica, is very useful as a palliative in 
painful menstruation (B.) ; gr. ss-j thrice daily to relieve the pain (R.). Nux 

Vomica, in neuralgic form. Syrup or elixir of iron, quinine, and strychnine 
(B.). Apiol, neuralgic form (B.) ; as emmenagogue, night and morning, for 
several days near the period (Wa.). Electricity, in neuralgic, a galvanic cur- 
rent ; in congestive, inverse current (B.). Croton- Chloral, in neuralgic form 
(R.). Iron, if depending on anaemia (B.). [See Amenorrhcea for formula.] 

Cajuput Oil, said to relieve the pains (R.). Rue and Sumbul, are reported 
useful (P.). Emetic of ipecac., with warm covering in bed, feet in hot water, 
hot ginger tea, liquor ammonii acetat. If pain very severe, a suppository of 
morphine and belladonna per rectum; best to avoid anodynes (E ). Ac- 
cessories, spinal ice-bag, when scanty discharge ; when menorrhagic, hot 
water spinal-bag. Sitz baths, either hot or cold, or cold alone, during 
intervals. 



DYSPEPSIA. 



587 



R. Ext. Belladonrae, . 

Ext. Stramonii, 

Ext Hyoscvami, aa gr. v. 

Quininae Sulphatis, . gr. xl. 
Fiant pii. no. xx. Sig. — One pill 
thrice daily. Neuralgic dysmenor- 
rhcea. 



Prescriptions. 
gr. iv. R. Ext. Ergotae Fluidi, 



R . Ext. Opii, . 

Ext. Cannabis Ind., 
Ext. Hyoscyami, . 
Camphorae, . 
M. Fiant pil. no. x. 



gr. v. 



Sig. — One 



• 5 V1 J- 
Tinct. Gelsemii, . . gj. 

Tinct. Aconiti, . . rtixvj. 

M. Sig. — Teasp. every 2, 3 or 4 

hours. In congestive dysmenorrhcea. 



pill 2 or 3 times daily. (McLane.) 



R . Ext. Cannabis Ind. Fl., . sgjss. 

Ext. Viburni Op. Fl., . gvj. 

Mucil. Acaciae, . . 5^iij. 

Aq. Cinnamomi, . ad%iv. 
M. Sig. — Dessertsp. every 4 to 6 
hours. 



Dyspepsia. 

Nux Vomica, gtt. v-x ter in die before meals as stomachic tonic (B.) ; when 
flatulence, weight on head and heartburn (R.). Often of the highest possible 
value in simple atonic form, or in the dyspepsia of drunkards (P.). Arsenic, 
drop doses of Fowler's solution before meals in irritative dyspepsia (B.) ; also 
when diarrhoea is excited by food (R.). Bryonia, in dyspepsia of liver origin, 
"bilious" headache with vomiting (P.). Charcoal, when flatulence; nux 
vomica in 5-Tti doses, before meals, better (R.). Mercury, gray powder gr. j, 
3 or 4 times a day, when dyspepsia during chronic disease or convalescence. 
If constipated, calomel gr. ss with extract hyoscy. gr. iij in pill for 3 nights ( R.). 
The yellow oxide, in doses of gr. -$q-jq, f° r dyspepsia septica and kindred 
disorders of the alimentary canal; remarkably efficient in Austrian navy 
(Schaffer). Ipecacuanha, lUv-x of the wine most valuable in atonic and 
chronic catarrhal dyspepsia (P.); constipation, depression, food "like a heavy- 
weight" (R.). Hydrastis, gtt. v-xv of the tincture before meals, a good stomachic 
tonic (B.) ; in chronic dyspepsia, sluggish liver (P.). Pulsatilla, a good rem- 
edy when depression with fear of death, white-coated tongue, little or greasy 
taste, nausea, flatulency, heartburn; gtt. v in water every 4 hours (P.). Cin- 
chona, with mineral acids in atonic dyspepsia (P.). Quinine, especially for 
town-dwellers and elderly people ; checks excessive fermentation in aliment- 
ary canal (R., P.). Chamomile, itlij of oil, very useful in atonic dyspepsia (P.). 
Ignatia, useful in nervous dyspepsia (P.). Taraxacum, certainly does good in 
simple atonic dyspepsia (P.). Belladoniia, gr. y^ to % of the extract, once a 
day when there is constipation (R.). Bismuth, mixed with vegetable charcoal 
in flatulent dyspepsia (R.); gr. x with same quantity of calcined magnesia, in 
chronic gastric catarrh, where diet cannot be regulated (Rose). Manganese, 
gr. x-xv of the black oxide in gastrodynia and pyrosis (B.). Sanguinaria, 
gtt. ij-v of tincture or gr. ^ of alkaloid, in atonic dyspepsia promotes secretion 
and increases the appetite (B.). Silver Oxide, j^-grain doses with same quan- 
tity of ext. hyoscyami before meals in nervous dyspepsia (B.). Xanthoxylin, 
as stomachic tonic, £j fl. ext. in atonic dyspepsia (B.). Simple Bitters, calumba 
best, quassia or gentian or infusions of them as vehicles for acids and alkalies 
(B.). Calumba easily tolerated when stomach weak (R.). Gentian as stom- 
achic and tonic very useful in atonic dyspepsia, and that of gouty subjects. 
The tinct. in some aromatic water, or in combination with alkalies and seda- 



588 



DYSPEPSIA, 



tives (Wa.) Pepsin, very beneficial. Scheffer's or Beale's saccharated pepsin 
with hydrochloric acid. Ingluvin also promotes digestion (B.). Mineral 
Acids. Hydrochloric or lactic with pepsin after meals in atonic dyspepsia. 
Hydrochloric after meals for acid pyrosis. Nitro-muriatic for dyspepsia with 
mental despondency, oxalate of lime in urine, offensive gas, sallow complexion 
(B., R.) ; Phosphoric, dilute, very efficient before meals (Da C). Sulphurous 
Acid, ""tv-gj well diluted, for acid pyrosis (B.). Alkaline Mineral Waters, 
before meals in atonic dyspepsia, and highly useful in the dyspepsia of obese 
subjects (B.). Alkalies, shortly before a meal increase the ga-tric juice, and 
are usually better than acids in atonic dyspepsia. Sodium bicarbonate is the 
best (R.); a full dose (gr. xl-lx), in dyspeptic attacks, with flatulence, etc., 
usually affords speedy relief (Wa,). Cascara Sagrada, in all cases of dys- 
pepsia, associated with a torpid liver and constipation ; small doses at first, 
gradually increased (Wa.). Chloroform, gtt. xv-xx in sweetened water, 
when rapid fermentation of food and evolution of gas soon after eating ; is 
promply efficient in giving relief (Willis). Aloes, combined with other agents, 
where habitual constipation accompanies dyspepsia (Rj; especially indicated 
in duodenal dyspepsia, gr. ij-iv with ipecac, gr. j-ij, two or three times a week 
(Wa.). Water. A dry diet will entirely relieve the ice-water dyspepsia, or 
that due to excessive beer-drinking (B.) ; half a tumbler of cold water l / 2 hour 
before breakfast acts to some people as a purgative and removes many dys- 
peptic symptoms, but flatulent dyspepsia is often traceable to excessive water 
drinking at meals, especially that of iced beverages (R.). Hot Water, x / 2 a 
pint to a pint at I io°-I50° F. an hour before each meal and y 2 an hour before 
going to bed, each draught sipped slowly during 15-30 minutes. As a cure 
for dyspepsia this is an old and efficient practice (Wa.). Milk-cure, has suc- 
ceeded admirably (B.); fresh buttermilk a most excellent article for dyspep- 
tics, as also is koomiss. Alcohol, in any form, especially good wines, are useful 
in the atonic dyspepsia of sedentary livers (B.) ; when loss of appetite and of 
digestive power from fatigue, a glass of wine or brandy-and-water before eating 
is very appropriate: useful also in indigestion of town dwellers, or during con- 
valescence from acute disease (R.). Diet. Avoid tea and hot beverages, 
over-cooked food, over-feeding and iced-water; masticate all food well, eat 
slowly, small quantities and frequently. Active out-of-door habits should be 
cultivated, and all articles of food known to disagree should be strictly avoided. 
[Compare Acidity, Biliousness, Flatulence, Gastralgia, Pyrosis.] 



Prescriptions. 



R 



Hydrarg. Chlor. Mitis, . gr. ss-j. 

Sodii Bicarbonat., . gr. xx. 

Pulv. Aromat., . . 3J. 
Trit. et div. in chartulas x. Sig. — 
One powder every 2 hours. For irri- 
tability of the stomach. {Hughes.) 



R. Sodii Bisulphitis, . . # lj. 

Tinct. Calumbae, . . Iss. 

Aq. Menth. Pip., . ad 31J. 
M. Sig. — Teasp. 2 or 3 times daily, 
as an antifermentative. 



R. Tinct. Nucis Vom., . . ^jss. 

Ac. Hydrochlcrici Dil., . ,^ijss. 

Glycerini, . . . §j. 

Aquae Lauro-cerasi, . . £iv. 
M. Sig. — Dessertsp. before meals, 
to improve appetite and digestion. 



R. Bismuthi Subnit., . . £jss. 

Pepsini, . . . . £j. 

Strych. Sulph., . . gr. j. 

Tinct. Cardam. Co., ad 5iv. 
M. Sig. — Teasp. thrice daily in 
water. For bilious dyspepsia. 



DYSPHAGIA DYSPNOEA. 



589 



R. Tinct. Capsici, . . TTixvj. 

Tinct. Nucis Vom., . £ij. 

Tinct. Gentianae Co., ad ^rj 4 
M. Sig. — A teasp. in water thrice 
daily, with gr. i Aloin at bedtime, 
avoiding a starchy diet. For aggra- 
vated dyspepsia with constipation. 

(Da Costa.) 






R . Sodii Bicarb., . 

Spt. Ammon. Aromat, 

Tinct. Zingib., 

Infusi Gentianae Co., 

U. S. P. 1870, q. s. ad %y\\). 
M. Sig. — Teasp. or two thrice daily. 
For acid dyspepsia. 



R • Pepsini (Jensen), . . ^iijss. 
Ac. Tartarici, . . . gr. v. 
Glycerini, . . . 5jss. 
Vini Xerici, . . ad £v\\]. 
M. Sig. — Teasp. after meals. 



R. Tinct. Gentianae Co., 

Sig. — Teasp. in water thrice daily. 



Iy 



R. Creasoti, . . . rnviij. 

Bism. Subcarb , . . £ij. 

Glycerini, 

Aq. Menth. Pip., . aa Jj. 

M. Sig. — To be well shaken. A 
teasp. every 3, 4 or 6 hours, for pain 

in stomach and wind. (B.) 



R. Ac. Hydrochlorici Dil., . Zj. 

Tinct. Capsici, . . gss. 

Tinct. Calumbae, . . Jjss. 

Vini Pepsini, . adgiv. 

M. Sig. — Dessertsp. after meals. 
In atonic dyspepsia. [Pancoast.) 



R. Rhei, Gentianae, et Carda- 

momi, contus., . aa gij. 
Spt. Vini Gallici, . . gij 
Aquae, .... 3VJ. 
Macera per horas 48, cola, et adde — 
Tinct. Nucis Vom., . £j. 
Potassii Carbonat., . gj. 

M. Sig. — Tablesp. in water thrice 
daily, before meals. 



Dysphagia. 

Cocaine, the hydrochlorate in solution, 20 per cent., as spray or by swab, 
relieves the dysphagia of phthisical laryngitis (P.). Cajuput Oil, in nervous 
dysphagia, used in India with considerable success (P.). Potassium Bromide, 
for congenital dysphagia of liquids in children, when no diphtheria or mal- 
formation (R.) ; in hysterical dysphagia (Wa.) : benefits a curious affection 
sometimes seen in children, who from their birth can swallow solids with 
ease but choke at liquids (R.). Sprays of ammonium bromide, chlorine water, 
or other sedative agents in warm solution, for the dysphagia depending on 
specific disease of the larynx (Muirhead). Galvanism, in the vicinity of the 
oesophagus will speedily remove hysterical dysphagia (Muirhead). Tonics, 
as strychnine, iron and quinine, for post-diphtheritic dysphagia. Iced Fluids, 
slowly swallowed, will often remove spasmodic dysphagia (Wa.). 



Dyspnoea. 

Morphine, hypodermically, the most efficient agent in relieving dyspnoea 
from cardiac disease, or any other form ; but if albumen in the urine it must 
be withheld (Allbutt). Grindelia, of great service in dyspnoea with cough, 
occurring in emphysema (W.). Cimicifuga, has often relieved most distress- 
ing cases from cardiac disease (P.). Spigelia Anthelmia, produces and often 



59° DYSURIA — 2CCHYMOSIS — ECTHYMA. 

relieves it when with palpitations (P.). Valerian, proved useful when ner- 
vous (P.). Primus Virginiana, has proved very efficacious in cardiac dysp- 
noea (P.). Amy I Nitrite, serviceable in cardiac dyspnoea and other forms 
(Wa.). Asafcetida, in combination with other antispasmodics, often very 
beneficial in the dyspnoea of chronic bronchitis (Wa.). Chloroform, a few 
whiffs give temporary relief in the cough and dyspnoea of phthisis and bron- 
chitis (Wa.), Iodide of Ethyl, by inhalation, is very serviceable in many 
forms (See). Dyspnoea is a symptom, and may be referable to cardiac, pul- 
monary, pharyngeal, laryngeal or tracheal disease (T.). [Compare Asthma, 
Bronchitis, Croup, Emphysema, Phthisis, etc.] 

Dysuria. 

Cantharis, gtt. j (sometimes v) of tinct. ter die, for frequent micturition with 
pain (R.). Irritable bladder, vesical tenesmus (B.). Cannabis Indica, relieves 
dysuria (R.) ; when bloody urine (P.) ; an excellent anodyne in painful affections 
of the bladder, having specific action on that organ. Belladonna and Hyoscyamus 
have similar sedative effects in vesical and urethral irritation (P.). Linseed, as 
infusion, is often a valuable adjunct (P.). Opium, in suppository, combined 
with hyoscyamus, gr. ij with gr. x, an excellent palliative (P.); an enema of 
laudanum or morphine hypodermically to relieve the strangury caused by 
blisters (B.). Camphor, is said to relieve strangury (R.). Chimaphila, has 
undoubted power (P.). Squill often produces the best effects, especially a 
combination of the acetum with spt. etheris nitrosi, equal parts, of which 
gss in gij anise water, every hour or oftener (Wa.). Gelsemium, a useful 
remedy (B.). Ergot, in paralytic dysuria, with sensation of bladder being 
imperfectly emptied (P.). Alkalies^ the citrates, when dysuria from uric acid 
crystals in young male children (R.). Nitrous Ether. Spt. etheris nitrosi 
^j-jss in any convenient vehicle, a popular and efficacious remedy (Wa.). 
Diluent Drinks, freely, especially a decoction of uva ursi, or of cotton-root 
(P.). [Compare Vesical Sedatives, page 424, also, Bladder, Irritable, 
P a g e 533> and Cystitis, page 570.] 

Ecchymosis. 

Arnica, rapidly disperses, if administered shortly after injury, rrtv-x in 
water every two or three hours (P.). Alcohol, diluted more or less, accord- 
ing to the amount of irritation present, is a good lotion (P.). Hamamelis, the 
tincture diluted with 5 to 8 parts of water, as lotion when much discoloration. 
Ammonium Chloride, in solution, as lotion on lint, or with bread or linseed 
to form a poultice, in ecchymosis of the eyelids (Wa.). [Compare Bruises, 
Purpura.] 

Ecthyma. 

Quinine, cures, though in many subjects will cause it (B.); malnutrition 
(R.). Lead, the liquor plumbi subacet. £j ad Oj aquae, a soothing applica- 
tion (Wa.). Zinc Oxide, the glycerite, with a little camphor, an excellent 
application (Wa.). Cod-liver Oil, internally and locally (B.). Grape-cure, 
often happily modifies (P.). Borax, a solution in rose or elder-flower water 
(Wa.). Chlorinated Lime, a solution as a lotion (Wilson). Chrysarobin, 
internally, half-grain doses, in water or pill, given with good results (Stoc- 
quart). 



ECTROPIUM AND ENTROPIUM — ECZEMA. 59 1 

Ectropium and Entropium. 

Silver Nitrate, freely to the exposed surface, in ectropium of lower lid 
due to hypertrophy of conjunctiva after inflammation (C). Collodion, suc- 
cessfully used in entropium to restore position of the lid by its contraction. 
Should be concentrated (Wa.). Faradization, in paralytic ectropium (C). 
Operative Measures, of great variety, are in use, Arlt's being the best for bad 
cases in the upper lid (Roosa). Epilation of lashes gives temporary relief 
in entropium. 

Eczema. 

Mercury, as black and yellow wash in early vesicular and pustular condi- 
tions. Mercurial ointments are the most efficient of the local applications, 
especially those of white precipitate, nitrate, mild chloride, and black oxide. 
Ointments of the biniodide or bichloride as irritating application in chronic 
indolent form (Pf.). Brown citrine ointment nightly in eczema of the mar- 
gin of the eyelids after detaching scales (B.) ; very useful when eczema on 
hairy parts of face, often is best mixed with a tar oint. (R.). Arsenic, V(\y of 
Fowler's solution thrice daily on a full stomach, gradually diminishing the 
dose for chronic type (B.) ; especially in eczema of vulva, anus and scrotum 
(R.). Small doses for acute, full doses for chronic form; the urine to be 
closely watched and the drug discontinued on the least sign of renal irrita- 
tion (Pf.). Arseniate of Sodium, hypodermically into an eczematous patch, 
to change the indolent form into an active one (Pf.). Rhus Tox., externally 
and internally, when burning and itching, quickly subdues in some cases 
(P.); in chronic form with rheumatism, worse at night-time; also in acute 
cases if given at the very beginning, tti 1 ^j S of a good tincture enough dose to 
begin with (Pf.). Phosphorus, of undoubted service in eczema of long 
standing, probably acts as a hepatic stimulant, gr. T \ T) to -^ in oil, or reliable 
pill (Pf.). Viola Tricolor, an infusion the best form, with purgative doses 
of senna for a few days, then alone, in eczema of the head and face ; gives 
prompt results (good or bad), often aggravating, which, though good in 
chronic forms, must be avoided in acute types (Pf.). Calcium Sulphide, gr. 
Ttfo^sV m acut e and chronic cases of pustular character, the impetigo of old 
writers; small doses in acute form, larger ones in chronic cases (Pf.)- Sul- 
phur, internally and sulphides as baths, but not in the acute stage (R.) ; solu- 
tion of potassium sulphide in water locally (B.). Liquor Potassce, or a 
stronger solution of potash, to infiltrated patch of chronic eczema, before 
attempting to heal it (Pf.). Croton Tiglium, the seeds bruised in alcohol, as 
liniment (Wa.) ; the oil as basis of stimulating applications in the chronic 
form (Pf.). Glycerite of Tannin, locally (R.). Potassium Iodide, is often 
efficient where a syphilitic history or inheritance can be traced. Salicylic- 
Acid, locally, in eczema of hands and feet has been very successful (B.). Bella- 
donna, gr. % of extract with gr. iij of quinine sulphate thrice daily in eczema 
of the hand, with bismuth subcarbonate as a dusting powder (B.). Zinc Salts, 
the oxide and carbonate as dusting powders, or the sulphate, etc., in astrin- 
gent ointments (Bulkley). Buckwheat Flour, one of the best dressings, a 
limb may be enveloped in a bag filled with the flour (Bulkley). Tar, inter- 
nally, the pix liquida in doses of gr. ij-v thrice daily, when arsenic fails to 
relieve or is contraindicated ; locally in third stage when redness, dryness and 
scaling. Oleum Cadini, when genuine, is the best form of tar, mixed with 
simple ointment (^ss-j ad ^). Ol. Rusci or Pix Liquida may be used (Pf.). 



592 ECZEMA. 

Conium, the tincture may be added to one of the ointments for the pruritus, 
which is usually very obstinate. So also Stramonium or crude Petroleum 
(Pf.). Hamamelis, locally as antipruritic, and in chronic eczema marked by 
decided venous retardation (Pf.) Benzoin, to allay itching, the compound 
tincture painted on the skin (R.). Lead, soluble salts as lotions when much 
inflammation and discharge (R.) ; also in early vesicular and pustular con- 
ditions. Diachylon ointment comes next in efficiency to mercurial ointments 
(Pf.). Zinc, the oxide and carbonate as dusting powders (R.) ; the sulphate 
with alum, glycerin and rose-water, an excellent lotion (B.); the oxide is 
not curative, but as a protective is the best ointment when freshly and well 
made, for use over a large surface (Pf.). Lime-water, as sedative application 
and to check discharge: after inflammation is subdued, lime-water and glyc- 
erin (R.). Carbolic Acid, externally and internally in chronic forms (B.); is 
analogous to tar, and suitable to the same types of the affection as the latter 
is given for (Pf.). Phytolacca has cured obstinate cases (B.). Graphite, 
in ointment, I to 10, or with some inert powder, as lycopodium or precipi- 
tated phosphate of calcium, in fissured eczema, especially that of the hands 
and behind ears (Pf.). Bismuth, the subnitrate or subcarbonate locally (R ). 
Anacardium Orientate (oil of Cashew), as ointment in patches of indolent 
chronic eczema (Pf.). Iris Versicolor, in chronic eczema of gouty patients 
invaluable as a hepatic stimulant, ttt.v-x of tincture from the fresh root twice 
daily (P.). Glycerin, locally at night when caustic lotions have been used 
(R.). Electricity has cured obstinate cases (B.). Milk- cure, when acid indi- 
gestion present (B.). Water, locally is injurious, unless its sp. gr. approaches 
that of the blood serum. Rosewater with a little glycerin and sodium chloride 
when ablution necessary in second stage, that of exudation and crusting (Pf.). 
Soaps, petroleum, cade or carbolic (R.); sapo viridis, to soften up infiltrated 
patches of chronic form, instead of the potash solutions mentioned above 
(Pf.). Diet should be largely vegetable, especially those which are eaten 
raw. Cod-liver oil as a supplemental article of diet. Chauhnoogra Oil, in 
old cases is often of great benefit, as ointment. The oil I part to 2 or more of 
vaseline (Wa.). Oil of Cajuput, put up by mistake of druggist for oil of cade 
made a remarkable cure in a case which had resisted treatment for some time 
(Claiborne). 

Prescriptions. 



Internal. 

R. Violae Tricolor, . . 5j. 

Sennae, .... gss. 

M. Fiant chartulae no. iv. 

Sig. — Make an infusion with hot 
water from each paper, and take every 
night. {Piffard.) 

R. Ol. Morrhuae, . . . gij. 

Vitellum Ovi, . . no.j. 

Liq. Sodii Arseniat., . ^j. 

Syrupi, . . . . gij. 

Aquae, .... 31V. 
M. Sig. — Half-teasp. thrice daily for 
chronic eczema in children. (Doyon.) 



Local. 

R . Ung. Zinci Oxidi, . . 5ss. 
Ung. Plumbi Subacet, . ^ss. 
Chloralis, Camphorae, aa gr. xv. 
M. Sig. — Use as oint. 2 or 3 times 
daily after bathing with warm water. 
For local use in general eczema. 

( Gross. ) 



R. Olei Cadini, . . . £ss-j. 

Zinci Oxidi, . . . ,^ss-j. 

Ung. Aquae Rosae, . 3J. 

M. Sig. — Ointment, antipruritic and 
mildly astringent. {Bulkley.) 



ELEPHANTIASIS — EMACIATION. 



593 



Internal. 

R. Picis Liquidae, 

Pulv. Sem. Anisi, 

Magnesiae Calcin., q. s. 

M. Ft. pil. no. c. Sig. — Two to ten 

pills daily. (Miguet.) 



aa ^ijss. 



R . Vini Ferri Amari, . . gjss. 

Syrupi Tolutani, . . ^iij. 

Liq. Potass. Arsenit., . gj. 

Aquae Anethi, . . gij. 

M. Sig. — Teasp. to dessertsp. thrice 
daily. {Wilson.) 



R. Ferri et Ammon. Citrat., gj. 
Potassii Citratis, . ^ij. 

Liq. Potassii Arsenit., . gj-ij. 
Tinct. Nucis Vom., . gij. 

Tinct. Cinchon. Comp., ad ^iv. 
M. Sig. — Teasp. in water, after 
meals, as tonic and alterative. 

(Bulkley.) 



Local. 

R . Aluminis, 

Zinci Sulphat., 
Glycerini, 
Aquae Rosae, 
M. Sig. — Lotion. 



gr. xx. 
gr. x. 

20- 

(B.) 



R. Liq. Plumbi Subacet., 


« 


Glycerini, 


* Q SS * 


Aq. Laurocerasi, 


• 3 l i ss - 


M. Sig. — Lotion, when 


there is 


much weeping. 


(B.) 


R . 01. Cadini, . 


• 3? s - 


Glycerini, 




Ung. Diachylon, 


. 31JSS. 


M. Ft. unguentum. In 


squamous 


eczema with thickened skin. 


(Fox.) 



R. Hydrarg. Ammoniat., 
Glyceriti Amyli, . 
M. Ft. unguentum. 



. gr. xv. 

(Muller.) 



Elephantiasis. 

Anacardium Orientale (Oil of Cashew), has been much lauded. Investi- 
gation established that much of its success was due to hygienic measures and 
use of fresh meat as food (P.). Arsenic ', with 5 or 6 times the quantity of 
black pepper, in esteem in India (Wa.). Sarsaparilla, as tonic and alterative, 
valuable (P.). Gurjun (Wood Oil), as ointment and emulsion, has been used 
with success in alleviating the disease, by Dr. Dougall, Port Blair, Andaman 
Islands. The ulcers of 24 lepers healed thereby. Ferri Arsenias, gr. \ daily, 
is used with success (Wa.). Mercury, the oint. of the red iodide, diluted I to 
10, or gr. j of the salt to £v of unguentum, gives very good results (Wa.). 
Diet. Nutritious food, cleanliness, baths, will do much to prevent the mani- 
festations of the disease (R.). Chaulmoogra Oil, see page 133, is credited 
with a few cures and many cases improved. The oil is mixed with Psoralea 
corylifolia as a liniment, and also used internally (Wa.). Hoang-Nan,\% con- 
sidered of utility by a number of writers on leprosy, and is given in combina- 
tion with Alum I, Realgar 2 or 1, and the drug 2 parts, the whole being made 
into 3-grain pills, one pill daily being given at first and gradually increased 
(Pf.). Argenti Nitras, is said to act as a tonic and alterative, and to control 
leprosy for a limited period (Pf.). 



Emaciation. 

Calcium Phosphate, is especially useful in chronic wasting disease (R.). 
Arsenic, is used by cattle-breeders to fatten oxen, etc., quickly (Tr.). Iodine, 

5o 



594 EMPHYSEMA OF THE LUNGS. 

improves the appetite and digestion, and gives strength and plumpness to the 
body ; Wa.). Cinchona, in. small doses improves the appetite, and the general 
tone (Wa.l. Iron Salts, cause marked gain in flesh and color (Wa.) ; re- 
markably promote the appetite and dige-tion B.). Cod-liver Oil, internally 
and externally with friction, often very effective in the mal-nutrition and ma- 
rasmus of children (P.). Olive Oil, by friction, daily inunctions are of value 
in many wasting diseases (P.). Pepin, to promote digestion of food (P.). 
[Compare Tabes Mesexterica.] 



Emissions and Erections. 

Belladonna, when emissions, genitalia relaxed, atonic state (B.) : in gradu- 
ally increasing doses produces good results, even in extreme cases of emis- 
sions (Wa.). Camphor, fails as often as it succeeds (P.). Potassium Bromide, 
exercises special influence as a sedative in irritable states of the genito-urinary 
organs (Wa.). Cimicifuga, as tonic to the nervous system, removes irritation 
and melancholy, procures sound and refreshing sleep (Wa., P.). Lupulin, 
useful to check emissions (P.); gr. v-x, or xv, to keep penis at rest (Wa.). 
Ruta, in small doses to limit discharge (P.). Chloral, at bed-time, repeated 
every night until the habit is broken off (Wa.). Iron, the tincture of the 
chloride in g doses at bed-time, sometimes conquers nocturnal emissions 
(Wa.). [Compare Anaphrodisiacs, page 427, also Chordee, Spermator- 



RHCEA.] 



Emphysema of the Lungs, 



Morphine, gr. \, and Atropine, gr. T \-^, hypodermically for the asthmatic 
attacks: no remedy so efficient. The disease being incurable, treatment must 
be chiefly palliative (B.). Potassium Iodide, in full doses alone, or combined 
with the bromide, affords most relief next to morphine (B.). Strychnine, is 
a valuable respiratory stimulant ; useful where there is constant dyspnoea with 
prolonged expiration (Wa.). Stramonium, the leaves smoked for the asthma 
and dyspnoea before retiring, will often give a good night's rest (Wa.). Am- 
monium Iodide, with arsenic, for the bronchitis, with copaiba, turpentine or 
eucalyptol, continued for some time (B.). Digitalis, or hydragogue cathartics 
as pulvis jalapae comp. for the dropsy (Da C). Arsenic, when connected with 
recession of a rash is esp. useful (R.). Long-continued it ameliorates (B.). 
Lobelia, allays the dyspnoea which accompanies capillary bronchitis in em- 
physema (R.). Senega, often acts beneficially (P.). Cod-liver Oil, continued 
for a long time (R.). Hypophosphites, are useful (B.). Chalybeates, the phos- 
phate of iron, quinine and strychnine (B. ). Grindelia, for asthmatic breathing 
and bronchitis (B.) ; of great service (Wa.). Chloral, for the short breath 
in such patients brought on by catching cold. If obstructed circulation, cau- 
tion required (R.). Bleeding and Purging, have been used with great success 
in many emphysematous conditions (R.). Compressed Air, the, only scientific 
remedy yet brought forward for this disease ; affords much relief which is 
sometimes permanent (B.) ; the apparatus of Waldenberg is the best for this 
purpose. [Compare Asthma, Bronxhitis, Dyspncea.] 



EMPYEMA ENDOCARDITIS ENDOMETRITIS. 595 

Prescriptions. 
& . Potassii Iodidi, . . ^iij. R . Potassii Chlorat., . . £jss 

Strychninge Sulph., . . gr. j. j Tinct. Belladon., . . jjss. 

Liq. Potassii Arsenit., . ,^ijss. Ext. Pruni Virgin. Fluidi, 

Tinct. Cinchonae Comp., aa 5ij. 
M. Sig. — A dessertsp. 4 times a 



Aquae Laurocerasi, . ad siv, 
M. Sig. — Teasp. 4 times daily. 



For relief of dyspnoea, toning the car- day. Where chronic bronchitis and 
diac action, removing the bronchial anorexia. Dry cups also to chest 
catarrh, and preventing the progress night and morning, 
of the affection. {Hughes.) \ {Da Costa.) 

Empyema, 

Carbolic Acid, a weak solution to be injected after evacuating the pus (R.). 
Carbolate of Iodine, has been injected with benefit (B.). Iodine, in solution 
to be injected after tapping (R.).; the undiluted tincture may be thrown in 
without risk and with great benefit; or the compound solution ^j to Jxv 
aquae, as wash for the cavity to prevent reformation of pus (B.). Chlorine- 
Water, or solution of Quinine, to wash out the cavity (R.). Salicylic Acid, 
in solution, answers well for the same purpose (P.). Ammonium Acetate. The 
official mistura ferri et ammonii acetatis, with quinine and stimulants, if the 
affection shows a tendency to linger (Da Costa). 

Endocarditis. 

Aconite, should be given early in all inflammations of serous membranes (P., 
Wa.) ; gtt. y 2 or less, frequently (R.). Spigelia A nth elmia, useful in rheu- 
matic endocarditis (P.). Bryonia, fully equals any remedy that exists to limit 
the effusion and promote its absorption (P.). Opium, in inflammations of 
serous membranes (B.). Digitalis, to control the circulation, especially where 
irregular heart* action (Da C). Veratrum Viride, has been used with re- 
markable effect on the pulse | Wa.). Blistering, of all local remedies the most 
serviceable, when effusion has taken place (Wa.). Alkalies, as potassium or 
ammonium carbonate, freely until urine is alkaline, to prevent permanent 
changes about the valves or orifices (Da C). Potassium Iodide, to promote 
absorption of the exuded lymph. Quinine, at the onset, may check the in- 
flammation (B.). Salicylic Acid, is useful in the rheumatic form (P.). Rest 
for some days after active signs have abated, with agents to lower the blood- 
pressure within the heart and vessels (Fothergill). Leeching, in the acute in- 
flammation is to be recommended if done early, later is useless. Use cups if 
no leeches are at hand (Da Costa). Poultices, give great relief and are of 
decided, benefit (Da C). Stimulants, as ammonium carbonate, etc., freely, 
if signs of oppressed circulation appear (Da C.). Iron, the tincture of the 
chloride with alkalies, if pyaemic symptoms are manifested (Da C). [Compare 
Pericarditis.] 

Endometritis. 

Carbolic Acid, undiluted, on cotton-wrapped probe ; no better method of 
treating uterine catarrh (B.). Iodine, the most valuable of all local remedies 
(E.); Churchill's tincture (Iod. gr. 75, Pot. Iod. gr. 90, Alcohol §j), one of 
the most useful applications to the endometrium (Mund6). Iodized Phenol 
(Iod. j, Ac. Carbol. iv), on cotton-wound probes, applied to the uterine cavity, 



596 



ENEMATA. 



has given the best results of any agent used for 8 years past (Battey). Chro- 
mic Acid, as caustic, when slough is required ; should only be used after dila- 
tation of cervical canal, and at the patient's house (Munde) ; a solution of gr. 
xv to £j of hot water applied with success to the uterine cavity for catarrh 
(Wooster). Nitric Acid, fuming, to uterine cavity through intra-uterine 
speculum (Atthill) ; is considered by many the one agent for all forms of intra- 
uterine medication. Is efficient and comparatively safe, but produces too much 
cicatricial tissue (Munde). Iodoform, as suppository in rectum (B.) ; in pencils 
to uterine canal. Iodo-tannin, locally in chronic cases (B.). Ergot, or better 
Ergotine, gr. j, subcutaneously, for the train of uterine disorders depending 
on passive congestion of the organ (P.). See Hysteria for formula. Gly- 
cerin, as a local application introduced by Sims, is of great value; esp. as 
vehicle for impure carbolic acid, iodine, on cotton, or oakum (E.). Hot 
Water injections in large quantity about the os uteri, are of great value (E.) ; 
as usually made are of no value, must be applied by special syringe, in the 
dorsal recumbent posture with elevated hips, at a temperature of ioo° to 120 
F. twice daily for at least 20 minutes each time, and persevered in for months 
and years (Munde). [Compare Uterine Congestion and Hypertrophy.] 



Prescriptions. 



r. 



Potassii Iodidi, 
Potassii Bromidi, . aa gr. xx. 
Tinct. Iodi, . . , 39s. 
Aquae, .... jjij. 
M. For hypodermic injection into 
cervix, in chronic cervical metritis. 

{Bennett.) 



xx, 



R. Ergotini, . . . gr. 

Tinct. Iodi, . . . ^j. 
Glycerini, . . tf^gj- 
M. Sig. — Apply twice daily with 
camel's-hair brush, in cervical me- 
tritis. 

(Dabney.) 



Enemata. 

Enemata, for an infant, ^ss-j ; child 2 to 5 years, ^ij-vj ; 5 to 15 years, 
gvj-Oj ; adult, Oj-I quart. A simple domestic enema consists of soapsuds 
with a little common salt, or a pint of cold water (B.). Simple warm water 
or gruel sometimes ; or, to one or the other of these add soap, turpentine or 
castor oil, with soap or gruel to suspend the two latter. Very cold water may 
be used without inconvenience. Starch, boiled or raw, of cream consistence, 
temperature 100 , with a few drops of tinct. opii, in extreme cases of choleraic 
diarrhoea, or that of phthisis, or typhoid fever (R.). Nutrient Enemata, should 
contain materials for artificial digestion, as the rectum is not an organ of diges- 
tion, and to secure rapid osmosis should have an acid reaction. A suitable 
formula is appended below. Inject slowly and not frequently, five times in 
twenty-four hours should be the maximum. Defibrinated blood has also been 
used as a rectal injection with good results, being completely absorbed (B.). 
Should not exceed three or four ounces of bland material, injected slowly, 
alter ascertaining that the rectum is not filled with faeces (R.). [Compare Ene- 
mata, ante, page 494.] 

Prescriptions. 

Enema Ricini et Terebinth, 



Nutrient Ene?na. 

R. Infusi Carnis (Beef-tea), . Jiv. 

Acidi Hydrochlorici, . rn,x. 

Glyceriti Pepsini (Scheffer), £ij. 
If rectum irritable add 10 to 20 
drops of Laudanum. 



R. 



01. Ricini, 


. Jjss. 


Ol. Terebinth., 


• 3 SS - 


Ovum, . 


. no. j- 


Decocti Hordei, vel 




Aq. Fervid., . 


• Ifxiv 



ENTERITIS — ENURESIS. 5 97 

Enteritis. 

Opium, to the point of tolerance, is the remedy, the deodorized tincture in 
io-drop doses every second or third hour, according to age (Da Costa) ; of 
great value to control inflammation and quiet the intestines (B.); proves of 
signal use (Wa.). Aconite, of great utility in acute inflammation with high 
temperature, sthenic condition, resisting pulse (R., P.). Arsenic, surprisingly 
curative ; small doses, with opium (B.). Podophyllum, with occasional doses 
of aconite, will often allay the vomiting and diarrhoea (P.). Ricinus Communis, 
is employed with great advantage (P.). Turpentine, stupes, hot, over seat of 
disease, are of manifest advantage (Wa.). Skim-milk, is of the highest value 
as sole diet in acute inflammation of digestive organs (B.). Water, cold and 
hot, principally cold, or ice, of unquestionable advantage (B.) Poultices, 
linseed, large and hot (Wa.) ; may be used or not, as the patient feels benefit 
from them or otherwise (Da C). Water, hot fomentations constantly, fol- 
lowed by a wet compress. Perfect quiet in bed. Ice or cold water freely 
swallowed. No food until inflammation subsides, then beef-tea, milk, gum- 
water, etc., the very mildest and most bland diet for four or five days (Da C). 
[Compare Diarrhoea, Dysentery, Cholera, Peritonitis, Typhlitis.] 

Enuresis. 

Belladonna, no single remedy so uniformly successful. Children require 
large doses. A solution of atropine, best, gr. T ^j. to -^ (B.). The best 
remedy for children, gtt. x-xx of the tinct. three times a day. If unsuccess- 
ful, and no worms or other irritation exist try strychnine, cantharides, turpen- 
tine, santonin or galvanism (R.). Small doses are useless (P.). Santonin, 
in over doses produces incontinence of urine in children, but curiously will 
sometimes stay the habit, even when not dependent on worms, and in cases 
where belladonna fails (R.) ; in the enuresis from worms (P.). Cantharides, 
one or two drops of the tinct. three or four times a day in middle-aged women 
or the aged, even when due to paralysis; sometimes also in children, but for 
them belladonna is generally better (R.). Chloral Hydrate, enuresis in chil- 
dren (R.); three-grain doses thrice daily for infantile incontinence (Da C). 
Strychnine, may succeed when above remedies fail (B.); sometimes useful 
for old people with paralysis of bladder, also for children (R. P.). Buchu, 
often successful in chronic enuresis (P.). Turpentine, small doses sometimes 
remove the trouble (B.). Lupulin, said to be useful; Herzfelder used it with 
advantage. Rhus Aromatica, has proven curative in 75 per cent, of cases 
treated with it, and of great benefit in the other 25 per cent. The fluid ex- 
tract, nix-xv four times daily in glycerin and water (Stem). Scutellaria, re- 
markably efficient in many instances, 5 doses of the fluid extract thrice daily 
for a child of 12 years old. Potassium Nitrate, has been recommended for 
children (R.). Potassium Bromide, succeeds in some cases (Wa.). Collodion, 
painted to form a cap over end of prepuce (R.). Ergot, when from paralytic 
state of sphincter (B.); said to be useful (R.). Iron Iodide, the syrup Tn_xv- 
xx, well diluted with water, ter die, in pale, delicate, strumous children (B.) ; 
sometimes useful even when no worms (R.). Habits. Children to be taught 
to retain water as long as possible during the day ; little salt to be eaten ; ab- 
stinence from fluids not necessary; bland fluids diminish acridity of the urine. 
Stopping meat from the diet has cured several cases permanently, after all 
remedies had been tried without success. 



59 8 



EPIDIDYMITIS EPILEPSY, 



R . Strychninae Sulph., 
Pulv. Cantharidis, . 
Morphinae Sulph., . 
Ferri Reducti, 
Ft. pil. no. xl, Sig.- 



Prescriptions. 



■ S r -J- 
. gr. ij. 
. gr.jss. 
. gr. xx. 
-One thrice 



daily to a child of io years. (Gross.) 



R. Tinct. Ferri Chloridi, . ^ij. 

Ext. Ergotae Fluidi, -. £v. 

Spt. Chloroformi, . . zij. 

Tinct. Quassias, . ad ^iv. 
M. Sig. — A teasp. in a winegl. of 
water thrice daily, for children. 



Epididymitis. 

Aconite, alternately with Pulsatilla, the latter in very small doses, a few 
drops of tinct. in a glass of water, a teasp. every 2 or 3 hours produces the 
happiest effects (Pf., St.). Bella donna, the extract, gj-ij ad gj of glycerin and 
water, on lint, applied to the inflamed testicle v Bumstead). Tobacco, with lin- 
seed meal, as poultice, cautiously (P.). Mercury and Morphine, locally, a 20 
per cent, oleate by inunction, in cases of syphilitic origin (R.). Silver Ni- 
trate, Qiv ad giv aq. destil. freely applied to the scrotum will sometimes abort 
an epididymitis (Wa.). Strapping and suspensory bandage to support the tes- 
ticle, and rest in the recumbent posture from the beginning, with a saline 
cathartic to clear the bowels, are all measures of great importance (Bum- 
stead). Compare Orchitis. 

Epilepsy. 

Amyl Nitrite, inhaled at the beginning of the aura will prevent an attack 
(B.) ; or Truj-v in mucilage, when fits are very frequent (R.). Nitro-glycerin, 
trijl-Q, slower in action than amyl nitrite, but more enduring (Pf.). Ignatia, 
convulsions unattended with cerebral congestion (P.). Par excellence the 
controller of functional phenomena of the cerebro-spinal axis (Pf.). Bella- 
donna, in petit mal and nocturnal epilepsy, in pale anaemic subjects, should 
be given for a year or more (B.,Tr.) ; extr. and leaves \ of each in pill, every 
day at same hour, one additional pill every month (Tr.). Useful, especially 
when from fright (P.). Atropine better, drop-doses of a 1 per cent, solution 
of the neutral sulphate in white brandy (Tr.). Arsenic, in epileptiform ver- 
tigo from stomach disorder (B.); sometimes useful (R.). Chloroform, by 
inhalation during paroxysm and also in interval (Wa.); is of high value es- 
pecially in cases of an hysterical character (Brown-Sequard). Chloral, the 
most suitable remedy for the nocturnal variety, in full doses at bed-time (B.). 
Cannabis Indica, has given good results ; is suitable for petit mal, the noc- 
turnal variety, and with strychnine, belladonna, or picrotoxin, for cases char- 
acterized by anaemia and depression (B.). Quinine, when of malarial origin 
(P ) ; often useful in intermittent epilepsy (Ros.). Silver Nitrate is not 
without efficacy, and was formerly much used, but the danger of staining the 
skin has caused its disuse, especially as better agents have been found (Wa.). 
Picrotoxin, anaemic subjects, attacks occurring at night, -^ to ^ of a grain 
hypoderm., or -^ to ^ by stomach (B.). Benefits cases resulting from onan- 
ism (P.). Copper Salts, may be useful in cases originating from stomach, 
formerly much used (B.) ; the nitrate or oxide often given with benefit (&.)• 
Strychnine, idiopathic epilepsy, injurious in symptomatic. Benefits when 
bromide of potassium fails. Cerebral anaemia ; nocturnal epilepsy (S., Pf.) ; 
if bromides fail and case is anaemic, give Strychnine, gr. -^ ter die, and push 
it (B.). Sodium Bro?nide, gr. xx ter die, will arrest epilepsy without produc- 
ing the cerebral symptoms of bromism (Clymer). Potassium Bromide, gr. 



EPISTAXIS. 



599 



xl ter die before meals, double dose at bed-time, for two or more years after 
all epileptic indications have ceased. Is generally useful, especially in day- 
time seizures and grand mal of sexual origin ; also for infantile convulsions 
(B.) ; especially in convulsive form, but often powerless (R.). Digitalis , Trvx 
of the tincture, with gr. xx of potas. brom. thrice daily, in cases complicated 
with cardiac dilatation (Gowers). Lithium Bromide, gss daily, acts in some 
cases after pot. brom. has failed, and is generally efficient in about one-half 
the dose of the latter salt (S. Weir Mitchell). Nickel Bromide ■, gr. v thrice 
daily, is remarkably efficient in the epilepsy occurring at the menstrual 
epoch, and those which have withstood the action of the other bromides (Da 
Costa). Ferrum Bromide will often cure cases in weak and anaemic subjects; 
also with potassium bromide to combat the anaemia and depression produced 
by the latter (B.). Zinc Oxide, probably useful only in cases originating from 
the stomach. Much said for and against it (B., R.). Turpentine, has long 
been used, when due to reflex impression of intestinal parasites (B.). Conium, 
not equal to the bromides (B.) ; not of much value (P.j. Valerian, has been 
used with some advantage (R.). Bryonia, has an ancient reputation (P.), Rue, 
may benefit when seminal emissions (P.). Anesthetics, are rarely called for 
(W.). Fats and Oils, especially cod-liver oil when faulty assimilation exists 
(B.). Galvanis?n, only in idiopathic epilepsy (B.). Meat Diet, in many cases 
must be prohibited entirely (B.). [Compare Convulsions.] 



Prescriptions, 



R. Potassii Bromidi, . 
Sodii Bromidi, 
Liq. Potas. Arsenitis, 
Ext. Conii Fl., 
Aquae Cinnamomi, . 
Infus. Gentian. Co., 



M. Sig. 
each meal. 




-Tablesp. two hours after 



R. Potassii Bromidi, * • §j- 
Ferri Bromidi, . . gr. iv. 
Aquae, . . . . Sij. 
Syrupi Simplicis, . . 3VJ. 
M. Sig. — Tablesp. twice daily. 



R. Strychninae Sulphatis, . gr.j. 

Acidi Sulph. Dil., . . -nix. 

Aquae Destill., . . . giv. 
M. Sig. — Teasp. after each meal, 
gradually increased to a dessertsp. 



aa 31 ij, 



R. Potassii Bromidi, 

Sodii Bromidi, 

Ammonii Bromidi, . 

Potassii Iodidi, 

Ammonii Iodidi, 

Ammonii Carbonat., 

Tinct. Calumbae, 

Aquae, . . q. s. ad ^vnj. 
M. Sig. — A teasp. and a half before 
each meal, and three teasp. at bed- 
time. (Brown-Sequard.) 




R. Potassii Bromidi, 

Ammonii Brom., . aa Jij. 
Ext. Ergotae Fl., . • 5J- 
Aq. Cinnamomi, . ad^vn], 
M. Sig. — Dessertsp. in water thrice 
daily. When maniacal excitement 
and danger of cerebral hemorrhage. 

(Smith.) 



Epistaxis. 

Aconite, has been used with the best results (P.) ; small frequent doses 
quickly check epistaxis in children and plethoric people (R.). Arnica, is of 
great service when from mechanical violence (P.). Belladonna, when of 
congestive origin (P.). Ipecacuanha, has been highly praised (R.) ; acts upon 
the vessels (B.); gr. j-ij every quarter hour until nausea is felt, but vomiting 



600 ERUPTIONS ERYSIPELAS. 

need not be excited (Wa.). Hamamelis, venous hemorrhage (Pf., R.). Er- 
got, ^ss-^j of fresh powdered ergot, or ^j-gij of flu. ext. every half-hour or 
hour, necessary in urgent cases (B.). Alum, injected or snuffed up in powder 
(R.). Iron Spray, in obstinate cases liq. ferri subsulph. ^j-^viij aquse by 
spray or injection. The tinct. of the chloride also useful (B.) ; diluted ^ij in 
gvj injected into the nostrils is often effectual (Wa.). Tannin, finely pow- 
dered, blown into the nostrils through a quill ( Wa.) ; a strong solution, gij ad 
giv, by nasal syringe (B.). Turpentine, may be given internally with advan- 
tage (Wa.) ; especially in debilitated conditions (B.). Lead Acetate, gr. ij-iv 
with opium gr. ss-j, proves signally useful (Wa.). Vinegar, on lint intro- 
duced into the nostrils, sometimes highly efficient (Wa.). Digitalis, is of un- 
doubted benefit (B.) ; the infusion best (R.)« Transfusion, when death from 
exhaustion is apparently imminent (B.). Facial Artery, compression of (R.). 
Sundry. Keep head elevated and cool ; warm the feet and hands by plung- 
ing into hot water ; apply ice over the nose ; resort at once to the tampon, if 
bleeding becomes alarming. [Compare Hemorrhage, for formulae.] 

Eruptions. 

The following-named drugs produce the eruptions indicated respectively 
after each, viz. — Aconite — vesicular exanthemata. Arsenic — erythema and 
papules, vesicles and pustules. Belladonna — as Quinine. Bromide of Potas- 
sium — papules, pustules, deep tubercles with ecchymoses, ulcers, pemphigus. 
Cinchona — as Quinine. Carbolic Acid — erythema. Chloral — erythema, 
itching, desquamation, eczema, purpura and petechia. Copaiba and Cubebs — 
pemphigus, erythema, eczema. Cod-liver Oil — acne. Digitalis — erythema 
after long using. Iodide of Potassium — papules, vesicles, pustules, eczema, 
ecthyma, ecchymoses and purpura. Mercury — erythema, eczema. Opium 
and Morphine — erythema, papular eruption with marked desquamation and 
itching. Phosphorus — purpura. Quinine — erythema scarlatina, papular ery- 
thema, hemorrhagic purpura, pemphigus and prurigo. Rhus Toxicodendron 
(and other varieties of Sumach) — vesicles, perhaps pustules, with redness, 
swelling, and intolerable itching. Salicylic Acid — purpura, pemphigus, vesi- 
cular angina. Santonin — pemphigus, vesicles. Stramonium — as Quinine. 
Strychnine — as Quinine. Turpentine — as Copaiba. 

Erysipelas. 

Pilocarpine, to abort the disease, very efficient if used early, gr. ^ hypo- 
dermically, or fluid extract of Jaborandi internally: when free diaphoresis 
occurs, the temperature and pulse fall to normal, and the disease is checked. 
Not suitable to debilitated cases, or those having a weak heart (Da Costa). 
Aconite, a favorite remedy with Liston, if used at beginning, when fever high 
(Wa.); no more useful agent in idiopathic erysipelas, especially facial, and 
cases of sthenic type (B.) ; at onset, often cuts the attack short; is very useful 
in the erysipelas following vaccination (R.) ; very valuable in sthenic cases 
(P.); especially so in traumatic erysipelas (Tr.). Belladonna, v(\y of tincture 
in water every hour for five or six doses, also locally ; has astonishing power 
in superficial and non-vesicular forms, also when erysipelas attacks the brain, 
and in the phlegmonous type (P.); for similar indications as noted under 
Aconite, also when adynamia; if much fever, combine it with digitalis or 
aconite ; when much depression, give it with quinine ; gr. j^ of the extract 
with gr. ij of quinime sulph. every 3 or 4 hours (B.); the extract with glycerin, 



ERYSIPELAS. 6oi 

equal parts, spread thickly over the surface (Quain) ; should be used both 
internally and externally, and may be combined with aconite (R.). Iron, 
Tincture of the Chloride, the nearest to a specific yet discovered ; the remedy 
of most service, any man being decidedly to blame who neglects it's use ; 
requires decided doses, gtt. xl every 4 hours (Da Costa) ; treatment by it very 
general, but questionable (B.) ; should be given with shorter intervals than 4 
hours (R.) ; is very successful in this disease (P.) ; ten-drop doses every hour, 
or ttixI every 4 hours (Quain). Is also used locally with much success, being 
painted over the surface in full strength. Quinine, may be given with the 
iron; also alone if thoracic complications, wherein iron might be contra-indi- 
cated (Da Costa); if pulse soft and tremulous, or very rapid, low muttering 
delirium (D.) ; a combination of quinine and tincture of the chloride of iron 
offers special advantages ( Wa.) ; in the more severe cases to sustain the vital 
powers, and prevent cerebral embolism ; but large doses, gr. v-xx every 4 hours, 
are alone of any use (B.). Ammonium Carbonate, when feeble circulation, . 
cyanosis and delirium ; also when any signs of embolism appear (B.) ; highly 
useful in debilitated subjects (Wa.); after free purgation the continued use of 
this salt is all that is needed in most cases (Sir T. Watson). Potassium Iodide, 
with agents to secure free action of the bowels, skin and kidneys, the only effi- 
cient treatment in erysipelas ambulans, in which iron and quinine are useless 
(Da C). Antipyrin, is particularly efficient when hyperpyrexia (Ernst). Rhus 
Tox., a very useful remedy in the vesicular form (P.). Tartar Emetic, in doses 
of gr. y 1 ^ frequently repeated, renders incontestable service (B.). Calomel and 
Jalap, as purgative at onset, followed in 4 or 5 hours by magnesium sulphate, 
Ijss (Da C). Chloral, is an admirable adjunct to give sleep at night (Da C). 
Turpentine, as a stimulant in traumatic erysipelas, more generally serviceable 
than alcohol (B.). 

Local Applications. Silver Nitrate, by Higginbotham's method in trau- 
matic form ; gr. lxxx of the brittle stick dissolved in giv of water and painted 
2 or 3 times over inflamed surface and beyond, after careful washing and dry- 
ing (R.) ; no agent more useful in subduing external inflammation. Iodine, 
painted over affected and neighboring surface, to prevent spreading (R.)« 
Iodized Collodion, very successful as a local application, see formula below. 
Collodion, a thick coating relieves (B.). Digitalis, an infusion locally is of 
much service applied as a lotion (R.). Sulphurous Acid, and glycerin, equal 
parts, or a solution of Sodium Bisulphite (Dewar). Zinc, Benzoated, as ointment, 
or the unguentum zinci oxidi, anything to exclude the air, and whichever one 
is most agreeable to the patient (Da C). Bismuth, the ointment of the oleate, a 
very certain application to allay itching and burning, lessen pain, etc. (Shoe- 
maker). Oil, by inunction, is very grateful in simple erysipelas (B.). Oil of 
Turpentine, painted over surface is said to be remarkably efficient. Vaseline, 
lard, or mercurial ointment, diluted, £j to Jjj of vaseline ; the simplest applica- 
tions are the best (B.). Carbolic Acid, one part, with 8 to 14 parts of oleic acid, 
locally by inunction for 3 to 4 minutes every % hour, all around the edge of 
the diseased part until it ceases to spread (Jacobi). Cotton Wool, sprinkled 
with flour or a mixture of starch and zinc oxide, is a good application (B.). 
Earth, clean yellow clay, free from grit or sand, and powdered, applied 
directly to the skin in the form of a smooth paste, made by mixing it with 
water, the best of all applications, having properties of antiseptic, antiphlo- 
gistic, antipyretic and antimorbific nature (Hewson). 

Tracheotomy, promptly if oedema of glottis occurs, the operation giving 
time for inflammation to subside (Da C). Incisions may be necessary in 
traumatic erysipelas, when limb is greatly swollen and inflamed ; also in the 



602 



ERYTHEMA. 



phlegmonous variety (Da C). Diet, a milk-diet is generally suitable; should 
be light but nutritious (R.); feed the patient well (Da Costa). [Compare 
Phlegmon.] 

Prescriptions. 

R. Quininae Sulphatis, . gss. 
Ext. Belladonnae, . . gr. ijss. 
Ft. pil. no. xx. Sig. — Two pills 
every 4 hours, where much depres- 
sion. (B.) 



3J- 



R. Quininae Sulphatis, 

Ac. Sulphurici Dil., q. s 

Aquae, . . . . 5ij. 

Tincturae Ferri Chlor., . gss. 

Spt. Chloroformi, . . ^vj. 

Glycerini, . q. s. ad ^iv. 
M. Sig. — A teasp. in water every 
two hours. (Zoomis.) 



R. Tinct. Ferri Chloridi, . 5j. 

Syrupi Tolutani, . . ±j. 

Liq. Potassii Citratis, . ^iv. 
M. Sig. — Teasp. to tablesp. accord- 
ing to age every 3 hours. gj = Tn_x, 
3U — nixx, ^ss = Tiixl. (Anderson.) 



;ij-nj. 



R. Tinct. Ferri Chlor., 

Glycerini, Aquae, . aa £). 

M. Sig. — Teasp. every 2 hours for 

children. (Gibney.) 



For Local Use. 




R. ^Etheris, 




Alcoholis, 


aa, ^v. 


Pyroxylini, 


- 5i- 


Solve, et adde — 




Ammonii Iod., 


. gr. xl. 


Cadmii Iod., 




Cadmii Brom., 


aa gr. xx. 


M. Sig. — For local use with a 


camel's hair pencil. If the cadmium 


salts are not to be had use £j Amra. 


Iod., and gr. xx Pot. or 


Amm. Bro- 


mide. (Humphreys.) 


R. Plumbi Acetatis, 




Ammonii Carb., 


aa. gj. 


Aquae Rosae, . 


. gviij. 


Ft. lotio. Sig. — Apply 


on lint, to 


allay irritation. 


(Peart.) 


R. Acid. Carbol., 




Alcoholis, 


aa^ij. 


01. Terebinth., 


. giv. 


Tinct. Iodi, . 


• 3 { y 


Glycerini, 


. ^x. 



M. Sig. — Brush over surface every 
2 hours, and cover with a thin layer 
of wadding. 



Erythema. 

Belladonna, useful in cases resisting ordinary treatment (B.). Quinine, the 
most valued remedy in erythema nodosum (B.). Rhus Toxicodendron, a val- 
uable remedy (P.). Zinc Sulphate, as lotion, with alum and glycerin. See 
Eczema, for formula ; or the Acetate in ointment, see below. Bis7tiuth, dusted 
over erythema about genitals of infants soothes pain and promotes healing (B.)". 
Mineral Acids, nitric and nitro-hydrochloric, have been advantageously used 
when from imperfect digestion (B.). Dusting Powders, of starch, lycopodium 
or buckwheat flour are very useful. 

Prescriptions. 

R. Plumbi Carbonatis, R. Zinci Acetatis, . . gr. ij. 

Bismuthi Subnit., . aa gj. Aquae Rosae, . . . gj. 

Sodii Bicarbonat., . . ^ss. Ung. Aquae Rosae, . . 3J. 

Ung. Zinci Oxidi Benz., . gij. M. Sig. — Ointment. 
Ft. unguentum. Sig. — Local use. 



EXHAUSTION — EYE-DISEASES. 603 

Exhaustion. 

Arnica, a few drops internally for aching of the muscles (R.) ; in nerve 
prostration with general aching from over-fatigue (P.). Phosphorus, for 
physical or mental exhaustion; also in depression from over-work (R.). Cal- 
cium Phosphate, combined with Calcium Carbonate and Phosphate of Iron, gr. 
j of each for a dose (R.). Potassium Bromide, when insomnia, bad dreams 
and irritability (R.). Opium, gtt. j of laudanum with 2 or 3 of the tinctura 
nucis vomicae, 3 or 4 times a day, for symptoms of exhaustion with headaches, 
flushing and dyspepsia (R.). Ammonia, internally ; its influence is but brief 
(R.). Coffee or Tea, in hot or cold climates (R.). Castor, is serviceable, but 
seldom used (P.). Musk, benefits all forms of nerve-exhaustion (P.). Cimi- 
cifuga, for headache from over-study or excessive fatigue (R.). Alcohol, of 
value in all conditions of fatigue (P.). Coca, lessens the sense of fatigue under 
exertion, relieves thirst, and obviates the effects of a too rarefied atmosphere; 
is suitable for weakly subjects easily fatigued, and to convalescents (P.). Co- 
caine, has been used successfully in exhaustion from sunstroke, loss of blood, 
and diarrhoea (P ; ). Wet Sheet, dripping, cold, as a restorative, and to prevent 
aching of muscles (R.). Sea Bathing, is also valuable (R.). Habits, change 
of occupation better than absolute rest. [Compare Adynamia, Conval- 
escence, Insomnia, Myalgia.] 

Exophthalmos. 

Belladonna, T(\y of tincture hourly, of great service (R.); results recorded from 
its use are very remarkable, but Digitalis will usually answer better (P.). Duboi- 
sine, gr. T ^ of the sulphate 2 or 3 times daily, has produced remarkable results 
in one case (Hunt). Opium, may be of use in some cases (P.). Digitalis, to 
raise the arterial tension and slow the heart, decidedly ameliorative in young 
subjects (B.). To tranquillize the heart is the main indication. Iron, with 
Digitalis, seems to do more good than any other medicines (Da Costa). Chaly- 
beate Waters, are beneficial (B.). Convallaria, ameliorates the painful palpi- 
tation (Wa.). Galvanism, of the cervical sympathetic and pneumogastric, and 
eyes and thyroid gland, is decidedly curative in uncomplicated cases (B.). 

• 

Exostosis. 

Potassium Iodide, may promote absorption when recent ; also friction with 
ointment of Mercury or Iodine (D.). Aconite, was used by Storck (P.). Mer- 
cury, a moderate course of mercurials may be effectual, when exostoses due 
to a blow or from syphilis (D.). Exostoses of clavicles in children almost 
always disappear themselves (D.). Excision if required (MacCormac). 

Eye-Diseases. 

Belladonna, locally and internally in iritis, conjunctivitis and other inflam- 
mations. Atropine, in iritis, locally; hypodermically, in glaucoma (R.); the 
best application in inflammatory conditions generally. Euphrasia, had an 
extended reputation in Germany, is a mild astringent, and of service in catar- 
rhal conjunctivitis (P.). Pulsatilla, as lotion in inflammations and ophthalmic 
cases (P.). Santonin, gives good results in inflammatory and atrophic condi- 
tions of the retina and optic nerve, and in the stage of effusion of many other 



604 EYELIDS — FACE. 

inflammations (Wa.). Ruta, minim doses, night and morning, in dimness of 
vision depending on functional amaurotic condition, produces good results 
(P.). Physostigma, topically, to contract pupils; to reduce excessive atro- 
pinization. Stimulates the third nerve (P.). Strychnine, hypodermically in 
muscular asthenopia, amblyopia, amaurosis, and in progressive nerve-atrophy 
not dependent on intercranial diseases (R.). Increases the sensibilty of the 
eye, the field of vision becoming extended, and the vision more acute (Br.). 
Ergot, useful in many eye affections, especially disturbances of accommoda- 
tion, acute and chronic inflammations, and the blepharitis and pustular con- 
junctivitis of children (Wa.). Is myotic. Pilocarpus, is used with great benefit 
in many eye-affections, particularly amblyopia from alcohol and tobacco, 
detachment of the retina, chronic iritis, keratitis, hemorrhage into the vitreous, 
glaucoma, muscae, atrophic choroiditis, hemorrhages of the retina, white 
atrophy of the optic nerves, and inflammatory affections with effusion and 
exudation to promote resolution and absorption (Wecker). Cocaine, as a local 
anaesthetic in ophthalmic surgery, a 4 per cent, solution, by instillation, some- 
times injection required, as into the muscles for squint operation. Is mydri- 
atic, and in rare cases panophthalmitis has resulted after operations under 
cocaine (R.). Chloroform, vapor, close to a photophobic eye, relieves (R.). 
Oleate of Mercury and Morphine, outside the eye in palpebral conjunctivitis, 
and stye ; also in syphilitic iritis (R.). Silver Nitrate, Copper and Zinc Salts, 
are much used (B.). [See Conjunctivitis* etc. Compare Mydriatics, 
Myotics, etc., page 406 ; also in this section the titles Amaurosis, Asthen- 
opia, Cataract, Conjunctivitis, Corneal Opacities, Glaucoma, Iritis, 
Keratitis, Myopia, Ophthalmia, Photophobia, Retina, Strabismus, etc.] 

Eyelids. 

Calomel, locally, or brown citrine ointment, as application in many diseases 
(B.). Mercury and Morphine, the 20 per cent, ointment with lard, outside 
lid, for stye (R.). Pulsatilla, internally, and externally as wash, in ophthalmic 
cases and inflammations ; the so-called " stye " may often be aborted by this 
treatment (P.). Cadmium, much esteemed as collyrium, gr. ij of sulphate to 
£) aquae rosae (R.). Zinc and Copper Sulphates, are esteemed applications 
(B.). [See Conjunctivitis for formulae.] Ergot, an aqueous infusion, as a 
collyrium, in ptosis and paralysis of the eyelids (Wa.). Tannin, a strong 
solution (1 to 3 aquae), locally; or a weaker solution (1 to 20, 30 or 50 aquae), 
is much employed. Also used in pomade, or as fine powder (Wa.). Vera- 
trine, in solution, brushed over lids once daily in painful spasmodic contraction 
of the orbicularis (Wa.). Ammonium Chloride, in solution as lotion, for 
ecchymosis of eyelids, vulgarly known as " black eye." [See Ecchymosis, 
Blepharitis, Conjunctivitis, Ptosis, Ectropium, etc.] 

Face. 

Amyl Nitrite, rtiyj to */£, in 30 times its volume of spirits, for flushing of 
face, or sensation of flushing, with cold feet and hands, and great prostration, 
chiefly in women at change of life (R.). Curare, effective in facial spasm, 
when other remedies failed (P.). Blisters, behind the ear, in facial palsy, 
followed by warm covering to part (H.). Strychnine, has improved some 
cases of facial palsy (P.). [Compare Neuralgia, Odontalgia, Tic-Doulou- 
reux.] 



FALSE PAINS — FEET — FEVER. 605 

False Pains. 

Tartar Emetic, combined with small doses of opium, together with 
external fomentations, where evidence of congestion (L.). Opiates, to allay 
uterine irritation, after rectifying any derangement of bowels (L.). Opium, 
is valuable, having specific action on uterine muscular fibres, relaxing some, 
stimulating others ("VVa.). 

Feet. 

Arsenic, swelled feet of old or weak persons (R.); cedema of feet and 
ankles in the old, from feebleness of the heart (B.). Lead, as ointment of 
equal parts of emplastrum plumbi and linseed oil spread on linen, and 
wrapped round the feet when they sweat — to be renewed every third day for 
nine days (R.). Potassium Permanganate, gr. j-§j, as wash, will remove 
fetor of feet (B.); temporarily discolors the skin. Boracic Acid, in strong 
solution, is used with good results. Chloral, I in 50 of water, as bath, effi- 
cient. Sodium Bicarbonate, a solution freely applied will remove fetor (B.). 
Belladonna, will check fetid secretions (R.)« Salicylic Acid, in solution with 
borax, the most agreeable and efficient deodorant for fetid perspirations (B.). 
gjss-iij with giij of dried alum, in powder, applied freely to foot after washing 
and drying. Acid, salicylic. 3, magnesium silicate 87, is the composition of 
the powder used in the German army for sweating of the feet. Ice, to the 
spine, or heat and cold alternately, to equalize the circulation, has been 
strongly advocated (Wa.). Stockings, should be changed every day, and if 
dipped in a strong solution of boracic acid and dried will effectually check fetid 
perspirations. Cold Foot-Bath, and drying with friction, for cold feet (Ri). 

Prescriptions. 



R. Ac. Salicylici, . . gr. xv. 

Amyli, . 4 . . gr. cl. 

Talci, .... Jiij. 
M. et trit. Sig. — Locally for sweat- 
ing feet. {Kohnhorn.) 



Be. Ac. Borici (pulv.), . . ^jss. 
Vaselini, .... 3J. 
M. Sig. — Ointment for bromidrosis. 
( Championniere.) 



Fever. 

[See also the titles of the various fevers, in their respective alphabetical 

order.] 

Aconite, has the highest value in the eruptive fevers, also in all hyperpy- 
rexia (B.). Always indicated in early stage of simple inflammatory fevers, 
pneumonia, and in most acute congestions (P.). Has marvellous power over 
sthenic fevers. Thermometer should go hand in hand with Aconite (R.). 
Veratrum Viride, possesses considerable power as an antipyretic; useful in 
rheumatism, pneumonia (P.); in delirium ferox of fevers it is of value (B.). 
Strongly recommended in both sthenic and asthenic fevers (R.)« Belladonna, 
in the eruptive fevers, especially scarlatina (B.). In typhus, with delirium, 
insomnia, painful sensitiveness to light and sound. In all hyperaemic states 
of brain and spinal cord (P.). Is prophylactic often against scarlet fever 
(P., Pf.). In delirium; also excellent in typhus (R.). Gelsemium, in remittent 
and typho-malarial, of real benefit. Is antipyretic (B.). In bilious remittent, 
of value (Pf.). Arsenic, in prostrating acute fevers to strengthen pulse and 
invigorate patient. Except quinine, no drug subdues intermittents so well 
(R.). In malarial, especially typho-malarial, it is of greit value (B.). Cin- 



606 FEVER. 

chona. Quinine in the eruptive, and all malarial, remittent, and intermittent; 
as apyretic, less effective and more dangerous than cold baths. Useless in typhus 
and typhoid, except for hyperpyrexia (B.). Is anti-miasmatic, antiseptic, and 
antiphlogistic; of great value in intermittent, septicaemic, and hectic fevers 
(P.). Large doses at night to reduce temperature in typhoid and other fevers 
strongly urged in Germany. Cinchonine best as prophylactic against ague 
(R.). Antipyrine, the type and the best of the new series of synthetical anti- 
pyretics, which includes kairine, chinoline, thallin, etc. (see pp. 72, 135, 
151); is antipyretic and diaphoretic, moderates the intensity of the febrile 
movement, and is especially indicated in self-limited diseases with persistent 
hyperpyrexia, especially pneumonia, typhoid, etc. Kairine, is an efficient 
antipyretic, but profusely diaphoretic, also a cardiac and nerve depressant ot 
great power, and highly dangerous in pneumonia, and other fevers where the 
heart is weak. It often produces 'nausea and vomiting with headache and 
tinnitus aurium (P.). Resorcin, has been given in acute rheumatism, typhoid, 
typhus, pneumonia, erysipelas, etc., as an antipyretic; like Kairine, however, 
its action in lowering temperature is transient as compared with quinine or 
salicylic acid (P.) ; may be used hypodermically as it is not irritant (B.). Sali- 
cylic Acid, or salicylate of sodium, nearly equal to quinine as antipyretic. Very 
useful in all forms with high temperature and in intermittents. Especially in 
septicaemia, pyaemia, erysipelas, and surgical fevers (B., R.). Digitalis, the 
German antipyretic. Very useful in scarlet fever, rheumatic, and pneumonia 
(B.); especially in typhoid (R.). Cimicifuga, as substitute for digitalis, but 
less effective; good in hectic (B.). Hydrastine, intermittents, typhoid with 
copious sweats (P.). Arnica, is antipyretic, full doses in sthenic cases, small 
(TUv of tincture) in asthenic. Large and small doses produce different results 
(B.). In rheumatic and typhoid is highly extolled (P.). Camphor, subdues 
reflex excitability; praised as stimulant in adynamic fevers (P.). In adynamic 
fevers and where there is delirium (R.). Mercury, large doses of calomel, the 
German " specific " treatment of typhoid (B.). Small doses in typhoid at com- 
mencement; has marked effect on tonsils in scarlatina (R.). Rhus Tox., in 
rheumatic fever after aconite, and in scarlatina with typhoid symptoms, is 
invaluable (P.). Opium, much less used than formerly. Useful in delirium, 
and with quinine in remittents and intermittents (B.). For fevers characterized 
by prostration, insomnia and delirium, noisy or muttering, with picking of 
bed-clothes and twitching of the muscles ; in such cases opium, judiciously 
given, may save an almost hopeless case (R .). Morphine, hypodermically, 
the best form in febrile diseases, being less disturbing to the stomach and 
digestive power (P.). Turpentine, in typhoid, puerperal, and yellow, as a 
stimulant to vaso-motor nervous system (rn_ x- 3 ss ) (B.); as enema (Tn.30-60 
in starch mucilage with nix of liq. opii if pain) invaluable when in typhoid 
hemorrhage occurs with tympanitis (P., R.). Tartar Emetic, minute doses 
(gr. y 1 ^) frequently repeated, and with opium, are of great value in many acute 
febrile diseases (B.); as a diaphoretic; in ague; in large doses to abort spe- 
cific fevers (R.)- Muriatic Acid, very useful in all forms, especially in typhoid 
and the exanthemata ; relieving dryness of the mouth and fauces, increases 
digestion, and restrains the diarrhoea (B.). Acid Drinks, such as raspberry 
vinegar, citric acid, etc., very grateful and useful (R.,B.) ; two sliced limes or 
lemons, with 5ij of sugar, in Oj of boiling water, cooled and strained, make 
an agreeable refrigerant beverage (Wa.). Baptisia, useful in common con- 
tinued fever, or in the first stage of typhoid ; drop doses of a fresh tincture 
every hour. Eucalyptus, has given varied results in malarial fevers, some 
observers praising it very highly (P.). Valerian, has done much good in fevers 



FEVER, SIMPLE — FISTULA. 607 

of a nervous character (P.). Sumbul, is used in Russia for low fevers of 
a typhoid type (P.). Cocculus, for tympanitis of typhoid (P.). Ammonium 
Acetate, as a diaphoretic, and in simple forms, as catarrhal; the Carbonate 
in scarlet fever and measles (R.). Purgation, by castor oil, sulphate of mag- 
nesium, etc., before exhaustion (R.). Mustard Bath, on recession of rash in 
eruptive fevers (R.). Aliment, milk and beef-tea alternately, every 3 hours. 
Milk only, in fevers and inflammations of the digestive tract (B.). Alcohol, 
in low conditions is useful when causes improvement in symptoms, which may 
become worse (B., R.). Coffee better than alcohol (P.). Water, is a valuable 
adjunct to remedies in the treatment of fevers. Warm baths, the wet pack, 
hot and cold compresses, fomentations, moist inhalations, etc., have great 
value [see various fever titles] : a most important agent. Cold baths or cold 
wet pack to reduce temperature (B.); cold affusion, baths, packing, ice, and 
ice-bag; hot affusion and sponging, all of great value in every form (R.). 

Fever, Simple. 

Aconite, in small repeated doses, the best remedy for febricula, etc (B.) ; 
in ordinary febrile conditions, if given early, will abate fever and induce free 
perspiration; may be administered in conjunction with any other remedy in- 
dicated (R.). Veratrum Viride, in small doses, as antipyretic (P., R.). Hy- 
oscyamus or Belladonna, very useful in febricula, especially for head-symp- 
toms and constipation (P.). Gelse?nium, with remittent or bilious symptoms 
(P.,B.). Arsenic, if typho-malarial symptoms ( B.). Antipyrine, in hourly 
doses of gr. iv or less, in the simple continued fever of children, as antipyretic. 
Even infants bear it well (Penzoldt). Hydrochloric Acid, in the continued 
fever of childhood, has a beneficial influence (West). Valerian, when ner- 
vous excitability (P.). Lemon-juice, as " lemonade," or with bicarbonate of 
potass., as mild diaphoretic and diuretic (P.). Pomegranate-juice is very 
grateful if mixed with sugar or honey (P.)- Bromides, gr. ss-j every quarter- 
hour are excellent for the febrile disturbances of children (A. A. Smith). 
Baths, warm, in simple fevers of children (R.). Aliment, milk and beef-tea 
alternately every three hours, the most useful (B.). 

Prescriptions. 



R. Ac. Hydrochlor. Dil., 
Spt. yEtheris Co., 
Syr. Rosae, 
Aquae Camph., 
M. Sig. — Teasp. to tablesp.,~ ac- 
cording to age, every 6 hours. 

(Modified from West.) 




R. Potassii Acetatis, 

Spt. ^Etheris Nitrosi, 

Syr. Simplicis, 

Liq. Ammonii Acetatis, . 

Aquae Camphorae, . ad ^viij. 
M. Sig. — Teasp. to tablesp. doses, 
according to age. Diaphoretic and 
anti-febrile. 



Fistula. 

Piper Nigrum, the confection, as a gentle stimulant in anal fistula (P.). 
Iodine, by injection, sometimes curative, but generally fails (Wa.). San- 
guinaria, as injection, has cured (P.). Capsicum, the weak infusion, a use- 
ful stimulant in fistulous ulcerations (P.). Surgical. Division of sphincter 
in anal fistula, by knife or ligature, the best treatment (D.). In fistula lach- 
rymalis, dilatation of passage by probing the canaliculus, or slitting the can- 



608 FLATULENCE — FLUSHING-HEATS — FOREIGN BODIES. 



aliculus up (D.). In vesico-vaginal, or recto-vaginal, surgical methods best. 
Diet should be nourishing and digestible ; fresh air and general good hygienic 
conditions are necessary (R.). 

Flatulence. 

Nux Vomica will remove flatulence and intestinal indigestion (B.); when 
constipation, heart-burn, weight on head (R.). Charcoal, gr. v or x, soon 
after or just before meals (R.) ; mixed with bismuth (R.). Chloroform, pure, 
in drop doses, benefits (R.). Carbolic Acid, when no acidity present (R.). 
Turpentine, gtt. iij-v on sugar, will quickly relieve (B.). Asafostida or Va- 
lerian, quickly relieves the flatulence of hypochondriasis (B., P.). Asaf. gj 
of tinct. to Oyi water, give gj; useful for children (R.). Sodium Sulpho- 
carbolate, gr. xxx after eating, will be found very serviceable (R.). Phos- 
phoric Acid, dilute, is often promptly alleviative. Anise, the oil, also Ether, 
or any other member of the Carminative group (see page 416), will promote 
the expulsion of gas from the stomach and intestines. Mercury, when with 
clayey stools (R.). Calumba, an effective remedy for flatulent disposition is 
an infusion of ^ss each of calumba and ginger, ^j of senna, hot water Oj, a 
wineglassful ter die (B., P.). Potassium Permang., in flatulence attendant 
on obesity (B.). Physostigma, flatulence of women at climacteric (B.). Sul- 
phurous Acid, in 5 to 10 minim doses, when due to fermentation (R.). Diet. 
Abstain from sugar, starchy food and tea ; eat little, slowly and regularly ; as 
a general rule abstain from alcoholic drinks and vegetables, especially cab- 
bage. Pepsin [or Ingluvin\ after meals, to promote digestion (R.). [Com- 
pare Colic, Dyspepsia.] 

Prescriptions. 

R. Tinct. Nucis Vomicae, R. Gummi Camphorae, 

Tinct. Physostigmatis, Pulv. Zingiberis, 

Tinct. Belladonnas, . aa £j. Pulv. Capsici, . . aa gr. j. 

M. Sig. — Fifteen drops twice daily, Ft. pil. no. vj. Sig. — One pill as 
in a little water. (B.) required for gastric and intestinal 

flatulence. 



Flushing-heats. 

Nux Vomica, lUij of the tinct. with minim doses of laudanum in hysterical 
flushings of the middle-aged, with flatulence, weight on head and perspira- 
tions (R.). Nitrite of Amy I, "HlyV to i m thmy times its volume of rectified 
spirits. Effective for flushing of face, or sensation of flushing, followed by 
coldness, with cold feet and hands and great prostration, occurring at climac- 
teric chiefly (R.). Potassium Bromide, at climacteric, with mental depression 
(R.). Zinc Valerianate, or Valerian, flushings at the climacteric (R.). Eu- 
calyptol, for the flushings, palpitations and flatulence incident to the change 
of life (R.). 

Foreign Bodies. 

In the Eye, — Remove by bathing, or wiping towards the lower inner corner 
with a soft, moistened handkerchief, or a bent bristle, the two ends being held 
in the fingers. Use tepid solution of vinegar (gss-gj) for removing lime, 
tepid water for powder. Then apply a weak zinc or alum collyrium, or instil 



FRACTURES AND DISLOCATIONS — FRECKLES. 6og 

a solution of Atropine, gr ij to the ^, or Cocaine, 4 per cent. In the Ear, — 
Examine carefully with speculum before removal ; first syringe with warm 
water, or a drop of sweet oil to drive out insects, before using forceps ; apply 
equal parts of laudanum and olive oil, a few drops on cotton, if much pain. 
In the Nose, — A current of tepid salt water, forced up one nostril, may force 
down the body through the other, if the mouth be held open. In the Larynx 
or Pharynx, — if water can be swallowed, the obstruction is in the trachea. 
Never push a body down. Remove by curved forceps or blunt hook. It 
passed into the stomach use solid diet to imbed the article. If all fail and 
the case be urgent, resort to catheterism or tracheotomy. In the Flesh, — re- 
move at once by forceps, or sponge and water. 



Fractures and Dislocations. 

Arnica, is excellent to neutralize the ill effects of mechanical injuries, ttlv-x 
in a wineglassful of water every 2 or 3 hours. When used after amputations, 
it certainly has the power of promoting the rapid union of the surfaces. The 
infusion is better than an alcoholic preparation for external use (P.). Aconite, 
quickly and repeatedly if feverish symptoms ensue (P.). Iodine, int. and 
frictions, occasionally useful in ununited fractures (Wa.). Calcium Phosphate, 
promotes formation of callus (Wa.). Opium, useless in surgical fever, and 
may do harm (CI.) ; for nervousness or muscular spasms after dressing, gr. }£ 
of morphine hypodermically as anodyne (Ag.). Benzoin, the tincture on lint, 
as a dressing for compound fractures and other severe injuries, leads to rapid 
and satisfactory healing (Bryant). Carbolic Acid, 1 to 20 or 1 to 40 solutions, 
for irrigation and dressings in compound fractures, obviates pyaemia and most 
of the other preventible causes of death (P.). Leadwater and Laudanum, on 
lint, or a Calendula lotion to the part, after reduction of the injury, with mor- 
phine hypodermically and perfect quiescence. Diet, should be very simple 
for a week or ten days. [Compare Wounds.] 



Freckles. 

Iodine, the tincture or glycerite, locally (B.). Liquor Potassce, %] to ^ij 
Aquae Rosae, as a lotion (Todd). Benzoin, the compound tincture with water, 
as cosmetic to remove freckles (P.). Sodium Borate, a saturated solution of 
borax is a safe and often efficient lotion to remove freckles (B.). Lime-water 
and olive oil, equal parts, with a little liq. ammoniae, as liniment (Wa.). Po- 
tassium Carbonate, makes a good lotion for freckles, sunburn and tan (B.). 
Mercury, the bichloride, with alcohol and glycerin, as a lotion, has been 
found effective. Donovan's solution, mjxxx to ^ v ^j of Water, and gj every 
three hours, has been found highly successful (Wa.). 

Prescriptions. 

R. Potassii Carbonatis, . ^iij. R. Hydrarg. Chlor. Corr., . gr.vj. 

Sodii Chloridi, . . gij. Ac. Hydrochlor. Dil., . gj. 

Aquae Aurantii Flor., . 2ij. Alcoholis, Aq. Rosae, aa j|ij. 

Aquae Rosae, . . . 3viij. Glycerini, %), Aquae, ad £v'ri]. 

M. Sig. — Face- wash. M. Sig. — Apply at night, and wash 

off in the morning. 




6lO GANGRENE GASTRALGIA AND GASTRODYNIA. 

Gangrene. 

Salicylic Acid, pure, in powder locally, to destroy fetor and change the 
character of the morbid action (B.). Carbolic Acid, acts in the same way 
(B.) ; a I per cent, solution as lotion in gangrenous ulcers (Wa.). Sodium 
Sulphite, in solution, I to 5 or 10 of water, as lotion or applied on compresses, 
to destroy odor, soothe pain and establish healthy action (Wa.). Ammonium 
Chloride, in solution as bath and fomentations, very successful in one case of 
senile gangrene (Wa.). Cinchona, or better, quinine, or the hydrochlorate, 
often proved of value (P.) ; generally decoction of cinchona best (Wa.). Tur- 
pentine, locally, after removal of gangrenous part, a most efficient application 
(B.); by stomach and inhalation from hot water in gangrene of lungs; the 
oil locally in dry and chronic gangrene (P.). Sanguinaria, has been recom- 
mended (P.). Oxygen, as gaseous bath in senile gangrene (R.). Charcoal, as 
poultice, value doubtful (R.). Citric Acid, lemon-juice dropped into wound, 
which is then covered with lint steeped in a solution of chlorine. Very effec- 
tive for hospital gangrene, in Parisian hospitals [Lancet, October, 1879]. P er ~ 
chloride of Iron, locally, is considered superior to the mineral acids (Wa.). Ni- 
tric Acid, strong, applied carefully until the ulcer is converted into a firm, 
dry mass (Wa.) ; is probably the best escharotic, next to bromine, for gan- 
grenous destruction (B.). Bromine, is the best escharotic for hospital gan- 
grene (B.). Chromic Acid, is a very efficient caustic, penetrating deeply with 
but little pain (B.). Opium, to soothe the pain, and diminish restlessness and 
irritability (Wa.). 

Gastralgia and Gastrodynia. 

Opium, in some form necessary to relieve the pain in severe cases (Da 
Costa). Morphine, is of great value (P.) ; subcutaneously in epigastrium very 
efficient, or in small doses with bismuth and milk before meals (R.). Bella- 
donna, is useful in painful affections of the stomach (R.). Atropine, often 
relieves promptly, and is excellent in neuralgic pain of the abdominal vis- 
cera (P.). Nux Vomica, an excellent stomachic, gt. v-x of tincture before 
meals (B.) ; gtt. j-ij every 2 hours in many forms of gastric derangement 
(R.). Strychnine, hypodermically for gastralgia and gastrodynia (R.); in very 
small doses, gr. rJo~¥2> two or tnree times daily, a very successful remedy 
(P.). Arsenic, sometimes dissipates the pain surprisingly (B.); a drop of 
liquor arsenicalis before food in irritative dyspepsia and gastralgia with heart- 
burn (R.). Bismuth, when gastralgia due to irritation of mucous membrane, 
acts well alone, but is most efficient when given with aromatic powder and a 
little morphine (R.); or a combination of bismuth and arsenic in more 
chronic cases (B.) ; subcarbonate is especially adapted to gastralgia with la- 
borious digestion and putrid or acid eructations (Wa.). Manganese, the black 
oxide in gastrodynia and pyrosis (R.). Zinc Oxide, an excellent remedy when 
gastralgia after food, gr. v-x with aromatic powder and morphine, before 
meals (B.). Silver AHtrate, in solution to check the pain of many stomachal 
disorders (R.) ; a pill of gr. ss, with extr. hyoscyami gr. ij-iv(Wa.). Hydro- 
cyanic Acid, often cures rapidly when gastralgia from nervous derangement 
(B.) ; may check vomiting as well as relieve pain (R.) ; cherry-laurel water a 
useful form (P.). Nitro-hydrochloric Acid, gtt. ij-iij of the dilute acid, is ser- 
viceable (Da Costa), jfcther, a few drops of sulphuric ether or the com- 
pound spirit Tn_x-xx, often relieves quickly (B.). Chloroform, TUjj-v on sugar, 
often relieves (B.). Chloral, sometimes relieves pain in gastralgia (R.). Pul- 



GASTRIC DILATATION. 



611 



satilla, is efficient in many cases of painful dyspepsia, with coated tongue, 
headache and nervous depression (P.). Pepsin, when gastrodynia from indi- 
gestion (P.). Creasote, checks pain after food (R.). Alum, often affords re- 
lief (B.). Ergot, of value in visceral neuralgias (P.). Alkalies, for pain in 
stomach, liquor potassae generally employed (R.). Quinine, in cases snowing 
periodicity, and those of neuralgic type (P.). Sodium Salicylate, for gastralgia 
with fermentation (R.) Nitroglycerin allays the pain speedily (B.). Car- 
bonic Acid Water, in painful and irritable conditions ; may be mixed with 
milk (R.). Milk-cure, very efficacious in obstinate cases (B.). Galvanism of 
the pneumogastric, and locally to the organ itself (B.). Aquapuncture has 
given extraordinary relief (B.). Diet is of the greatest importance. Food 
should be easily digestible, varied and plainly cooked. Sedentary livers should 
refrain from much animal food. Meals should be regular and frequent, eating 
little at a time, and that very slowly. Alcoholic beverages do harm as a rule, 
but may benefit particular cases. Eating should be done in as agreeable a 
frame of mind as possible, and the patient should rest for a time after a meal. 
[Compare Acidity, Dyspepsia, Neuralgia.] 



Prescriptions. 



r. 



Morphinae Sulph., . . gr. j. 
Ac. Carbolici, . . . Zss. 
Aq. Menth. Pip., . adgiv. 
M. Sig. — Teasp. thrice daily. 

[Da Costa.) 



R. Atropine Sulph., . . gr. j. 

Zinci Sulph., . . . gss. 

Aquae Destill., . . . Sj. 

M. Sig. — 3 to 5 drops two or three 
times daily. (B.) 



R . Bismuthi Subnit, 

Magnesii Carb., . aa gr- xyj. 

Ac. Hydrocy. Dil., . nix. 

Aquae, ; giv. 

M. Sig. — Dessertsp. for a child of 
3 years in flatulent gastrodynia and 
gastralgia. 



R. Ac. Hydrocy. Dil., . . gij. 
Aq. Laurocerasi, . adgiv. 
M. Sig. — Teasp. every 4 hours. 



R. 



3 l J- 

3 SS - 



Bismuthi Subnit., 
Aq. Hydrocy. Dil., . 
Mucil. Acaciae, 
Aq. Menth. Pip., . aa ^ij 
M. Sig. — Tablesp. thrice daily. 



R. 



Pepsini, . 
Ac. Hydrochlor. 
Glycerini, 
Aq. Cinnam., . 
M. et filtra. Sig. 



* 3J- 
Dil., . gss. 
. 3Jss. 
, gijss. 
-Tablespoonful 



doses for slow and feeble digestion. 



Gastric Dilatation. 

Carbolic Acid, internally to allay fermentation, with an occasional washing 
by the stomach pump (Da Costa); Strychnine, hypodermically or by the 
mouth,' or Nux Vomica, the best remedy, conjointly with washing of the sto- 
mach and a strict diet (Da C). Bismuth, with magnesia or soda, or lime- 
water frequently, for the acidity, which is one of the most distressing symp- 
toms (Fenwick). Diet, should be free from all starch and sugar, and from 
vegetables of any kind (Fenwick); Milk not advisable, as much fluid will 
further dilate the organ ; solids better, as small quantities of dry, stale bread, 
or gluten bread, and underdone meat (Da Costa). 



6 1 2 GASTRITIS. 

Gastritis, Acute, 

Mercury ', calomel in broken doses, with ice, frequently swallowed, for the 
idiopathic form, which is occasionally seen and cannot be distinguished from 
that due to irritant poisons (Da Costa). Bismuth, subnitrate or subcarbonate 
in full doses after the more acute symptoms have abated (Da C). Morphine, 
hypodermicallv for pain (B.)* Ice, internally and externally, gives great 
relief (R.). Aliment should be given per rectum; no food, except milk and 
lime-water, being admitted to the stomach for some time (Da C). Antidotes, 
in cases of irritant poisoning, as alkalies to neutralize acids, dialyzed iron or 
the hydrated sesquioxide for arsenic, turpentine for phosphorus, etc. [See 
page 434, ante.~\ Then oil, albumen or milk, to protect the mucous mem- 
brane, stimulants, opium, ammonia, etc., to antagonize the depression of the 
vital powers. 

Gastritis, Chronic, 

Arsenic, sometimes surprisingly curative ; for the vomiting gtt. j-ij of 
Fowler's Solution before meals (B.j. Pulsatilla, in subacute gastritis of 
phlegmatic temperaments, white tongue, heartburn, nausea, flatulency, little or 
no taste (P.)- Hydrastis, gtt. v-xv of tincture or fluid extract, daily before 
meals, especially for gastric catarrh of acute alcoholism (B.). Nux Vomica, 
gtt. j of tincture every 5 or 10 minutes for 8 or 10 doses in acute gastric catarrh, 
with headache or sick-headache; also drop or 2-drop doses every 2 hours or 
oftener, when chronic gastric catarrh in the course of chronic disease (R.)« 
Cinchona, to promote healthy state of mucous membrane, the infusion best 
with mineral acids, or quinine ; the red bark in gastric catarrh of drunkards 
(B ). Alkalies, either shortly before meals, to stimulate production of gastric 
juice; or some hours after, to neutralize the acids of decomposition (Da C). 
Pepsin, gr. v immediately after a meal, to assist digestion (Da C). Podophyl- 
lum, in small doses at night, to act on upper bowel. Purgation as a method of 
treatment stands at the head (Da Costa). Ipecac, in small doses may prove 
highly useful, iri,v-x of the wine (P.); for the nausea and vomiting (R., B.). 
Tannic Acid, in 4-grain doses with a drop of glycerin to make a pill (B.). 
Hydrocyanic Acid, is much used (R.); in subacute gastritis it often proves 
useful given in an ordinary effervescing draught (Wa.). Silver Nitrate, in j£ 
or j^-grain doses, with opium if pain, or preferably belladonna, is extremely 
useful (Da C.) ; to check pain and vomiting (R.). Silver Oxide, is nearly as 
good as the nitrate, and not liable to produce staining (Da C). Opiu?n or 
Morphine, to quell pain in chronic gastritis from alcoholic excess (R.). Euca- 
lyptus, a most useful stomachic, not to be used in inflammatory states (B.) ; is 
used with benefit (R.). Mercury, the yellow oxide, in doses of gr. yV~t&> m 
chronic form. [See under Dyspepsia.] Calumba, and other bitters are use- 
ful (B.). A?nmonium Chloride, in high repute in Germany (B.). Caffeine, 
especially when associated with migraine (B.). Bismuth, is very useful in 
chronic gastritis, especially that of drunkards, and the chronic gastric catarrh 
of children with vomiting (R.) ; invaluable for its sedative, alterative and 
astringent action; 10-15-grain doses several hours after meals (Da C). Lead 
Acetate, in chronic gastiitis with gastralgia and pyrosis, may be combined with 
morphine beneficially (B.). Alum, when vomiting of glairy mucus (B.). Ali- 
ment, such as will be digested in the small intestines ; requires careful atten- 
tion. The milk-cure has been very effective in bad cases ; malt liquors are 
harmful (B.). Mineral waters of purgative type, to keep the portal system 
drained. Exercise is not beneficial ; better live quietly, and occasionally 



GASTRIC ULCER. 



613 



spend a day or two in bed (Da C). Kumyss very agreeable, and tolerant to 
stomach; the milk-cure and buttermilk have been very efficacious. The 
farinaceous vegetables, rice, tapioca, arrowroot, aerated bread. [Compare 
Dyspepsia, Gastralgia.] 



Prescriptions. 



R 



gr. lxxx. 

3jss. 

5ss. 



;iv. 



Sodii Bicarbonat., 

Spt. Chloroformi, 

Tinct. Gentianae, 

Infusi Rhei, 

Aq. Menth. Pip.,q. s. ad Jjviij. 
M. Sig. — A tablesp. or two before 
each meaL In chronic gastric catarrh, 
with flatulence. 



R . Argenti Oxidi, . 
Ext. Belladonnae, 
Olei Caryophylli, 
M. Ft. pil. no. xxiv. 

pill twice daily. 



. gr. xi] . 
. gr. nj. 
. gtt. xx. 
Sig. — One 

(Da Costa.) 



R . Sodii Bicarbonat., . . 3[jss. 

Tinct. Aurantii Cort, . jfss. 

Infusi Calumbae, q. S: ad %vii). 
M. Sig. — Two tablesp; before each 
meal. In chronic gastric catarrh. 



R. Aluminis, 

Ext. Gentianae, ; 
M. Ft. pil. no. xxx. 
twice daily. 



• 3 SS - 
Sig. — Two 



R. Magnesii Sulphatis, . gj-ij. 
Sodii et Potassii Tart., . gss-j. 
Ac. Tartarici, . . . gr. xx. 
Sig. — Dissolve in a glass of water, 
and drink, an hour before breakfast. 



Gastric Ulcer. 

Arsenic, Fowler's solution in drop doses lessens the pain and relieves the 
vomiting remarkably (B.) ; has given relief when commonly-used reme- 
dies failed (R.); gives good results when used in very small doses (Da 
Costa). Bismuth^ relieves pain and vomiting, and contributes to the cure 
(B;). [See under Gastralgia for formulae.] Silver Nitrate, in solution, 
to check pain and relieve the vomiting (R.) ; is next in value to bismuth, 
promoting cicatrization and easing the pain (B.). Silver Oxide is equally effi- 
cient, and is not liable to produce staining (Da C). Atropine often happily 
relieves the pain and vomiting, even when given in very small quantity (Bj). 
Morphine, for the pain and vomiting (R.) ; in full doses if perforation occurs, 
to localize peritonitis until adhesions take place (DaC). Ergotin,] to water 
x, of which gtt. xv hypodermically several times a day for the hemorrhage. 
Gallic Acid, in 5-grain pill every hour for hemorrhage. Lead Acetate, is 
sedative and hemostatic ; gr. ss-ij in pill with opium, very useful to check 
hemorrhage and allay pain (R.). Turpentine, 5 to 10 drops frequently 
repeated in hemorrhage (R.). Charcoal is said to ease the pain by preventing 
formation of acid products (R.). Mercury. Corrosive sublimate an effective 
remedy; gr. •£$—$■$ thrice daily before meals (B.). Pepsin, by facilitating 
digestion, is useful (B.). Iron, for the anaemia : the lactate or ammonio-citrate 
if stomach irritable (Da C). Ice-bag, to the epigastrium, for pain and vomit- 
ing, etc. (R.). Nutrient Enemata, to rest the stomach. [See under Enemata 
for formula.] Brandy may be added, also laudanum, gtt. x-xx, if the rectum 
is irritable (B.). Milk-cure, has succeeded admirably (B.) ; a strictly skimmed 
milk diet with lime-water, 2 parts of milk to I of aqua calcis (Da C.). Diet, 
should be of unirritating character, which, with cold or hot compresses to the 
epigastrium, leaves little room for medicine. In bad cases nourish per rectum, 



6 14 GLANDERS AND FARCY GLANDULAR ENLARGEMENTS. 



so as to give the stomach complete rest. In any case such food as is 
chiefly digested in the small intestine, e.g., farinaceous vegetables, rice, arrow- 
root, etc. A nice change from milk diet is a warmed pancreas, chopped up 
with rare meat, being nutritious and well relished (Da C). Rest in bed for 
several months is imperative (Da C). Defibrinated Blood, by injection into 
rectum, in doses of from giij— vj (A: H. Smith). [Compare Hematemesis.] 

Prescriptions. 



R . Argenti Oxidi, 

Ext. Hyoscyami, . aa gr. x. 
Ft. pil. no. xx. Sig. — One pill 
thrice daily before meals. 


B . Argenti Nitratis, 
Ext. Opii, . 
Ft. pil. no. xx. 
thrice daily. 


• 
Sig.- 


. gr. v. 
gr. iij. 
— One pill 



R. Bismuthi Subcarb., . ^iij. 

Morphinae Sulph., . gr. j-ij. 

Pulv. Aromat, . . £j. 

Ft. pulv. no. xij. Sig. — One powder 
in milk before each meal. 



R . Argenti Oxidi, . . gr. v. 

vel Zinci Oxidi, . . gss. 
Morphinae Sulph.,. . gr. j-ij. 

Ft. pil. no. x. Sig. — One pill thrice 
daily, before meals. 



Glanders and Farcy. 

Ai?i?nonium Carbonate, in water, hourly, as concentrated as can be swal- 
lowed, followed by an opiate, and preceded by an emetic of ipecac, and an 
incision into each of Wharton's ducts ; proved successful in a case of acute 
glanders (Wa.). Carbolic Acid, and the Sulphites, as sodium sulphite, are 
most worthy of .trial. Creasote, or Carbolic Acid, in glycerin, locally (Wa.) ; 
or dilute chlorinated soda, and lime-water. Escharotics, to destroy the 
affected spot, if inoculation occurs. Iodine, internally, also Arsenic and 
Strychnine, have been recommended. Quinine in large doses, and Chlo- 
ride of Iron, may be useful. No drug yet tried has any marked specific 
effect on the disease (Durham). 



Glandular Enlargements. 

Iodine and Iodides, no remedy more efficient, when simple hypertrophy. 
Useless (with all other medicines) when caseation or suppuration has set in. 
Iodine injected into cystic and glandular growths of neck. Syrup of the 
Iodide of Iron occupies an important place (B.). The iodide of potassium for 
mammae and testicles, but especially for thyroid ( R.). Iodoform is equal, if not 
superior to iodine, in enlarged scrofulous glands, and other glandular swellings 
(Wa.). Iodide of Lead, as an ointment. Ung. Hydrarg. Iodidi Rubri, pro- 
duces very striking effects in goitre, enlarged spleen, etc. (B.). Sulphides, 
especially the Blue Lick water, are said to abort or to mature suppuration in 
glanders (R.). Calcium Sulphide, for hard, swollen glands behind angle of jaw, 
with deep-seated suppuration ( R. ). Calcium Chloride, highly useful in strumous 
inflammation and suppuration (B.). Pilocarpus, is curative in acute affections 
of parotid and submaxillary glands (B.). Mercu?y, useful in acute inflamma- 
tory states, tonsillitis, parotitis, etc. Hydr. chlor. corr. gr. ^ or hydr. cum creta, 
gr. -£, every 2 hours (B.). The oleate of mercury and morphine in obstinate 
and painful tonsillitis, and inflammation of lymphatic glands (R.). Belladonna, 
especially in tonsillitis (P.). Valerian with Guaiacum, in strumous enlarge- 
ment (P.). Hydrastis, frequently controls (P.). Carbolic Acid Injections, 



GLAUCOMA GLEET. 6 1 5 

a 2 per cent, solution injected into substance of gland (B.). [Compare Bubo, 
Goitre, Tabes Mesenterica, Parotitis, Tonsillitis, etc.] 

Glaucoma. 

Atropine, gr. ■£$ hypodermically, beneficial (Anstie) ; imprudently used has 
caused the disease (Von Graefe, Soelberg Wells). Eserine, lowers intra-ocular 
tension, and is indicated with Quinine in all cases of threatened glaucoma, to 
preserve the eye from the risk of consecutive glaucoma, and after iridectomy 
or sclerotomy (De Wecker). Iridectomy, the only remedy for the disease, 
medicine being worse than useless. The operation should be performed as soon 
as a state exists which can be called glaucomatous. Even when vision is lost, 
the operation will best relieve the pain (C). Almost a certain cure in early 
stages; in later, nearly always palliative ; often curative. Drainage of Eye, 
by gold wire or catgut, has had success (De Wecker J. 

Gleet. 

Cantharides, in drop doses, when frequent desire and pain in region of 
prostate (R.) ; of benefit in subjects of relaxed fibre and feeble circulation 
(B.). Blisters, to the perinseum, of undoubted benefit (B., R.). Piper Me- 
thysticum, has cured obstinate gleet (Switzer). Bismuth, I, glycerin I, water 
6 parts, as an injection, often useful in gleet (R.). Eucalyptol, is used with 
benefit in chronic catarrh of the genito-urinary tract (R.). Iron, the tincture 
of the chloride £ss, in Oss of water with ^j of laudanum, makes a good in- 
jection for gleet (R.); internally for anaemic subjects (St.). Mercury, ]4, 
grain of corrosive sublimate in gvj of water, is a good injection in gleet, used 
every 2, 3 or 4 hours (R.j. Zinc Salts, the sulphate or chloride, gr. ij of the 
latter to a pint of water, as injection every hour (R.). Bougies, of gelatin, 
medicated with astringents, are extremely efficient. Turpentine, in moderate 
doses, when due to relaxed condition (B., R.). Copper Sulphate, a solution 
as injection (R.). Astringent injections may be used with benefit (Wa). 
Copaiba, smeared on a bougie, and introduced into the urethra, will some- 
times cause gleet to yield (Wa.). Oil of Sandalwood, m.xv ter die (R.). 
Glycerite of Tannin, with equal quantity of olive oil or mucilage, as injec- 
tion, ^ij enough. Persevere 8 or 10 days after discharge ceased, and do not 
use at bedtime (R.). Balsams of Peru and Tolu, Buchu, Canada Balsam, 
Copaiba, Mastic, and Tamtin, are used with advantage (P., R.). Often kept 
up by over-treatment. Will some time or other come to an end (St.). Diet 
and Habits important. Stimulants, both solid and liquid, should be rigidly 
avoided, also coffee. Frequent ablutions, fresh air, good nourishment. [Com- 
pare Gonorrhoea.] 

Prescriptions. 



R. Tinct. Ferri Chlor., . . gvj. 
Tinct. Cantharidis, . . gij. 
M. Sig. — 15 drops in water three 



times daily. 




(B.) 


R. Zinci Sulphatis, 


. 


. gr- "j. 


Ac. Carbol., . 


. 


. Tlllj. 


Ext. Hydrastis, 






Ext. Belladonnoe, 


. 


aa gr. vj. 


Gelatini, 


. 


. q.s. 


M. Ft. bougia no. 


V J- 


Sig. — One 


in urethra at bedtime. 







R . Pulv. Cantharidis, . . gr. iij. 

01. Terebinth., . . gj. 

M. Ft. pil. no. xij. Sig. — One 

thrice daily in obstinate gleet. If 

strangury occur, stop for a day or two. 



R . Ac. Tannici, . . . gr. x. 
Bismuthi Subnit., . . gij. 
Aq. Rosae, . . . 3 vj 
M. Sig. — Shake and use as an in- 
jection thrice daily. 

{Maury.) 



6 1 6 GLOSSITIS — GOITRE. 



Glossitis. 

Bismuth, gr. xx of subnit. with ^j of glycerin and sjvij of water, as lotion, 
for erythematous inflammation of tongue (A.). Purgathes. with gargles, 
leeches, antiphlogistic regimen generally (D.). Quinine and Iron, should be 
given internally, with dilute acid washes, and free purgation | CI.). Alum, dry, 
powdered, may be dusted on tongue (CI. j. Leeches, applied beneath the jaw, 
if symptoms are urgent CI. . Abscess, should be opened, if any form. In- 
cisions, along superior surface, followed by vapor of hot water, may instantly 
relieve congestion (A.). Tracheotomy, or Laryngotomy, if suffocation is 
imminent (A.). 

Glottis, CEdema of. 

Emetics, non-depressing when cedema slight (A.). Inhalations, of steam 
with benzoin, or conium, of great service (A.) ; or of tannin, gr. viij or x to 
^j of water; or alum, gr. x to the t > , or a saturated solution of potassium 
chlorate, all as spray (Walker . Ethyl Iodide, by inhaladon, proved curative 
in one case in which it was repeated twelve times iSeej. Scarification, by 
laryngeal lancet, of paramount value (A.!. Tracheotomy, if the above fail 
A. , O'Dwyer's laryngeal tubation promises well. [Compare Croup, Lar- 
yngitis.] 

Goitre. 

Iodine, is curative in simple hypertrophy (ordinary goitre . used both inter- 
nally and externally. Deep injection of the tincture is very successful in c 
degeneration of the gland (B.j ; also in the hbrous and hbro-cy-ric varieties, 
if injection be made into the tumor ; dangerous, if into a vein or into the 
surrounding areolar tissue (Wa.j. Mercuric Iodide, as oint. assisted by the 
sun's rays, a piece the size of a large pea rubbed in daily, very successfully 
used in India for simple hypertrophy R. ; the official unguent, hydrarg. iodidi 
rubri, l in io daily iB.) ; is too strong Gro-< ; gr. xv to the 3 strong enough 
for the worst cases Wjl). Potassium Iodide, internally, also externally as 
ointment, in simple hypertrophy of the gland 1 R. \. Strychnine, gr. y^ thrice 
daily, has been successful in several cases 1 Holmes). Chloride of Iron, injec- 
tions of the solution used in thirty-eight ca>es with curative results (Macken- 
zie). E?'gotin, injected with benefit into the parenchyma of the goitre (P.); 
also used hypodermically with good results Wa. . Ammonium Chloride, as 
an internal remedy, has proved curative | Stevens). Electrolysis, has sometimes 
cured in cases of simple hypertrophy and cystic gland B. . S/sngia L'sta, was 
formerly considered a sovereign remedy Wa. 1. Seton has cured. Eluo?'ic 
Acid, in doses of tti xv to jj thrice daily, largely diluted, cured seventeen cases 
out of twenty (Woakes). Excision, is a very difficult operation, only to be 
considered in extreme cases ; it has been performed successfully by Desault, 
Harris, Hedenus, Billroth and Greene. [Compare Exophthalmos.] 

Prescriptions. 

R. Ammonii Chloridi, . . £vss. rj. Ung. Hydrarg. Iodidi Ru- 

Syrnpi Simplicis, . . 5SS. bri, . . . . gj. 

A'q. Cinnamomi, . . giv. Vaselini, .... 3 v ij. 

M. Sig. — Teasp. thrice daily. M. Sig. — Use as directed. 



GONORRHOEA. 617 



Gonorrhoea. 

Aconite, a drop of tinct. each hour in the acute stage (R.) ; when inflam- 
mation (Pf., St.). Gelsemium, serviceable, acute stage (Pf.). Cannabis Sativa, 
after acute symptoms subside, a few drops 3 or 4 times a day, is fully as effect- 
ual as copaiba or sandal, and infinitely more pleasant to take (Pf.). Canna- 
bis Indica, relieves pain, diminishes discharge (P.) ; occasionally useful (R.). 
Mercury \ excellent results from corrosive sublimate ( Pf. ) ; gr. X~ J4 to ^ss aquae 
destill. in subacute and chronic stages, as injection thrice daily ; may have 
gr. ss-j of zinc chloride added with benefit. Often effectual (Wa.). See page 
495 for formula. Hydrastis, the infusion best for injection, £j of root to ^viij 
aquae (Pf.); the fluid extract is one of the best injections, properly diluted ; 
or the muriate of berberine (hydrastin) £j to ^iv of mucil. acacise (B.), Col- 
chicum, the wine of the seed has frequently cured gonorrhoea, and was used 
in thirty-minim doses nightly for the relief of chordee by Brodie (B.). Chlo- 
ride of Iron, when acute stage has passed and the discharge is degenerating 
into gleet, few remedies are more useful than this tincture, in doses of ni xv- 
xx thrice daily. See Erysipelas for formula (Wa.). Alkalies, citrates or 
bicarbonates to render the urine alkaline (R.) ; Lithium Carbonate in five-grain 
doses thrice daily, for the same purpose. Alkalies are the chief factor in 
Otis' treatment ; Potassium Bicarb., gr. x in a tumbler of water, or in flaxseed 
tea, or infusion of triticum, with gr. xv of Potass. Bromide if great pain 
present. Vichy Water (Celestin's) freely (Otis). Turpentine, in chronic 
stage, when parts are relaxed, moderate doses are of great benefit (B.). Can- 
tharides, drop-doses may be used (R.) ; in the chronic stage (B.). Pulsatilla, 
in subacute and gonorrhoeal ophthalmia (P.). Copaiba, especially adapted to 
gonorrhoea (B.) ; pour it upon half a wineglassful of water to which add some 
bitter tincture (Chapman) ; if given too early in the disease it will aggravate 
the symptoms (P.) ; should not be used until pain in urinating is nearly gone, 
chordee ceased, and the discharge is diminishing and of yellow color (Wa.) ; 
is no good, but rather injurious, and prolongs the disease (Otis). See page 
492 for formula. Sandalwood Oil, valuable in subacute (P.) ; a good quality 
difficult to obtain (Pf.). Best internal remedy; Copaiba next (St.). Silver 
Nitrate, a weak solution (gr. j-v-gj) as injection. In vaginal gonorrhoea a 
strong solution (3J-J;j) through speculum to every part of canal (B.). As 
abortive injection is useless and dangerous (St.). Cubeba, unlike copaiba, 
given with good effect in acute stage ; best results from mixture of both as in 
electuary. See formula below. Is not irritating to the stomach, and agrees 
with some patients better than copaiba (Wa.). Zinc Salts, a weak injection 
of the chloride, gr. j to gvj or viij of rose-water; or the sulphate gr. j to the 
^, frequently repeated, is probably the best treatment (B.). The best injec- 
tions are those of the sulphate or acetate, gr. vj-xij to ^iv aquae, after the acute 
inflammation subsides (St.). Bismuth, the oleate, smeared on a sound, and 
inserted for 5 minutes (Shoemaker); with mucilage as an injection, excellent 
in chronic gonorrhoea (Hill). Lead Acetate, the dilute solution of the sub- 
acetate, as injection, may be employed at any stage (B.). Chloral, a weak 
solution, gr. j-iv to the ^, a very good injection (Hill). Resorcin, a 1 per 
cent, solution makes a useful injection (Wa.). Injections, of tannin, copper 
sulphate, iron, cadmium, port-wine, brandy-and-water, and 1000 other agents 
(R.). Injections are very bad, especially in the acute stage; should never be 
used until the 4th week and then only if the case is not progressing (Otis). 
Jrue gonorrhoea is never cured in less time than four weeks (Van Buren and 
Keyes); urethritis is a different disease entirely (Otis). Balsams of Peru and 

52 



6i8 



GONORRHCEA. 



Tolu, also Buchu, Uva Ursi, Chimaphila, Pareira, etc., are among the numerous 
remedies used for gonorrhoea (R.). Alcohol, as a beverage, or any other stim- 
ulant, must be avoided entirely (R.). Soluble Bougies made of iodoform, 
eucalyptus and cacao-butter, are highly recommended to cut the disease short 
(Wa.) ; a series of similar preparations, having a basis of gelatin and glycerin, 
medicated with the usual astringent and sedative drugs, is manufactured 
by C. L. Mitchell of Philadelphia, and may be obtained of the drug trade. 
Wrappings of several folds of cotton are heating and uncomfortable, also dirty, 
and productive of balanitis, etc. Pin a false front to shirt for a covering (St.). 
Rest in bed is an absolute desideratum, especially during the inflammatory 
stage. Hot water, ioo° F., to the penis during urination, extreme cleanliness, 
milk diet; water freely as a beverage, flavored with a few drops of oil of gaul- 
theria, or flaxseed tea, or infusion of triticum with potassium bicarbonate. 
Sexual thoughts to be entirely avoided (Otis). [Compare Chordee, Gleet, 
Orchitis, Rheumatism Gonorrheal, Urethritis, Urethral Stric- 
ture, Vaginitis.] 

Prescriptions, 

For Intei'nal Use. For Local Use. 



R . Potassii Citratis, 

Spt. Limonis, . 

Syr. Simplicis, 

Aquae, 
M. Sig. — Dessertsp 
luted, 3 or 4 times daily, 
for the increasing stage. 



. ^ss. 

• $- 

largely di- 

As alkali 

{Otis.) 



R 



The Black Paste. 

Pulv. Cubebae, 
Copaibae, 
Aluminis, 
Sacchari Albi, 
Magnesiae, 
Olei Cubebae, . 
Olei Gaultheriae, 
M. fiat electuarium. Sig. — A piece 



the size of a walnut after eac 



1 meal. 
(Otis., 



B 



Oleoresinae Cubebae, 
Potassii Bromidi, 
Olei Sassafras, 
Syr. Acaciae, . 
Aquae, . . q. 

M. Sig. — Dessertsp. 3 or 4 times 
daily. (J. Wm. White.) 




R . Resorcini, . . £j. 

Ac. Borici, . . gr. xx. 
Zinci Acetatis, . . gr. %—%* 
Aquae Destil., . . §iv. 
M. Sig. — Dessertsp. as injection. 



R 



. Pulv. Iodoformi, . ^ss. 

Ac. Carbolici, . . sjij. 

Glycerini, . . . i|ij. 

Aquae Destil., . ad^vu]. 

M. Sig. — Teasp. as injection. 



R . Zinci Sulphatis, 

Plumbi Acetatis, 

Ammonii Chloridi, 

Aluminis, . 

Aquae Rosae, 
M. Sig. — Injection, to be used after 
acute symptoms subside. 



g r - 
g r - 
g r - 
g r - 



viiij, 

iv. 

v. 



R . Zinci Sulphatis, . 

Liq. Plumbi Subacet. Dil., 
M. Sig. — Use as an injection 



S*. 



Vllj. 



R . Zinci Chloridi, 
Aquae Rosae, 
M. Sig. — Use as injection. 



g r -J- 
gvj-viij. 



[For Alkaline Emulsion of Copaiba [For Injection Brou and others, see^ 
see ante, page 492.] ante, page 495.] 



GOUT. 



619 



Gout. 

Aconite, may certainly relieve pain (P.). Belladonna, the best remedy to 
effectually and speedily soothe pain; also in gout of the stomach, 5-nt doses 
efficacious (P.). Potassium Iodide, especially when pain is worse at night 
(R.), Colchicum is merely palliative ; a large dose (£j) of the wine often 
removes the severest pain in an hour or two, and soon after the swelling and 
heat subside (R.) ; it is especially useful in acute and rheumatic gout (B.) : is 
not specific, nor a lasting or final remedy for gout, but acts very directly on 
the pain and inflammation of acute attacks. Laville's tincture is a colchicum 
preparation, though colocynth is also a constituent [V.\ : is useful in the bron- 
chitis, asthma, dyspepsia, urticaria, etc., of gouty subjects (R.). Veratrine, 
as ointment to painful joints (R.). Sulphides ■, as baths in chronic gout, or 
fumigation with sulphurous acid, and bed-clothes exposed to strong fumes 
(R.); sulphur waters certainly benefit (B.). Iodine, painted round joints in 
chronic (R.). Strychnine, hypodermically for later stage of gout paralysis 
(R.). Arsenic, very serviceable in a form of chronic arthritis allied to neu- 
ralgia (B.). lithium, the bromide internally and a strong solution of lithia 
to the joints (B.); the carbonate (gr. v to the §) on lint around gouty en- 
largements, joints, etc. (R.). Sodium Salicylate, gr. x internally every 2 
hours, also ^ij to ^viij water warmed, as lotion on lint covered with oiled silk. 
Guaiacu7?i has long had a high repute, and may be given for a long time with- 
out injury (Wa. ). Rhubarb with an alkali, regularly during intervals, very 
serviceable (Hal ford). Manganese, syrup, ferri et maiig. iodidi (rn_ x-^ss) 
for the cachectic state (B.). Alkalies, to relieve indigestion, especially lithium 
salts. Alkaline mineral waters have long had a deserved reputation (B.) : 
Magnesia and its carbonates often of great service ; the latter dissolved in 
excess of CO2 an elegant form of administration (Wa.). Alkaline Poultice, 
9 of linseed meal to 1 of sodium bicarb, is a useful application (R.). Turkish 
Baths, are useful in chronic gout (B.,R.). Alimeiit. Farinaceous vegetables 
and acid fruits. Avoid animal or saccharine food. Milk-cure has improved 
cases, and apparently removed the diathesis (B.). Cod-liver oil in chronic 
gout (B., R.). Entire abstinence from alcoholic beverages is best; the worst 
wines are port, sherry and madeira. Local Measures. The affected limb 
should be raised, aud surrounded with hot, moist flannels. Wrap the hands 
in flannel dripping with water, and cover with water-proof bag, to dissolve 
gouty deposits. [Compare Rheumatic Arthritis, Lith^mia.] 

Prescriptions. 



Scudamore"* s Mixture {Modified). 
R. Vini Colchici Radicis, . ^j. 

Magnesii Sulphatis, . . gj. 
Magnesias Optimse, . . ^ij. 
Aquae Menth. Pip., . . gx. 
M. Sig. — Tablesp. every hour until 
it operates. 



R. Colchicine, . . . gr. j. 

Ext. Colocynthidis Co., . gss. 

Quininae Sulphat., . . ^iij. 

Ft. pil. no. lx. Sig. — One every 

four hours. (B.) 



B 



Lallemand 's Specific. 

. Ext. Colchici Acet. (B. P.), 

Ext. Opii Aquosi, . aa gr. xv. 

Potas. Iodidi, . . . giv. 

Potas. Acetatis, . . pjij. 

Aquae Destill., . . ^iijss. 

Vini Albi, . . . gss. 
M. Sig. — 20 drops thrice daily. 



aagj. 



R . Lithii Citratis, 

Magnesii Carbonat., 

M. et div. in pulv. no. 1. 

Sig. — One in water thrice daily. 
In chronic gout. 



620 



GUMS — HAIR. 



Gums. 

Myrrh, the tincture for spongy and ulcerated gums (P.) ; ^ij-iv in ^iv of 
water or infusion of cinchona, is highly serviceable as a gargle or mouth- 
wash (Wa.). Alum, for spongy and ill-conditioned gums, tending to recede 
from the teeth, whether of mercurial or scorbutic origin (Wa.). Catechu, a 
piece dissolved slowly in the mouth is often of service in similar conditions 
(Wa.). Rhatany, the powder as a dentrifice, keeps gums in good order (P.). 
Potassium Chlorate, gr. ij every four hours for a child of one year, for inflam- 
mation of gums in teething ( Wa.). Carbolic Acid, gr. iij ad gj aquae,as lotion 
in diseases of the gums (Hilditch). Pomegranate, the bark an excellent basis 
for gargles in relaxed gums (P.). Potassium Iodide, gr. x thrice daily, for 
periostitis of alveolar processes, marked by looseness of teeth, pain and swell- 
ing of gums (Graves). Iodine, gr. j ad t ^j aquae, applied by a camel's-hair 
brush after each meal, for retraction of gums with loosening of the teeth 
(Stille). Tannin, the glycerite, for spongy and bleeding gums (B.). Carbo- 
tate of Iodine, when fetor (B.). Benzoin, the tincture a good application ^B.). 
[Compare Scurvy, Teeth.] 



a 





Prescr 


iptions. 


. Aluminis, 


. 3ss. 


R. Tinct Orris, 


Tinct. Myrrhae, 


- Si- 


Spt. Rosae, 


Tinct. Cinchona, 


. Ziv. 


Alcoholis, . . aa 3iv. 


Mel. Rosae, 


Ol. Amygd. Amar., . gtt. ij. 


Vini Albi, 


• Sviij. 


M. Sig. — Violet Mouth-wash. 


M. Sig. — Mouth-wash. 




(Piesse.) 



Hair. 

Rosemary, encourages the growth of hair, mitigates baldness, and is sup- 
posed to prevent uncurling in a damp atmosphere (P.). Hydrogen Peroxide, 
and other preparations of oxygen, are used to " blonde" the hair, for pur- 
poses of fashion (Wilson). Hair-dyes, comprise potassium permanganate, 
pyrogallic acid, black oxide of lead, which are temporary, and the black 
oxide of silver, which is permanent in its action (Wilson). Depilatories 
usually consist of powders containing quicklime 3 parts, sodium sulphide I, 
and starch 4. A powerful depilatory is barium sulphide made into a thin paste 
with starch (Wilson). Another contains yellow sulphide of arsenic, gr. xx, 
quicklime gss* starch !jij. A very effective one is barium sulphide and oxide 
of zinc (B.). Sarsapai'illa is stated by Teste to possess the curious property 
of changing red hair to a light flaxen color when taken internally for three 
months. [Compare Alopecia, Syphilis, Tinea Tonsurans, etc.] 

Prescriptions. 



E 



. Sodii Boratis, . . . ?iv. 

Aq. Ammoniae, . . *j. 

Spt. Myrciae, . . . gij. 

Aq. Rosae, . . . Jfxiij. 

M. Sig. — Shampoo Hair Wash. 



R. Ac. Salicylici, . 
Tinct. Benzoini, 
Alcoholis, Glycerini, 
M. Sig.— Hair Wash. 



. gr. xl. 
. zss. 
aa 3viij. 



R. 



. Ol. Ricini, 


• 


• .?J SS - 


01. Bergamii, . 


. 


. 3Jss. 


Ol. Cinnamomi, 






Ol. Caryophylli, 


• 


aa TUvij 


Ol. Lavandulae, 


. 


. rn.xl. 


Tinct. Cantharidis, 


. 


• 51- 


Aq. Ammoniae, 


. 


• 3»j- 


Alcoholis, . 


q. 


s. ad Oj. 


M. Sig. — Hair Tonic. 





HAY-FEVER. 



621 



Hay-Fever. 

Arsenic, especially valuable when disease is more of catarrhal than of asth- 
matic type, 3-minim doses of liquor arsenicalis | Mackenzie) ; as cigarettes, 2 
or 3 daily (see Asthma for formula) (B.). Belladonna, when nasal secre- 
tion is very profuse (B.). Euphrasia, of decided benefit for the catarrhal 
symptoms (Pf.). Quinine, very useful after the more acute symptoms have 
subsided (R.) ; injected into the nares checks catarrhal discharge and spas- 
modic symptoms (P.) ; a solution of the hydrochlorate, gr. iv-viij ad ^j aquae, 
applied locally to nasal mucous -membrane by a spray-producer or a brush, 
will arrest the disease if confined to the nares and fauces (B.). Ipecacuanha, 
in hay-asthma (R.) ; is of great value, though the smallest doses cause similar 
effects (P.). Aconite is better than arsenic in true hay-fever (R.) ; has been 
used with the best results (P.). Grindelia benefits cases of asthmatic type 
(B.). Iodides are very serviceable, locally and internally ; large doses until 
some iodism observed, may be combined with arsenic (B.). Opium, espe- 
cially as morphine, of great value in any stage, but great danger of the opium- 
habit (B.): the tincture in doses of TTi_ij— iij every 2 hours for three doses, 
then -mj every 2 hours until the discharge abates, has given excellent results 
(Wa.). Black Coffee is highly recommended (P.). Cocaine, a 5 to 20 per 
cent, solution of the hydrochlorate, brushed over the nasal mucous membrane 
after drying it as far as possible, is the most efficient palliative yet obtained 
(R.) : a 4 per cent, solution dropped from a medicine-dropper well into ante- 
rior nares, the head being thrown well backwards, or sprayed up the nostrils 
from a small atomizer ; gives immediate relief, and though not curative it 
prevents so much suffering and distress that in no case should it be left untried 
(Da Costa). Ignatia, the tincture has seemed to benefit some cases, and to 
favorably influence the course of the disorder (Da C). Lobelia, has been 
found an efficient remedy (Wa.). Tobacco, smoking helps some and aggra- 
vates the symptoms in other instances. Internally ad nauseam it helps, but 
there are better and safer remedies (Wa.). Rem ai'al to the sea-coast, or to a 
barren, mountainous district, gives the only relief to some subjects; though 
many of the worst cases, hitherto unaffected by medicine, are now relieved 
by the local application of Cocaine. [Compare Asthma, Catarrh, Con- 
junctivitis, Influenza.] 

Prescriptions. 
For Internal Use. 1 For Local Use. 



R. Potassii Iodidi, . . . ^j. 
Liq. Potass. Arsenit., . 7 ) ). 

Aquae Cinnam., . . ^iv. 

M. Sig. — Teasp. every 4 hours. 



R. Ext. Hyoscyami, . . gr. xij. 

Potassii Iodidi, . . £j. 

Potassii Bicarb , . . gij. 

Ext. Glycyrrhizae Pur., . t ^iv. 

Aq. Anisi, . . . givss. 

M. Sig. — Dessertsp. every 4 hours 
until relieved. ( Weber.) 



R. Tinct. Iodi, . . . £j. 
Ac. Carbol., . ; . gtt. x, 
Aq. Destill., . . . giv. 
M. Sig. — For local use with atom- 
izer or post-nasal syringe. 



R. Menthol, .... 

Ac. Carbol., 

Zinci Oxidi, 

Ol. Amygd. Dulcis, . 

Cerati Simplicis, 
M. Sig. — Apply thoroughly to the 
nostrils every few hours. 



622 



HEADACHE, BILIOUS-SICK. 



R. 



For Internal Use. 

Liq. Potassii Arsenit., . . gj. 
Tinct. Belladonnae, . . ^ij. 
M. Sig. — 5 to 10 drops after meals, 
as a prophylactic. 



R. Tinct. Euphrasia, . . zjss. 
Aq. Camphorae, . ad Jij. 

M. Sig. — Teasp. four times daily, 
for the catarrh. 



For Local Use, 
R. Quininae Bisulph., . . ?iij. 
Aquae, .... giv. 
M. Sig. — Irrigate the nares, after 
cleansing with a weak alkaline solu- 
tion. 

R. Cocainae Hydrochlor., . gr. vj. 

Aqu« Destill., . • 3*j« 

M. Sig. — 5 per cent, solution. A 

few drops to be instilled into nares 

while head is lowered. [Da Costa.) 



Headache, Bilious-sick. 

Nux Vomica, gtt. j of tinct. frequently, when acute gastric catarrh, with 
headache and nausea (R.); gtt. j every io minutes, soon after meals, often 
gives marked relief in sick-headache not of neurotic origin (A. A. Smith). 
Strychnine, with aloin and belladonna, in minute granules, for bilious head- 
ache from obstinate constipation, effective if given several times a day for a 
week or ten days (Roy). Belladonna, the extract in doses of gr. ^— yjy, m 
similar form. Iris, blinding headache in right supraorbital region, nausea, 
vomiting, usually the result of hepatic derangement, ny every half-hour for 
three doses. Usually relieves promptly (Pf.). Bryonia, ordinary bilious with 
vomiting (P.). Picrotoxin, gr. -fa by stomach, in periodical form (B.). Cha- 
momile, a popular remedy (R.). Podophyllum, in sick headache, with dark, 
bilious diarrhoea, or constipation with dark motions (R.). Sangzanaria, when 
due to stomach derangement, a few doses relieve (P.). Hydrastis, from con- 
stipated bowels (P.). Mercury, as " blue pill," to prevent or mitigate; or, 
gr. t ^q of bichloride when with light-colored diarrhoea (R.). Ammonium 
Chloride is an efficient remedy in most forms of headache (Wa.). Sodium 
Phosphate, a useful laxative in so-called " bilious-sick-headache" (B.). Po- 
tassium Bromide, a large dose in ordinary or sick-headaches (R.). Ginger, 
in paste, as counter-irritant (P.). Water, as cold or hot effusion, or ice-bag 
to head ; hot sometimes best The purgative waters (as Friedrichshall) before 
breakfast in a cup of hot water (R.) ; a brisk saline purgative, or small doses 
of Epsom salts thrice daily, very effectual for frontal headache with constipa- 
tion (Br.) Nitro-muriatic Acid, io drops of the dilute acid in a winegl. of 
water, before each meal, often an effectual remedy (Br.). Charcoal, two tea- 
spoonfuls stirred in half-glass of water, as a draught, is an efficient remedy 
for sick-headache with sour stomach and flatulence, etc. [Compare Hemi- 

CRANIA.] 

Prescriptions. 

R . Podophylli Resinae, 



R. Ammonii Chloridi, . 

Morphinae Acetatis, 

Caffeinae Citratis, 

Spt. Ammonii Aromat., . 

Elix. Guaranae, 

Aquae Rosae, . 
M. Sig. — Dessertsp. every quarter- 
hour until relieved. {Carpenter.) 



Tinct. Zingiberis, . . zij. 

Alcoholis, . q. s. ad£). 

M. Sig. — Teasp. in a winegl. of 
water every night at bed-time, or every 
second, third or fourth night as re- 
quired. (Dobell.) 



HEADACHE, CONGESTIVE — HEADACHE, NERVOUS. 623 



Headache, Congestive. 

Aconite, to reduce the circulation (R.). Vefatrum Viride, at menstrual 
periods (R.). Belladonna, relieves cerebral congestion, and distress from 
light and sound (P.) ; pain over brows and in eyeballs — often due to stomach 
or uterine derangements — especially in young women ; 7Ti,iij of tinct. every 
three hours (R*)» Potassium Bromide, a large dose (gr. xv-xx) in ordinary 
or sick-headaches (R.) ; Bromides are useful when nervous system has been 
irritated, but when exhausted they do harm (Hammond). Calomel, gr. J^, 
every hour for ten or twelve doses, will relieve the headache of syphilis 
occurring at night (Tr.). Cannabis Indica is given with uniformly good 
results in the headache of the climacteric. Potassium Iodide, throbbing, 
intolerance of light, pain passing from back of neck over vertex to brow, noc- 
turnal, tender scalp, almost unbearable; ten-grain doses ter die will cure (R.). 
Hydrastis, when constipated bowels (P.). A my I Nitrite, for headaches with 
severe flushing heats at menstruation or climacteric, TrtgV a sufficient dose 
(R.). Mustard, in hot foot-bath, or as poultice to nape of neck in various 
forms of headache (R). Water, cold water poured gently over forehead, 
sometimes warm water better (R.). A very hot foot-bath often effectually 
relieves (Wa.). Purgatives are often beneficial, especially when congestive 
headache arises from suppression of hemorrhoidal discharge, or in persons of 
phlegmatic habit; aloes best (Wa.) ; or colocynth, as derivative, when cere- 
bral hyperemia (Da Costa). 

Prescriptions. 



R. Ext. Colocynthidis Co., gr. xij. 
Pulv. Capsici, . » gr. iv. 
Ext. Gentianse, . . gr. xxiv. 
Ft. pil. no. xij. Sig. — One pill thrice 
daily. Also a 25-grain dose of So- 
dium Bromide every night at bedtime. 

(Da Costa.) 



R. Spt. Ammoniae, . . 5j. 

Spt. Camphorae, . . Jss. 
M. Sig. — For a quart of water in 
which a handful of common salt has 
been dissolved. Cork tightly, and use 
locally on lint as an evaporating lo- 
tion. 



Headache, Nervous. 

Cannabis Indica, ten-minim doses of the tincture thrice daily in the inter- 
vals, often curative in bad cases of neuralgic headache ; or % to x / 2 grain 
doses of the extract (P.). See under Hemicrania. Belladonna, triiij of 
tinct. every 3 hours, when pain over brows and in eyeballs, especially when 
at menstrual periods ; also when from overstudy or fatigue (R.). Nux Vomica, 
if with gastric symptoms (R.) ; is better than strychnine, and should be given 
in quarter-grain doses of the extract after meals, combined with iron and 
quinine if patient is chlorotic (Hammond). Bromides, when the nervous 
system has been irritated are useful, but harmful when it is exhausted (Ham- 
mond). Silver Nitrate, half-grain doses with minute doses of pil. coloc. 
comp., invaluable in headaches of hysterical women, and especially stomach 
headaches of delicate and literary men (Wa.). Ignatia, removes clavus 
hystericus (Pf.). Ammonia, the aromatic spirits (^ss-^ij) or the carbonate 
(gr. v-x) in nervous headache (B.) ; the hydrochlorate (gr. x-xx) in bilious 
and hysterical headaches, especially in hard-worked and delicate young women 
(Wa.). A my I Nitrite, inhaled when extreme pallor of face (B.). Arsenic, 
throbbing supra-orbital (R.); as a nerve tonic stands next in value to Zinc 
(Hammond). Cimicifuga, in nervous or hysterical women, especially at men- 



624 



HEART DISEASES. 



strual periods (R.) ; in rheumatic headaches and menstrual (P.)- Coffee and 
Tea, when from nervousness or exhaustion (R.) ; coffee especially useful 
(P.). Guarana, a very effective palliative, gr. xx every half-hour for three 
doses (P.); "m_xv of the fluid extract every quarter-hour increased to nixl 
will often relieve periodical headaches not of malarial origin (A. A. Smith). 
Caffeine Citrate, two-grain doses, in capsule, every half-hour, a very effectual 
remedy for nervous and sick headache, but causes insomnia if used in the 
evening. Phosphorus, as dilute phosphoric acid, in doses of Tn,xxx well 
diluted, thrice daily ; or zinc phosphide, gr. -^ in pill, ter die, very useful in 
most forms of nervous headache (Hammond). Cajuput Oil, well rubbed in 
twice daily (P.). Menthol, locally to forehead in frontal headache (Wa.). 
Potassium Cyanide, locally in reflex headaches, as gastric, cardiac, pulmo- 
nary, menstrual (B.). Valerian is of great value in excitable persons (P.). 
Camphor, a saturated solution in eau-de-cologne rubbed on head, when of 
uterine origin (R.) ; in hysterical females, internally, with magnesium carbonate 
(P.). Podophyllum, purgative doses often give relief when near menstrual 
periods, with constipation and dark stools (R. ). Zinc Oxide, two- to five-gr. 
doses useful (R.) ; a remedy of great value (Hammond). Bismuth, the sub- 
carbonate, in two-grain doses after each meal, often better than zinc, especially 
where gastric disturbance (Hammond). Ether Spray, for frontal headache 
after acute illness or fatigue (R.). Chloroform, mxv-xxx of the spirit inter- 
nally, often effective (Wa.). Galvanism, sometimes valuable; the constant 
current always, avoiding too great intensity lest amaurosis ensue (Hammond). 
[Compare Hemicrania, Neuralgia.] 



R. 



Prescriptions. 



-xx. 



Potassii Cyanidi, . gr. x 
Aquae Laurocerasi, . ^iv. 
M. Sig. — Apply locally on a com- 
press for % to yi an hour. (B.) 



R. 



g r - 



Zinci Phosphidi, 

Ext. Nucis Vom., . 

Confect. Rosae, q. s. 
M. et div. in pil. no. xxx. 
Sig. — One pill after each meal. 

(Pordyce Barker 



nj. 
x. 



R. Extracti Nucis Vom., . gr. iij. 

Ferri Reducti, . . gr. xij. 

Quininae Sulphatis, . gr. vj. 
Ft. pil. no. xij. Sig. — One after 
each meal. [Hammond.) 



R . Ext. Cann. Ind. Fl., . . gss. 

Pulv. Acaciae, ... . ^v. 

Syr. Aurantii Cort., . . 5ij. 

Aquae, . . q. s. ad£vj. 

M. Sig. — Teasp. every 3 hours. 



Heart Diseases. 

Aconite, in the highest degree serviceable to diminish excitement or irrita- 
bility. Is more a remedy for functional derangement than for organic disease 
(Wa.). In pericarditis (R.). Nervous palpitations and hypertrophy (P., B.). 
The heart seldom affected in rheumatic fever if aconite be used from the start 
(P.). Veratrum Viride, as cardiac depressant (B.) ; in chronic cardiac dis- 
eases where excessive hypertrophy, i. e., when digitalis is contraindicated 
(W.). Cimicifuga, safer than digitalis in fatty heart (B.). Its action is 
strongly stimulating and tonic ; it relieves excessive dyspnoea when weak 
heart (P.)' Arsenic, for dyspnoea from weak heart (R.) ; in all cardiac neu- 
roses it is especially valuable when combined with iron and strychnine, and 
is regarded as indispensable in all forms of weak heart accompanied by pain 



HEART, DILATED — HEART, FATTY. 625 

(Wa.). Digitalis, acts as a stimulant tonic (P.); small doses for its sedative 
action; tonic or physiological doses to create hypertrophy in dilatation (Tr.) ; 
irregularity of pulse is best indication (R.). Irritable heart (Da Costa). The 
freshly-made infusion the best preparation (B.) ; especially indicated in weak 
heart acting rapidly because of its weakness, and in valvular disease ( Wa. ). 
Convallaria Majalis, will usually succeed in all cases in which digitalis is use- 
ful, acting similarly to that drug, but with less reliability ; is useful in aortic 
disease and in others where digitalis cannot be used (Wa.); valuable in all 
forms of heart disease where there is oedema of tissues (See). Strychnine, 
in medicinal doses, said to strengthen heart-beats (R.). Blisters, flying, over 
precordial region, to stimulate action in extreme weakness (R.) Alcohol, 
brandy when heart suddenly enfeebled by fright, loss of blood, etc. (R. ). 
Iron, useful in various forms, especially anaemic disorders and palpitation. 
Also in dilatation and fatty heart, and mitral regurgitation (B.). Hyoscyamus, 
in functional derangement from emotion, is specially indicated ; requires large 
doses (TTLxl-lx), or gr. ^ of hyoscyaminse sulph. hypodermically (Wa.). Amyl 
Nitrite relieves heart-pains resisting all other treatment. (W.). Morphine, 
hypodermically, is employed in many cardiac disorders with marked advan- 
tage, especially in dyspnoea and angina with diseased coronary arteries ; mitral 
regurgitation, with its dyspnoea and insomnia ; aortic disease, etc. [Compare 
Angina Pectoris, Dropsy, Endocarditis, Pericarditis, and the five fol- 
lowing articles.] 

Heart, Dilated. 

Digitalis, where much dilatation, and hypertrophy of left ventricle without 
valvular disease. Is not contrainjiicated when aortic disease (R.); physio- 
logical doses (Tr.). In simple dilatation gives most favorable results (W.). 
Very useful in mitral disease, with dilatation of the left ventricle (P.) ; gives 
miraculous relief, is not sufficiently appreciated, but requires skilful adminis- 
tration. Use the infusion in preference to other preparations, a tablespoonful 
thrice daily, watching its effects (Da Costa). Scoparius, the infusion (broom- 
tea), to maintain the kidney action if digitalis is not sufficient (Da C). Pur- 
gation, brisk, free watery stools next to digitalis are the best treatment (Da C). 
Morphine, hypoderm. gr. }>£-*£ two or three times a week in dilated heart 
with dyspnoea (B.). Amyl Nitrite, dyspnoea from dilatation (R.) ; is useful 
when great dyspnoea (cardiac asthma) (P.). Ether, the compound spirit an 
excellent remedy for the dyspnoea (Da Costa). 

Heart, Fatty. 

Iron, the tinct. ferri perchlor. in small doses for a long time, has been of 
remarkable benefit (Wa.). Cimicifuga, safer than digitalis (B.); the latter 
should not be used (Wa.). Digitalis of no value except for very tempo- 
rary use and for some special indication (Da Costa). Strychnine, often the 
first remedy to do good. Unduly pushed will produce nervous worry and 
be injurious (P.); is the remedy with iron, nourishing but not fatmaking diet, 
and wine to keep up the tone of the blood (Da C). Ergot, occasional doses 
have been given with apparent benefit (Wa.). Ether, the compound spirit for 
sudden attacks of pain or dyspnoea (Da C.). Amyl Nitrite, for the same, 
but chloral must be entirely debarred (Da C). Stimulants, freely, in an acute 
attack of any kind, give the only chance (Da C.). 



626 HEART, HYPERTROPHIED — HEART, PALPITATION. 

Heart, Hypertrophied. 

Aconite, often better than digitalis (R.); dangerous in hypertrophy of left 
side, with diseased valves, but useful in simple hypertrophy (P.) ; for over- 
action, with hypertrophy (B.); the one remedy which can be depended on. 
Small doses for months, say gtt. j of a good tincture ter die, to lower the 
heart gradually and keep it low (Da Costa). Digitalis, very useful in pure 
hypertrophy due to valvular disease or excessive muscular exertion (R.). The 
primary action (small doses) required, as it creates hypertrophy when given in 
physiological or tonic doses (Tr.). Veratrum Viride, as a cardiac depressant 
(gtt. v ter die) will relieve in simple hypertrophy, and irritable heart from abuse 
of tobacco^ inadmissible when valvular lesions exist (B.) ; gives the best results, 
next after aconite (Da C). Lead Acetate, for violent palpitations, in some 
instances (Wa.). Amy 'I Nitrite, in dyspnoea, syncope (R.). Ergot, in enlarged 
heart without valvular lesion ; maybe combined with digitalis (B.). Potas- 
sium Iodide, small doses long continued, benefit some cases (Wa.). Camphor, 
in doses of gr. iij-xij daily for tumultuous palpitations, and dyspnoea of hyper- 
trophy with dilatation (Wa.). Iron is necessary where anaemia exists (DaC). 
Quiet Life of great importance, no stair-climbing, no long walks ; rest in bed 
often of service for days at a time, moderate diet, avoiding fattening foods, 
meat, and stimulants (Da C). 

Prescriptions. 



B . Ext. Ergotse Fl., . . |iijss. 
Tinct. Digitalis, . . 3SS. 
M. Sig. — Teasp. thrice daily in 
enlarged heart without valvular le- 
sion. (B.) 



R . Spt. yEtheris Comp,, 
Liq. Morphinae Sulph. 

(U.S. P., 1870),. . aagj. 
M. Sig. — Teasp. as required for 
the dyspnoea. 



Heart, Palpitation. 

Aconite, for " fluttering " of nervous persons, and nervous palpitations (R.) ; 
for over-action, with hypertrophy (B.) ; for palpitation with simple hypertro- 
phy (P.). Hydrocyanic Acid, when from dyspepsia (P.). Iron, when due to 
anaemia, a very frequent cause. Other causes are tobacco, coffee, tea, etc., to ex- 
cess, dyspepsia, venery, excessive exercise (Da C). Spigelia Anthelmia, when 
due to mitral and aortic disease, with much dyspnoea (P.). Digitalis, in small 
doses as sedative (Tr.); combined with iron in palpitations with valvular disease, 
or alone in very severe cases (Wa.) ; suits a large number of cases, especially 
for temporary purposes (Da C). Camphor, recommended in nervous palpi- 
tations (R.). Veratrine, as ointment to chest, when rapid, irregular pulse, 
hurried breathing, dropsy and lividity, palpitation, inability to lie down (R.). 
Bromides, in " fluttering" heart (B.) ; are useful when tolerated by the stom- 
ach (Da C.). Hyoscyamus, in nervous, and violent palpitations from excited 
state of the brain (P.) ; in large doses, for functional disturbance arising from 
emotion (Wa.). Belladonna, in small doses, may also be applied externally, 
when irregularity of rhythm (Da C). Valerian, nervous, with dyspnoea (P.). 
Eucalyptus, palpitation and weak heart (B.). Galvanization, of cervical sym- 
pathetic and pneumogastric, for palpitation (B.). Hot Foot-Bath relieves 
palpitations (R.). Milk-cure, has been beneficial in irregular action (B.). Ice, 
to the cardiac region, has benefited many cases ; is of chief value when patient 
can be kept in bed, which sometimes becomes necessary (Da C). 



HEART, VALVULAR DISEASE HEMATEMESIS. 



627 



Prescriptions. 



R . Pulv. Digitalis, . . gr. xx. 

Pulv. Colchici Sem., . gr. xl. 

Sodii Bicarb., . . gr. lx. 

M. et div. in pil. no. xl. Sig. — One 
pill at first 3 or 4 times daily, gradually 
reduced to one at bedtime. For irreg- 
ular cardiac action. {Bowditch.) 



R 



&l 



Tinct. Digitalis, . 

Tinct. Aconiti, 

Tinct. Verat. Viridis, . aa ^j. 
M. Sig. — Three or four drops thrice 
daily for palpitation. Must be used 
with caution. 



Heart, Valvular Disease. 

Aconite, useful for the palpitation, but dangerous in hypertrophy of left side 
with diseased valves (P.) ; when heart is acting with power (Da Costa). Digi- 
talis, in aortic regurgitation (R.) ; most effective in mitral insufficiency (P.) ; 
in rapid action with low arterial tension ; and in mitral disease. Infusion 
best ; tablesp. doses twice daily (B.) ; rnj of tinct. every % hour or hour, often 
gives more relief than larger doses (A. A. Smith) ; when heart is weak and 
struggling (Da C). Morphine, hypodermically for dyspnoea, better in mitral 
than in aortic disease (R.). Purging, with jalap, etc., in engorgement of right 
side of heart (R.) ; occasionally useful (Da C). Treat?7ient is directed chiefly 
to the dilatation or hypertrophy resulting from the valvular disease. The 
simplest rule is to use judgment as to when the heart needs strengthening by 
Digitalis or reducing by Aconite or Veratrum Viride (Da C). [Compare 
Endocarditis.] 

Hectic Fever. 

Quinine, large doses, gr. xv-xx daily, if stomach and intestines don't rebel 
(P.) ; given before the paroxysm, to limit it (Roberts). Morphine and other 
anodynes, are of especial value, given in full dose towards bed-time (Gross). 
Prunus Virginiana, the bark has been found useful, especially when irritable 
cough (P.). Calcium Phosphate,'^ especially useful (R.). Calumba, excellent 
for tonic effects (P.). Antipyrin, a midday dose will control the evening rise 
(Wa.). Digitalis, the tincture, combined with tinct. ferri chloridi, abates the 
temperature and diminishes the sweats (B.). Iron, the mistura ferri com- 
posita has obtained great celebrity, especially when much debility and ansemia 
(Wa.) ; the sulphate and tincture of the chloride of especial value in the treat- 
ment of hectic (Gross). Ipecacuanha. A few grains of Dover's powder at 
bed-time, will stop the profuse perspirations (Wa. 1 ). Salicin, for profuse per- 
spirations (Wa.) ; as antipyretic. [Compare Perspiration, Phthisis.] 



Prescriptions. 



r. 



Tinct. Digitalis, . . giij. 

Tinct. Ferri Chlor., . . 3 v. 
M. Sig. — 15 drops 3 or 4 times a 
day. (B.) 



>J SS * 



R . Quininae Sulph., 

Elix. Taraxaci, . . . giv. 
M. Sig. — Teasp. every hour for six 
hours. 



Hematemesis. 

Ipecacuanha, is decidedly effective in small doses, also when hematemesis 
is vicarious of menstruation (P., Wa.). Hamamelis, mj-ij of tinct. every 2 
or 3 hours (R.) ; effective from its tannin (B.). Alum, serviceable in passive 
hemorrhage ; iron better (B.). Turpentine, especially in passive hemorrhage 



628 HEMATOCELE, PELVIC — HEMATURIA. 

with debility (R.) ; and in hemorrhagic transudations on the free mucous sur- 
faces — hematemesis, etc. (B.1. Ergot, has often cured when other means 
failed (P.) ; most valuable. In urgent cases ergotine in 2- to 5-gr. doses hypo- 
dermically (R.). Iron, the subsulphate (Monsel's solution) or pernitrate, the 
best remedies; gtt. j-ij frequently diluted with ice-water (B.). Lead Acetate, 
especially in gastric ulcer, gr. ss-gr. v (B.). Tannic Acid, gr. x-Qj, when from 
gastric ulcer or obstructive disease of liver (B.). Gallic Acid, an extremely 
useful agent; is best used in combination with dilute sulphuric acid (Wa.). 
Ice, small pieces swallowed, a most useful agent, with perfect rest for stomach ; 
when hematemesis from that organ, nutrient enemata must be employed. 
Iced champagne to arrest faintness, if persistent; when moderate need not 
give cause for alarm. 

Prescriptions. 



R. Olei Terebinth., . . giij. 

Ext. Digitalis Fluid., . %}. 

Mucil. Acacise, . . . J^ss. 
Aq. Menth. Pip., . . gj. 
M. Sig. — Teasp. every 3 hours. 



R . Ac. Gallici, . . ^j. 

Ext. Ergotse Aquosi, 

Digitalis, . . . aa gr. xx. 
M. et div. in pil. no. xx. 
Sig. — One every 4 hours. 



Hematocele, Pelvic. 

Opium, or morphine, if needed for pain, with absolute rest in bed, and a 
moderately tight abdominal bandage (E.). Hemostatics, as gallic acid, lead, 
turpentine, etc., to arrest the hemorrhage, if it be still going on, combined 
with opiates, and the use of ice-bags or cold lotions to the abdomen or per 
vaginam. Tonics, as iron and quinine, while resolution of the extravasation 
is going on. Bromides and Iodides, to quiet the action of the ovaries, if the 
hemorrhage recurs at different periods. Potassium Iodide, as an absorbent, 
may be given with quinine (Braxton Hicks). Iodized Cotton, an excellent 
application to the cervix uteri in cases of hematocele (Wa.). Leeches, should 
be applied early in cases of peri-uterine hematocele ; later, except to check 
inflammation, they are inadmissible (Wa.). Mercury, gr. ^ of the bichloride 
thrice daily, with iron and ergot, conjoined with vaginal injections of hot 
water morning and evening ; later in lieu of the mercurial the syrup of the 
iodide of iron in 20-drop doses thrice daily, was thoroughly efficient treatment 
in one very bad case of retro-uterine hematocele (Hengst). Surgical interfer- 
ence has many advocates, but is criminal in a large majority of the cases (E.). 
If the case does not end in resolution it will terminate in pelvic abscess. 

Prescription, 

Mix and saturate 8 oz. of cotton with 



R. Iodi, 

Potassii Iodidi, 
Glycerini, 



the mixture ; then carefully dry, and 
label " Iodized Cotton." 



Hematuria. 



Turpentine, when with constitutional debility (B.) ; in very small doses 
(R.) ; often is very efficacious (P.). [See ante, Hematemesis, for formula.] 
Hamamelis, has arrested severe cases (R.). Chimaphila, controls hematuria 
(P.). Gallic Acid, the most uniformly successful remedy (B.); gr. x-xx 
every hour or two (Da Costa). Sulphuric Acid, alone or with gallic acid, is 
an efficient remedy (Da C). Acetic Acid, in a case of alarming hemorrhage 



HEMERALOPIA AND NYCTALOPIA HEMICRANIA. 



629 



from the bladder, which occurred after an operation for vesico-vaginal fistula, 
and resisted all other means, an injection of apple vinegar and ice-water, 
equal parts, succeeded in arresting it (Ghent). Quinine, large doses neces- 
sary ; cures when intermittent or from malarial infection (B.) ; useful in some 
cases of intermittent hematuria (R.). Iron. Tinctura ferri perchlor. Tn_x-xx 
several times daily ; in this affection the best form of iron for internal use 
(Wa.). Ipecacuanha, exercises a powerful influence (Wa.). [See ante, He- 
MATEMESis.] Ergot, by stomach or subcutaneously ; may be combined with 
ipecac, krameria, or other astringents (B.). Ergotine, hypodermically, is far 
superior for efficacy and rapidity of operation (Wa.). Matico, the infusion, in 
doses of ^ i j every 2 or 3 hours, is fully equal to gallic acid, lead, etc. (Thomp- 
son). Ammonium Benzoate, in 5-grain doses, for the albuminuria and hema- 
turia of scarlatina (Hillier). Cannabis Indica, is especially indicated in 
dysuria and strangury when there is bloody urine (R.). Camphor, in 2 to 
5 -grain doses is said to promptly remove the renal hyperemia with bloody, 
coagulable urine, caused by cantharis, turpentine, oil of mustard, copaiba, etc. 
(R.). Ice in rectum or to perineum, for vesical hemorrhage (Thompson). 

Prescriptions. 



R. Acidi Gallici, 

Ac. Sulphurici Dil., . 

Tr. Opii Deodor., 

Infusi Digitalis,. 

M. Sig. — Tablesp. every 

or oftener. In hematuria, menorrha- 

gia, purpura hemorrhagica, and the 



3 SS - 
hours 



hemorrhagic diathesis. 



(D.) 



B . Ext. Ergotae Fluidi, 

Tinct. Krameriae, . . aa 3y. 
M . Sig. — A teasp. every hour or two. 



R. Ext. Ergotae (Squibb), . gj. 

Aquae, . . . . 3J. 

M. Sig. — For hypodermic use; 
Tn.x contain gr. j. 



Hemeralopia and Nyctalopia. 

Strychnine, night-blindness; small doses, gradually increased, of service 
(Wa.). Mercury. Hydrarg. chlor. corr.gr. ij ad aquae gj, dropped into the 
eye twice daily, with blister on each temple, and mild aperients, cured hemer- 
alopia (Smith). Quinine, in as large doses as can be borne, after cathartic 
and emetic, for night and day-blindness (Howard). Blisters, small, 1^ 
inches in diameter, close to external canthus of the eye (Bampfield). Elec- 
tricity, occasionally useful (Wa.). Rest, protection of eyes from bright light, 
constitutional remedies, as indicated by state of general health, change of 
climate, speedily cures hemeralopia. It is sometimes merely a symptom of 
pigmentary degeneration of the retina, or a feature of scurvy. 



Hemicrania. 

Belladonna, when due to vaso-motor spasm, the face being pallid (B.) ; the 
tincture in small and repeated doses if the disease be of reflex character (H.). 
Iris, in blinding form, from hepatic trouble, right supra-orbital region ; mj 
every half-hour for 3 doses, usually relieves promptly (Pf.). Cannabis Indica, 
one of the must valuable remedies for megrim or sick headache, apparently 
acting on the nervous centre whence the disorder springs ; is most useful in 
the intervals to prevent the attacks, and especially when the paroxysms are 
becoming more frequent ; it may be combined in pill with either iron or aloes 



030 



HEMICRANIA. 



(R.) ; in the congestive form of especial value, the tincture in repeated doses 
until physiological action is induced (H.) ; gr. y£ of the extract before each 
meal, increased gradually to )4 or % g ram > i n the intervals, kept up for 3 
months (Seguin). Camphor, gr. iij-v, with xx or xxx-grain dose of magnesic 
carbonate, is very useful, especially in hysterical females (P.)- Croton- chloral, 
in milder forms without severe vomiting, headache being predominant ; the 
bromides are useful after it (R.) ; rarely of any use, but if given it should be in 
20-grain doses twice daily (H.). Guarana,is, useful (B.),a very effective palli- 
ative; gr. xx every J^-hour, for three hours (P.); efficacy diminishes by de- 
grees, attacks usually become longer (Tr. ) ; £ij of fluid extract in course of an 
hour or two, to anticipate the attack when expected (Seguin). Caffeine, in 
typical migraine; gr. j ad mxxv-xxx aquae, hypodermically (P.); is especially 
adapted when chronic gastric catarrh, gr. j every ^-hour (B.). The citrate 
in grain doses every hour for some time before a paroxysm (Wa.) ; gr. j every 
J^-hour often gives marked relief (A. A. Smith). Valerian, of especial value 
when in excitable temperaments; after profuse or painful menstruation (P.). 
Ammonium Chloride, is exceptionally serviceable ; seldom fails to cut short 
an attack (Austin), x-xv gr. doses (B., R.) ; as a diffusible stimulant is very 
efficient, gr. xx up to £j every hour during the attack (H.). Podophyllin 
or Mercury, bilious origin (R.). Bromides, for true migraine. Raspail's eau 
sedatif locally, gives great relief (B.). When due to uterine disorder (R.). 
Potassium Bromide, very serviceable in the paroxysm, also in continuous form 
(R.). Eucalyptus, in cerebral anaemia (B.). Digitalin, granules (-1$ bis die), 
for congestive hemicrania (B.). Ergot, if due to miliary aneurisms of inter- 
cranial arterioles; also in congestive migraine, and in nearly all kinds (B.). 
Menthol, locally in frontal headache due to migraine, is said to be very effi- 
cient (Wa.). [See formula below.] Piscidia, is highly recommended (Wa.) ; 
efficient in doses of ^ij of the fluid extract (Ford). Arsenic, for cerebral con- 
gestion and hemicrania (B.) ; for throbbing pain in one brow (R.) ; often has 
the best effect. Watson believed that gtt. iv-vj of liq. arsenic. 3 or 4 times 
a day, with due attention to the bowels, would cure 9 out of every 10 cases 
(Wa.). Aconitine or Veratrine, ointment, over brow (R.) ; Aconitine is of great 
service internally (Seguin). Phosphorus, is strongly recommended (R.)« 
Amyl Nitrite, by inhalation, in migraine, with pallor of face (B., R.). San- 
guinaria, a few doses very successful, when m. due to stomach derangement 
(P.). Ignatia, removes clavus hystericus (Pf.)- Nux Vomica, when of gastric 
origin (R.). Cimicifuga, is strongly recommended (P.). Rtibber Bandage, 
applied tightly from eyes up, protecting the temporal arteries by pads, or a dry 
muslin bandage wetted after being put on (Weir Mitchell). Acupuncture,Xhz 
needle run down to the cranium, will give relief in clavus hystericus, when 
nothing else will do so (Pancoast). 



Prescriptions. 



R. Quininae Sulph., 
Pulv. Belladon., 
Ext. Digitalis, 
Ext. Valerianae, 
Mellis, . 
Ft. pil. no. xl. Sig.- 



3 SS - 

gr. x. 
gr. xv 

3 SS - 
q. s. 

■2 to 10 pills 



daily, gradually increased, during 3 or 
4 days before the expected attack. 



R. Ammonii Chloridi, . . ^vj. 

Ammonii Bromidi, . . ^iv. 

Spt. Etheris Nitrosi, . %. 

Syr. Pruni Virgin., . . Jfiij. 

Aquae, . . q. s. ad §vj. 

M. Sig. — Dessertsp three or four 
times daily, conjoined with the use of 
RaspaiPs Eau Sedatif (see page 61), 
locally. 



HEMIOPIA — HEMIPLEGIA — HEMOPTYSIS. 



63I 



R. Menthol., . . . gj. 

Alcoholis, . . . 3J. 

Ol. Caryophylli, 

Ol. Cinnam., . . aa ttixx. 
M. Sig. — Apply with finger over 
seat of pain. 



R. Aconitinae (Duquesnel), . gr. y 1 ^. 
Alcoholis, Glycerini, aa sjj. 
Aq. Menth. Pip., q. s. ad ^ij. 
M. Sig. — Teasp. thrice daily. 

(Seguin.) 



Hemiopia. 

When established, hemiopia offers little hope of cure, though it has no ten- 
dency to progress. In hemiopia scintillans, Potassium Bromide gr. xl-lx 
daily, or band of such metal as idiosyncrasy of the patient may decide, 
with stimulants to ward off the aura ; Quinine, Iron, Hydropathy, when 
Potassium Bromide fails (De Wecker). 

Hemiplegia. 

Strychnine* is most useful when members are relaxed ; hypodermically, 
when paralysis incomplete, and the muscles flaccid but not wasted (B.). [See 
Paralysis for formula.] Potassium Iodide, gr. x-xviij daily, occasionally 
proves effectual (Wa.). Galvanism, constant current to the brain or cord, 
faradic to the muscles opposite those contracted (Hammond). Physostigma, 
prevents muscle wasting, and hence is given with benefit to hemiplegics ; gr. 
-g^-yV of the extract repeated frequently (R.). Massage, in hemiplegia and 
other forms of paralysis due to intercranial lesions, when cold and blue skin, 
wasting and contracted muscles, ulcerations, etc. (B.). Cocculus, in hysterical 
epileptic, and choreic hemiplegia, acts well ; also in hemiplegia from cold 
(P.). [Compare Paralysis, Facial.] 



Hemoptysis. 

Gallic Acid, exceedingly effective (P.) ; may be combined with ergotin and 
digitalis. [See Hematemesis and Hematuria for formulae.] Acetate of 
Lead, with opium (B.) ; proves signally useful (Wa.). Ergot, the fluid extract 
in 30 to 40-minim doses, every 3 or 4 hours, or hourly in severe cases ; or 
Ergotin hypodermically for urgent cases, in 2 to 3-grain doses (R.). Opium, 
should be freely used for the attendant excitement (W.). Turpentine, drachm - 
doses every 3 hours, may cause unpleasant symptoms which soon disappear on 
its discontinuance (R.) ; has proved very efficient (P.) ; after other hemostatics 
fail it is worthy of trial (Wa.). Alum is serviceable in purely atonic hemor- 
rhages (Wa.) ; in 10-grain doses every 2 hours (B.). Oil of Erigeron, is very 
efficient when no fever or other signs of constitutional irritation (Wa.). Hama- 
melis, mj-ij of tincture, every 2 or 3 hours (R.) ; rn_ij-x of fresh tincture sev- 
eral times a day (Pf.). Ipecacuanha, has been highly praised (R.); in emetic 
doses (Tr.) ; arrests as emetic (B.) ; arrests, though in poisonous doses pro- 
ducing hemoptysis (P.). Ferric Acetate, a little added to water so as to taste, 
this constantly sipped (R.). Iron spray will often arrest (B.). Digitalis, has 
undoubted power over hemoptysis (B.). Small doses daily (P.). Infusion in 
large doses (R.). Arnica, of great service, if from violence (P.). Aconite, 
employed with best results (P.). Sodium Chloride, half a teaspoonful of 
common salt, taken dry, repeated till nausea (R.). Sulphuric Acid, the 
dilute acid a useful adjunct to other treatment (Wa.). Spinal Hot- Water 



632 



HEMORRHAGE, HEMORRHAGIC DIATHESIS. 



Bag, to cervical or upper dorsal vertebrae (R.). Auxiliaries. — Cold exter- 
nally, acidulated drinks, perfect rest, and antiphlogistic diet (Wa.). 

Prescriptions. 

R. Aluminis, . . . £j. 

Sacch. Alb., . . . £ss. 

Pulv. Ipec. Comp., . gr. xx. 

M. ft. pulv. no. vj. Sig. — One ev- 
ery 2 hours. [Skoda.) 



R 


. Ext. Ergotae Fl., 
Ext. Ipecac. Fl., 




. gjss. 




Tr. Opii Deod., 


. 


aa 31J. 




M. Sig. — Teasp. 


every 


y z hour. 


R 


. Plumbi Acetat., 


• 


. gr. xx. 




Pulv. Digitalis, 


. 


. gr. x. 




Pulv. Opii, . 


. 


. gr. v. 




M. ft. pil. no. x. 


Sig.- 


-One every 


4 


hours. 




(B.) 



R. Liq. Ferri Subsulph., . ttixx. 
Aquae, . ... . §ij. 
M. Sig. — Use as spray by inhala- 
tion every hour for 5 minutes. 



Hemorrhage, Hemorrhagic Diathesis. 

Acids. Sulphuric sometimes very effective in uterine hemorrhage (B.). 
Dilute Vinegar to leech-bites, piles, cuts, etc. (R.). Apple- Vinegar as injec- 
tion for vesical hemorrhage. [See under Hematuria.] Iron, when hemor- 
rhagic diathesis due to anaemia; the tincture of the chloride preferred (B.). 
The tincture of ferric perchloride as styptic ( Wa.) ; I or 2 teaspoonfuls of the 
concentrated solution in a glass of water, an excellent hemostatic (Tr.). The 
acetate, just enough to make water taste, in hemorrhage of lungs and kid- 
neys (R.). Ergot, in uterine hemorrhage of any kind, and many forms of 
hemorrhage, ergot or ergotine of great value (P.) ; not to be relied on alone 
(B.). Alum, is sanctioned by high authority (B.) ; dusted on in slight cases 
(R.) ; in uterine and traumatic hemorrhage, when small vessels open (Tr.). 
Hamamelis, " rr Lj— ij of tincture every 2 or 3 hours, effective in many forms 
(R.). Ipecacuanha, produces hemorrhage in poisonous doses, yet has great 
energy in arresting it (P.); exercises a powerful influence on internal 
hemorrhage generally, and in exhaustion therefrom ; gr. j-ij every % 
hour (Wa.). In emetic doses serviceable (Tr.). Turpentine, few agents 
more useful in the passive forms (B.) ; small doses in hematuria (R.). ; 
for serious hemoptysis, and hemorrhage of typhoid (P.). Belladonna, 
hemorrhage from rectal ulcers (P.). Digitalis, in uterine, and many other 
forms, of great value (P.) ; with restoratives has undoubted power in the 
hemorrhagic diathesis (B.). [See Hemoptysis.] Chimaphila, controls he- 
maturia (P.). Gallic and Tannic Acid, in all passive hemorrhages, especially 
in that of the bladder (P.). Tannic Acid for local use, Gallic for systemic 
effects upon remote parts. When hemorrhage occurs in relaxed and debili- 
tated constitutions, Gallic Acid may be combined with Ergot and Digitalis 
(B.). Matico, proves useful in many cases, especially menorrhagia, hematuria 
and hemoptysis (Wa.). Nux Vomica, in hemorrhagic diathesis, especially 
when occurring in anaemic subjects. Also the syrup of iron, quinine, and 
strychnine; no prescription more generally useful (B.). Aconite, to reduce 
the circulation, in epistaxis, hemoptysis, etc. (P.). Cinchona, internally, very 
efficient in some forms of hemorrhage (Tr.). Copper Sulphate, in stick, solu- 
tion, or ointment, to arrest hemorrhage from small vessels (R.). Arnica, in 
hemorrhages (ecchymoses), from mechanical violence (P.). Rhatany, the 
extract, one of the most powerful hemostatics (Tr.). Grape-cure, as tonic for 



HEMORRHAGE, POST-PARTUM. 



633 



convalescents (P.). Alcohol, in hemorrhagic diathesis, to elevate the arterial 
tension (B.) ; brandy, wine, when heart suddenly enfeebled by hemorrhage 
(R.). Venesection, will promptly arrest pulmonary hemorrhage (B.). Styp- 
tics, are either needless or' inefficient, hence practically useless in general 
surgery; hemorrhage should be controlled by either pressure or ligation 
(Roberts). Hot Water, sponged over a bleeding surface, the best agent to 
stop hemorrhage (Gross). Transfusion, when death imminent (B.). Ice, in- 
ternally in wounds or hemorrhage of lungs, or from stomach ; small pieces 
frequently (R.). Rest. Perfect rest often indispensable, especially in hema- 
temesis, in which nutrient enemata may be required. [Compare Dysentery, 
Epistaxis, Hematemesis, Hemoptysis, Hemorrhoids, Hematuria, Hem- 
orrhage Post-partum, — Intestinal, Menorrhagia Metrorrhagia, 



Purpura, Wounds, etc.] 



lb.j. 
lb.x. 



PagliarVs Styptic, 
R. Tinct. Benzoini, 
Aluminis, 
Aquai, . 
Boil 6 hours in a glazed earthenware 
vessel, adding hot water in lieu of that 
vaporized and keeping well stirred; 
filter, and put up in stoppered bottles. 



Prescriptions. 

Pancoasfs Styptic. 
R. Potassii Carbonat., . . £ij. 
Saponis, .... ^j-ij. 
Alcoholis, . . . ^iij. 
Mix and use as a styptic, especially 
for operations about the face. 

{Jos. Pane oast.) 



R . Infusi Digitalis, . . ^ij. 

Ext. Ergotae Fluidi, 
Tinct. Krameriae, . aa 5J. 
M. Sig. — A tablesp. as required in 
hemorrhagic conditions generally. 

(B.) 



R. Ext. Ipecac. Fl., . . ^ij. 
Ext. Ergotae FL, . . ^iv. 
Ext. Digitalis Fl., . ^ij. 

M. Sig. — Half-teasp. to a teasp. at a 
dose, repeated as required. An excel- 
lent anti-hemorrhagic combination. 

(B.) 



Hemorrhage, Intestinal. 

Turp_entine, should be used (B.) ; especially in typhoid (P.). [See Hema- 
temesis, for formula.] Belladonna, for irritable and bleeding rectal ulcers 
(P.). Iodine, in passive, gtt. j-ij of tinct. frequently repeated, of great ser- 
vice (B.). Sulphuric Acid, is serviceable (B.). Acetate of Lead, often of 
great service, especially when used as an enema (Jenner). Tannin, one of 
the most serviceable remedies for the intestinal hemorrhage of typhoid fever 
(B.). Hamamelis, very effective in intestinal hemorrhage, owing to its large 
proportion of tannin (B.). Ergot is most valuable; may be given hypoder- 
mically in urgent cases (R.). Gallic Acid, gr. xv with gtt. iij-vof laudanum, 
in a winegl. of iced water, every 2 or 3 hours in the hemorrhage of typhoid 
(Jenner). Opium, a valuable adjunct to astringents, allaying the nervous ex- 
citement (Wa.) : is most useful (Da Costa). [Compare Hemorrhoids, Dys- 
entery, Typhoid Fever.] 



Hemorrhage, Post-Partum, 



Hama?nelis, for persistent oozing (R.) 
livery (R.). Iron, Monsel's solution, j- 

53 



•nj 



Ipecacuanha, in flooding after de- 
of water, strong enough and safe 



634 



HEMORRHOIDS. 



as injection (B.); the perchloride diluted (R). Amy I Nitrite, rrtv by inha- 
lation, has stopped a hemorrhage promptly and permanently (Kerr). Ergot, 
a full dose of the fluid extract as soon as birth is completed as a prophylactic 
(Play fair) ; hypodermically in urgent cases, gr. ij oi Bonjean's Ergotine deeply 
into the tissues of the arm (Wa.) : gss doses of the fluid extract every 4 hours 
in secondary hemorrhage. Cimicifuga, will check post-partum hemorrhage, 
especially when tediously prolonged (P.). Digitalis, the infusion best; a 
tablesp. bis die, or in urgent cases every half hour for 4 doses (B.). Nux 
Vomica, gtt. xx ; ext. ergot, fl. gtt. xxx ; each hour for 2 or 3 doses (B.). 
Opium, the tincture £j, with brandy, in profuse flooding (R.). Vinegar, a 
handkerchief soaked in vinegar and carried into the uterus, will often check 
a severe hemorrhage (Xandis) : is antiseptic, astringent and sufficiently irri- 
tating to produce contraction, yet not so irritating as to cause subsequent mis- 
chief, and always acts promptly (Penrose). Tamponade by absorbent cotton, 
plugs of linen, etc., is indicated in hemorrhage from abortion or placenta 
prsevia (Parvin) ; never tampon after delivery ! you might as well hang the 
woman by the neck (Wallace). Auxiliary Measures of importance are firm 
pressure on the uterus, compression of the abdominal aorta, the plug, and if 
necessary intra-uterine injections (Wa.). Hot Water, no° to 122 F., injected 
into uterus, extremely successful in checking post-partum hemorrhage (Att- 
hill): the most prompt and certain method, and the least unpleasant to the 
patient (Parrish). See also Dr. Cameron in Canada Med. and Surg. Jour., 
March, 1878, with record of 16 cases so treated. Ice, to abdomen or within 
the womb (B.) : into womb or rectum (R.). As a prophylactic against hem- 
orrhage and to secure firm contraction of the uterus, a good method is to 
grasp the womb through the abdominal parietes with a hand kept cold by 
frequent immersion in a pan of broken ice, while waiting for the expulsion of 
the placenta. While one hand is kept on the uterus the other may be im- 
mersed in the ice. Transfusion of milk into veins may be necessary in cases 
of collapse (Thomas). 

Hemorrhoids. 

Galls, as ointment, very useful : the official unguentum gallae, or combined 
with lead and opium. See formula below (R.). Iron, a solution of the sub- 
sulphate as wash to bleeding piles, which should then be well oiled (B.): or 
an ointment of the subsulphate, gr. xv to the 3, locally night and morning, 
with gr. j of the salt thrice daily by mouth ; gives excellent results. Hama- 
melis, by mouth, also lotion or injection in bleeding piles (R.) ; is employed 
with satisfaction; Tnjj-x of tincture several times a day; also enema or 
suppository (Pf.). Nux Vomica, emphatically beneficial (P.). Sulphur, gr. 
v-x, with £j confec. sennae, as laxative (R.). Exercises a most soothing in- 
fluence (Wa.). Sulphides, especially Blue Lick waters (B.). Podophyllum, 
as cathartic for hemorrhoids of recent formation, bleeding from stasis in portal 
circulation (B.). Aloes, causes congestion of pelvic viscera, yet Fordyce 
Barker shows it to be curative in piles, especially in recent ones, as after de- 
livery (B.); to greatly relieve bowels (R.); cures by removing constipation 
(P.). Hydrastis, as lotion or ointment to external piles, of great value; rrtv 
of tincture ter die internally at same time (P.). Ergot, with or without nux 
vomica, in dilated hemorrhoidal veins without new tissue, given by the stomach 
and used locally will often cure (B.). [See Diarrhcea for formula.] Stil- 
lingia, will remove permanently when due to constipation, and temporarily 



HEMORRHOIDS. 



635 



when from hepatic obstruction (B.). Senna, to procure soft and easy evacu- 
ations, use the confectio sennae at bedtime, gr. cxx in a bolus (B. ). Iodoform, 
the ointment, and in suppository (B.). Nitric Acid, as caustic, followed by 
free use of olive oil (B., R.) ; Jss or gj-Oss of water as lotion for bleeding 
piles (R.). Hyoscyamus or Stramonium, leaves bruised, or ointment, locally, 
for pain (P.). Oleum Lini. Linseed Oil, boiled, in doses of ^ij twice daily, 
has quite a reputation as a remedy for piles (W.). Alum, to painful bleeding 
piles, a crystal trimmed and passed into rectum, or as an ointment (B.). 
Ice, to painful, bleeding piles, or cold water injected daily (B.) ; locally, for 
pain after operation ( R. ) • Leeches, directly to swollen, irreducible, and painful 
piles (B.). Alkaline Mineral Waters, excellent (B.). Carbolic Acid, 3 parts 
to 1 of olive oil, a few drops injected into the tumor. A favorite and suc- 
cessful treatment by itinerants (Andrews) ; uncertain in all cases and in many 
fraught with danger (Gross). Grape-cure, is used with success (B.). Saline 
Purgatives, notably Epsom salts, in bleeding piles, combined with sulphuric 
acid, will often stop the hemorrhage (B.). [See Dysentery for formula.] 
Diet, etc. Avoid stimulants, indigestible food and overeating; during an 
attack use little animal food. Petroleum soap when piles protrude, with cold 
or tepid water ablutions. Injections, Oj cold or tepid water, are very useful. 
Stool should be at night. Surgical Methods are — the ligature for internal 
hemorrhoids, excision for external ones. Ligation is the proper treatment for 
the former, all other methods of operating radically being now discarded as 
unsurgical, and dangerous to life (Gross). Prevention. Soft seats favor the 
production of piles, as also of uterine disorders, by pressure on the arteries 
as they emerge from the pelvis, and so tend to drive the blood into the interior 
of that cavity (Holden). 

Prescriptions. 

R. Pulv. Gallae, . . gr. xx. 

Pulv. Opii, . . . gr. x. 

Ung. Plumbi Subacet., . gr. xl. 

Ung. Simplicis, . . 5£j. 

M. et ft. unguentum. Sig. — Oint- 
ment for piles. (CEsterlen.) 



R. Ext. Colocynth. Co., . gr. xxx. 
Ext. Nucis Vom., . . gr. vj. 
Hydr. Chlor. Mitis, 
Ext. Hyoscyami, . aa gr. xij. 
M. et div. in pil. no. xij. 
Sig. — One as required for sluggish 
bowels. [Barker.) 



R. Ac. Carbolici, . . . gij. 
Ac. Tannici, . . •- 3J- 
Alcoholis, .... ^iv. 
Glycerini, .... %]. 
M. Sig. — Hypodermic injection for 

piles. ( Girard.) 



R. Iodoformi, 


, 


• 3> 


Balsam. Peruv., 


. 


• 3*j- 


Magnes. Calcin., 


. 


■ 3h 


01. Theobromae, 






Cerae Albae, 


. 


aa ^jss. 


M. et fiant suppositoria xij. 


Sig.- 


One twice daily. 






R. Pulv. Gallae, 




Pulv. Opii, 






Plumbi Acetat, 


aa 


\ gr. xx. 


Ung. Picis Liquidae 






Cerati Simplicis, 


aa 


; gss. 


M. et ft. unguentum. 


Sig.- 


-Apply 


night and morning after 


bathing parts 


with cold water. 







R. Ext. Opii, . . . gr. x. 

Pulv. Stramonii, . . ^j. 
Pulv. Tabaci, . . . £ss. 
Ung. Simplicis, . . ^ss. 
M. Sig. — Ointment for piles. 

[Shoemaker.) 



636 



HEPATALGIA HEPATIC CONGESTION. 



Hepatalgia. 



Ammonium Chloride, grains xx-xxx, every 4 hours, is highly efficacious 
(Anstie). Bryonia, worthy of commendation in many liver affections (P.). 
Nux Vomica, has been found of much benefit. Dose should be small, gr. 
T l^ to ■£% twice or three times a day (P.). Quinine, would naturally be 
thought of in malarial subjects, but does not afford any relief (Anstie.) 

Hepatic Cirrhosis. 

Nitric Acid, in long standing diseases, as this, will augment flow of bile 
after liver has struck work from mercury (R.). The mineral acids do not 
benefit (B.). Arsenic, small doses perseveringly, give good results in improv- 
ing the nutrition of the organ (B.). Bryonia, of great value in many liver 
complaints (P.). Iodides, are the best remedies for the first stage (B. ): the 
potassium iodide is highly recommended by some authorities (Da Costa). 
Stillingia and Alkaline Mineral Water j, are important in the first stage (B.) ; 
alkalies early, especially Carlsbad water, with total abstinence from alcoholic 
beverages (Legg). Mercury. Corrosive sublimate in small doses, gr. -^ 
thrice daily, for a long time, does benefit the condition, and has possibly cured 
a few cases (Da C). Sodium Phosphate is said to produce good results 
(Da C.) ; has power to retard the sclerosis, and may possibly arrest the changes 
and restore a state of comparatively normal function (B.). Chloride of Gold 
and Sodium, in doses of gr. ^, as an hepatic alterative, may be used con- 
jointly with phosphate of sodium (B.). Tapping becomes necessary for the 
dropsy, though purgation and diuresis may help to lessen it (Da C); Diet, 
should be easily digested, especially milk, avoiding starches and fats, and 
quitting alcohol (Da C). 

Hepatic Congestion. 

Nitric Acid, in chronic congestion, will augment flow of bile after liver has 
struck work from excessive use of mercury (R,). Nitro- Muriatic Acid, is 
found useful in India, with the acid bath (giij ad gall, j) to hypochondrium 
(B.) : formerly held high rank but is now superseded by ammonium chloride ; 
the acid baths being now rarely employed (Fayrer). See page 496 for for- 
mula. Sulphur. Sulphates in purgative natural waters, small doses often 
repeated; potassium sulphate is occasionally poisonous (R.). Chelidonium, 
as deobstruent (P.) ; energetically affects the liver (Pf. ). Iodine, tincture and 
unguent.- locally for hepatic engorgement after malarial attack. The iodide 
of ammonium in moderate frequent doses in functional derangement, from 
malarial disease (B.). Sodium Phosphate, gj-ij, 3 or 4 times daily, in plenty of 
water, as a purgative (B.). Ammonium Chloride, in passive congestion, and 
chronic torpidity, is well worthy of attention; gr. xx every 4 hours (Wa.) ; 
an excellent remedy (Da Costa). Turpentine epithems, hot, often found very 
beneficial (Wa.). Quinine, gr. xv-xx with morphine, gr. %-}£, in the acute 
congestion due to climatic or malarial causes, no remedy so efficient (B.). 
Bryonia, is worthy of commendation in liver affections of various kinds (P.). 
Iris, really serviceable when stools clay-colored and skin jaundiced (B. ); is 
one of the best aperients in hepatic derangement (P.). Mercury, valuable 
only as a purgative ; its use restricted to cases where there is deficiency or 
excess of bile (B.) ; a full calomel purgative is of utility in cases of conges- 
tion (Wa.). Podophyllum, the resin in congestion of the portal circulation, is 



HEPATIC CONGESTION. 



&37 



especially useful (B.); Ye-% gr. doses every six hours will speedily relieve 
symptoms (P.). Sanguinaria, is useful in hepatic engorgement without or- 
ganic disease (P.)- Colckicum, in hepatic congestion and dropsy; an active 
remedy in congestion of the liver (B.). Resin-bearing Purgatives, as Rhu- 
barb, Podophyllum, Iris, Euonymus, etc., are all actively cholagogue. (See 
list on page 418.) Ipecacuanha, decidedly stimulant to the flow of bile (B.) ; 
is the Indian treatment now for the local liver, given in large doses for a week 
or two (Da C). Taraxacum, has had a reputation, but I cannot recommend 
it (Da C). Aliment. No starches or fats. Milk, eggs, oysters, beef broth, 
whitefish, etc. (B.). Cold Water Belt around the abdomen, covered with oiled 
silk, gives great comfort in chronic cases (Da C). [Compare Biliousness, 
Jaundice, etc.] 

Prescriptions. 
R. Elaterii, . . . gr. j. R. Pil. Hydrargyri, 



Elaterii, . . . gr. j. 
Spt. ^Etheris Nitrosi, . gij. 
Tinct. Scillse, 

Tinct. Colchici, . aa 3ss. 
Syrupi Simplicis, . . sfj. 
M. Sig. — Teasp. thrice daily. (B.) 



R. Hydrarg. Chlor. Mitis, . gr. vj. 

Pulv. Ipecac, . . . gr. j. 

Sodii Bicarb., . . . gr. x. 

Div. in pulv. no. ij. Sig. — One at 

bedtime, followed by the following — 

R. Ac. Nitrohydrochlor. Dil., giij. 
Elix. Taraxaci Co., . ad Jyj. 
M. Sig. — Dessertspoonful before 
meals, and a milk diet. 



R. Ext. Taraxaci, * 

Ext. Aloes, 

Ext. Colchici Rad., 

Pulv. Ipecac, . aa gr 

M. et div. in pil. no. xxiv. 

Sig. — 2 nightly in chronic enlarge 

ment and torpidity. [Martin. 



gr. Ixxij. 
gr. xxiv. 



Xlj. 



R. Sanguinariae, . . gr. viij. 

Podophyllini, . . gr. iij. 
Ext. Hyoscyami, . . gr. iij. 
Saponis, . . . gr. viij. 
M. et div. in pil. no. xx. 
Sig. — 2 to 4 pills daily. In hepatic 
torpor without organic disease. 

[Phillips.) 



Pulv. Aloes Socot, 

Pulv. Rhei, 

Extr. Hyoscyami, 
M. et div. in pil. no. vj 
Sig. — 2 pills every other night. 



aa gr. iv. 



aa gr. vj, 



R. Cinchonidinae Sulph., 
Euonymini, 
Leptandrini, 
Juglandini, 

Irisini, . . . aa %]. 
Podophyllini, 
Ext. Belladonnas, 
Ext. Hyoscyami, . aa gr. x. 
M. et div. in pil. no. lx. 
Sig. — One pill thrice daily. In 
obstinate hepatic torpor. 

(Blac&wood.) 



R. Enonymini, . . . gr. xij. 
Ext. Hyoscyami, . . gr. vj. 

M. et div. in pil. no. vj. 

Sig. — One at bedtime, followed next 
morning by a full dose of an aperient 
mineral water. 



R. Potass. Bicarb., 

Potass. Citratis, . . aa ^j. 

Syrupi Simplicis, . . gyj. 

M. Sig. — A teasp. to a tablesp. 

with a similar quantity of lemonjuice, 

in *4 glass of water ; the whole to be 

drank while effervescing. ( Wood.) 



6 3 8 



HEPATIC DISEASES. 



Hepatic Diseases, 



Ammonium Chloride is highly serviceable in all cases of liver disease, 
whether due to organic changes or to functional derangement ; especially 
indicated after the more acute symptoms have abated (Wa.). Nitro-hydro- 
chloric Acid formerly held high rank, but is now superseded by ammonium 
chloride ( Wa.) ; even the acid baths, so long considered of great importance, 
are now but little, if ever, used in India (Fayrer). Nitric Acid acts in some 
way beneficially on long-standing liver-diseases, as in chronic congestion and 
cirrhosis (R.) ; with vegetable bitters, long continued, useful in waxy liver 
(Wa.). Podophyllum has a high reputation in a variety of liver diseases 
(P.); is actively cholagogue (R.). Mercury, mercurial purgatives are used 
for both deficiency and excess of bile ; harmful in many acute forms of hepatic 
disease, and generally are of doubtful propriety in liver affections (B.) ; in 
hepatic congestion a full calomel purge is of great benefit ( Wa.). Red Iodide 
of Mercury, as ointment, gr. j to £v, gives best results in malarial enlarge- 
ment of the liver (W.). Calomel is used in inflammatory disorders of the 
liver, but is less suited to parenchymatous than to serous inflammations (Da 
Costa). Ipecacuanha promotes the flow of bile (B.) ; may be used in small 
doses with great advantage in functional derangement of the organ (Wa. ). 
Resinous Purgatives, as Leptandra, Iris, Euonymus, Rheum, etc., are de- 
cidedly cholagogue (B.). Euonymin is of great value in torpid liver and its 
accompanying headache (W.). Bryonia is worthy of commendation in liver 
affections of various kinds (P.). Chelidonium powerfully affects the liver 
(Pf.). Taraxacum is highly recommended in all chronic affections of the 
liver, especially in indolent enlargement and incipient scirrhus (Watson). So- 
dium Phosphate is cholagogue, and extremely useful in liver affections, es- 
pecially the jaundice of children and hepatic calculi (Thudicum). Phosphorus 
specifically affects the liver, and used early in acute yellow atrophy may have 
an action of antagonism upon the disease (B.). Potassium Salts, as depura- 
tives, are of decided value, especially the citrate, in hepatic torpor and other 
affections (W.). See preceding article for formula. Sulphur, the sulphurous 
mineral waters, prolonged, give excellent results in liver disorders (B.). Al- 
kaline Waters are veiy serviceable (B.); especially the sulphur waters. Glau- 
ber's salt in their place (Da Costa). Chlorine Water has been employed 
with benefit in chronic hepatic affections, in doses of ^ss-ij in ^iij or iv of 
water (W.). Iron preparations, long continued, in amyloid degeneration 
(Da C). Gentian, and other bitter tonics, in functional hepatic disorder; 
also Nux Vomica occasionally, but use mercurials and podophyllum sparingly 
(Da C). Iodine and Iodides in waxy enlargement, simple hypertrophy and 
chronic congestion, of great value (Wa.); the iodide of potassium alternately 
with the iodide of iron in waxy liver (Frerichs); a few drops injected into 
hydatids (B.). Sanguinaria is of great value in hysteria from chronic hepa- 
titis, and in hepatic engorgement without organic disease (P.). See preced- 
ing article for formula. Stillingia, for torpid liver and jaundice following 
ague, in the first stage of cirrhosis, and in ascites from hepatic changes (B.). 
Malt Liquors are harmful in all chronic affections, especially in fatty liver 
(B.). Galvano-puncture for hydatids, the negative needle into the hydatid 
(B.). [Compare Lists of Agents acting on the Liver, page 418, ante ; also, 
the articles in this section entitled Biliousness, Calculi, Cancer, Hepa- 
talgia, Hepatic Congestion, Hepatic Cirrhosis, Hepatitis, Jaundice.] 



HEPATITIS HERNIA HERPES. 639 

Hepatitis and Hepatic Abscess. 

Ammonium Chloride is almost a specific in hepatitis and abscess of the liver 
(Stewart) ; often preventing the latter disorder and in many instances curing 
it (Wa.). Quinine, in large doses for the acute parenchymatous inflamma- 
tion (Da Costa). Tartar Emetic, gr. %-% every two or three hours, with 
opium or calomel as indicated by symptoms ; of especial value early in the 
acute attack (Wa.). Leeches to margin of the anus in the acute type (B.) ; to 
unload the portal system (Wa.). Mercury is used, but is better suited to serous 
inflammations than to parenchymatous ones (W.). Chelidonium has been 
used with benefit in both acute and chronic hepatitis (P.). Alkalies and Col- 
chicum, when the affection is of a gouty nature (Wa.). Sulphites are recom- 
mended in chronic forms (Da Costa). Sinapisms and linseed poultices over 
the hepatic region in acute hepatitis (Wa.). Saline Purgatives, as the sul- 
phates of sodium or magnesium, to increase the watery exudation from the 
mucous membrane of the intestines, in acute hepatitis (Wa.). Nitro- Hydro- 
chloric Acid, for some time in chronic form tending to abscess (Da C). As- 
piration, when pus forms ; early operation the rule of practice ; has induced 
many recoveries (Da C). [Compare Jaundice.] 

Hernia. 

Opium, or morphine hypoder. to narcotism, often obviates the necessity of 
an operation in strangulated hernia (Wa.). Chloroform, of evident benefit 
(Wa.) ; inhaled to assist reduction (R.); has superseded the use of tobacco 
and lobelia in strangulated hernia (P.). Coffee, large doses, has certainly a 
remarkable influence in aiding or causing reduction of strangulated hernia 
(Wa.). Oak Bark extract, as injection into the tissues, for a radical cure by 
stimulating the occlusion of the rings (Heaton's radical cure). A similar 
operation was patented by a Dr. Gage in 1840, the oil of cloves being the in- 
jection used. Professor Pancoast injected tincture iodine for the same pur- 
pose. Operations for radical cure all unsatisfactory. A properly adjusted 
truss (Ag.) : is the best remedy for a reducible hernia, answering the purpose 
of a retentive apparatus, and often permanently curing the disease by the 
steady, gentle and uniform pressure of its block (Gross). Ice Poultice is of 
use if no strangulation of gut or omentum (Wa.). Sternutatory, as snuff or 
ipecac, to cause sneezing while patient lies on his shoulders with elevated hips 
and legs over the back of a chair, frequently successful after taxis has failed 
to effect reduction. 

Herpes. 

Ferrum Arseniate, in doses of gr. \ daily, will effect the cure of a herpetic 
affection in the adult, however extensive or long established (Duparc). Mer- 
cury, calomel ointment, ^j to the §, is one of the best mercurial preparations 
(Pereira). Potassium Carbonate, as lotion, gr. xxx to Oj, to allay irritation 
(Wa.); or as ointment, gr. xx to ^j, smeared over eruption at night, and 
washed off in the morning with a solution, gr. xxx to Oj (Neligan). Glycerin, 
diluted, is a serviceable application in herpes labialis (Wa.). Ergot, the oil 
prepared by the action of benzin upon ergot, which, upon evaporation of the 
solvent, makes a valuable application in herpes genitalium and other skin af- 
fections (Shoemaker). Alum, in herpes praeputialis, a solution of ^j to ^j 
aquse, applied on lint to the glans penis, is generally effectual (Wa.). Collo- 
dion, the flexible form, is applicable to various kinds of herpes (Wa.). Mag- 
nesium Citrate, as a cooling laxative, with soothing and protective lotions and 



640 



HERPES ZOSTER HICCOUGH, 



ointments, and the Liquor Picis Alkalinus, diluted 10 to 20 times for the itch- 
ing (Bulkley). Astringent Lotions, of tannin or zinc sulphate, in herpes prae- 
putialis, to render the parts less sensitive (Da Costa). [For Herpes Circinatus 
see Tinea Circinata.] 

Prescriptions. 

Tragacanthae, . . ^ij-iv. [ R. Ac. Carbolici, 



R 



;ij-iv. 
;iv. 



Liq. Calcis, 
Glycerini, , . • j?j- 
Aquse Rosae, . . . giij. 
M. Sig. — A soft jelly for local use 
as ointment. 



. gtt. v-xv. 
Pulv. Calaminae Praep., 
Zinci Oxidi, . aa ^ss-j. 

Ung. Aq. Rosae, . ^j. 

M. et ft. unguentum. 
A soothing and protective applica- 
tion. 



Herpes Zoster. 

Rhus Toxicodendron, very readily subdues, especially when burning or 
itching (P.). Aconite and Opium, locally, for pain (VVa.). Morphine, oleate 
ext., without friction (R.) ; hypoder. to mitigate the pain (Anstie). Celandine 
has been recommended (P.). Dulca?nara has an old reputation (P.). Silver 
Nitrate, painted on the warning patch of erythema, before or as soon as 
vesicles begin to form (R.). As a local application, reported on favorably 
(Wa.). Veratrine, as ointment, Qj-ij-Jj, m neuralgia following shingles (R,). 
Zinc Phosphide, gr. y^ every 3 hours, is said to control the pain and abort the 
eruption (Hughes). Grindelia is reputed to relieve the pain (Stille). Mer- 
cury, the Ung. Hydrarg. Ammoniat. is said to relieve the pain and irritation 
remarkably (Wa.). Blisters, for subsequent neuralgia (R.). Hot Fomentations 
will often disperse (R.). Baths daily, exercise out of doors, abundant nutri- 
tious food. Flexible Collodion, constantly reapplied to exclude air (Anstie). 
Galvanization of the affected intercostal nerves, the positive pole over 
their points of emergence, the negative brushed over the terminal filaments 
in the skin (B.). Starch, dusted over the eruption, and on a muslin band 
sewed tightly around the body to protect it from the friction of the clothes, 
gives the greatest relief (Bulkley). Rest, absolute, when eruption is exten- 
sive (Fournier). 

Prescriptions. 



R. Zinci Phosphidi, 

Ext. Nucis Vomicae, . aa gr. x. 

M. et div. in pil. no. xxx. 

Sig. — One every 2 to 4 hours, as a 
nerve tonic. (Bulkley.) 



R. Liq. Sodii Hypochlorite, . liv. 
Aquae, . . . ^ij. 

M. Sig. — Wash for ulcerated ves- 
icles. {Fournier.) 



R. Bismuthi Subnit., . . ^iv. 
Hydr. Chlor. Milis, 
Zinci Oxidi, . . aa £). 
M. ft. pulvis. Sig. — To be dusted 
on cotton- wool, and applied to the 
ulcerated vesicles, after washing with 
the solution of Sodium Hypochlorite. 

(Fournier.) 



Hiccough. 

Nux Vomica, in 5- or io-ttl doses of tincture, with ttlxv of dilute nitric 
acid; a short course frequently curative (P.). Chloroform, combined with 
opium (R.). Pepper, gr. ij-x, to stop hiccough (P.). Laurel-water, a useful 



HYDROCELE HYDROCEPHALUS. 64 1 

remedy, nxv (P.). Morphine, hypoderm., often arrests (R.). Camphor has 
been recommended (R.). Mustard, gj infused in giv aq. fervid, has cured 
most obstinate cases (R.). Pilocarpine, gr. -^ of the muriate, has cured bad 
cases which resisted all other means (Ortille). Ether, as spray to the epi- 
gastrium for ten minutes, then the site of the phrenic in the neck (Regoni) ; 
or the spirit, tt^xx-xxx in some aromatic water, given internally, will often 
arrest the spasm immediately (Wa.). Zinc Valerianate, gr. ^ with a small 
portion of extr. belladonnas, cured a severe case of fifteen days' duration. 
(Danet). Nitro-glycerin, sometimes arrests (R.). In mild cases deep inspira- 
tions, holding breath as long as possible, or a firm belt around epigastrium (T.). 

Hydrocele. 

Iodine, injection of tincture 1, water 2, into the sac to excite obliterative 
inflammation, the usual procedure for radical cure after tapping the sac 
(Wa.) ; may be used full strength, or with equal part of water ; the latter the 
safest method in ordinary cases, but relapses are not infrequent (Gross). Car- 
bolic Acid, ^ss, with a minute quantity of water or glycerin to render it fluid, 
injected into sac and manipulated to bring all portions under its action, after 
which rest in bed and support to scrotum (Levis) ; a very efficient method for 
radical cure, but may cause erosion of vessels and hemorrhage into sac 
(Gross). Ammonium Chloride, as discutient lotion to the scrotum in hydrocele 
of children (Wa.). Galvano- pun dure, a current of 20 to 40 elements, by 
two needle electrodes, will invariably cure (B.). Operations for radical cure 
include that by iron-wire sutures to excite adhesive inflammation (Simpson) ; 
and the incision of the hydrocele under antiseptic precautions (Volkmann) ; 
the same end may be obtained by the simpler methods of injection noted 
above (Gross). [Compare Dropsy, Orchitis.] 

Hydrocephalus, Acute. 

Iodine, lotions to scalp, or inunction of iodine ointment together with ferric 
iodide and cod-liver oil internally, offer the best chance of success, although 
most remedies often fail (Wa.). Tartar Emetic, oint. as counter-irritant to 
scalp in tubercular meningitis (R.) ; in large doses internally was formerly 
employed (Wa.). Croton Oil is said to have removed the excess of fluid 
from the ventricles (R.). Mercury, hydrarg. chlor. corr., in doses of gr. -^ to 
y 1 ^, has proved successful (Wa.). Magnesium Carbonate, ^j-ij saturated with 
lemon-juice, every 2 or 3 hours, a useful purgative in hydrocephalus (Wa.). 
Turpentine, in doses of iUv-x with lUxx-xl Q f castor oil, or terebinthinate 
enemas, in incipient hydrocephalus (Wa.). Purgatives, in small doses every 
4 or 6 hours after having overcome the constipation, to maintain action for 
some days. A single full dose of calomel, followed up by magnesium sulphate 
at short intervals. Their value can hardly be overrated (Wa.). Leeches, on 
crown of head rather than on temples, when much febrile action ; inadmis- 
sible if patient is much debilitated; sometimes serviceable (Wa.). 

Hydrocephalus, Chronic. 

Mercury, holds a high place in the opinion of many. Calomel gr. %-% 
twice daily, with mercurial inunction to the shaved head, or the latter alone ; 
child to wear a woollen cap. This treatment for 30 or 40 days (Wa.). Fer- 

54 



642 HYDROPHOBIA — HYDROTHORAX — HYPOCHONDRIASIS. 

ric Iodide, with cod-liver oil, always gives good results among the poor (Wa.). 
Iodine, lotions. [See Hydrocephalus, Acute.] Potassium Iodide, may- 
arrest progress (Wa.) ; is of value certainly; appears to have power of pro- 
moting absorption (W.). Cod-liver Oil, sometimes improves the condition, 
especially in scrofulous children (Wa.). [Compare Dropsy.] 

Hydrophobia. 

Belladonna, in all hyperaemic states of the brain and spinal cord, is one of 
the very best remedies (P.). Stramonium, is used by Brahmins in India 
with apparent success. Glonoin, may be of benefit (Wa.). A my I Nitrite, 
should be fairly tried (B.). Curare, is encouraging, grm. 0.02 injected, 7 
doses in 5^ hours, dispelled the symptoms, but replaced them by paralysis 
of limbs continuing over 2 months (Ros.) ; has seemed to antagonize the con- 
vulsive phenomena (B.). Chloride of Lime, a filtered solution injected into 
wound, very effective in snake-bites (Binz). Morphine, chiefly palliative. 
For deep injection into the tetanized muscles (B.). [See Tetanus.] Conine, 
is indicated; has not succeeded (B.). Cauterization, with ho.t iron or caustic 
potash after cleansing wound, which should be kept open by unguentum ba- 
silicon for 5-6 weeks (Ros., A.) ; with Silver Nitrate sharpened to a point, 
and applied freely to every sinuosity of the wound as preventive (Wa.). Ex- 
cision, the safer practice (Wa.). Baths, warm and hot, produce calm (Ros.). 

Hydrothorax. 

Digitalis, in purely dropsical form, also in passive pleuritic effusions; used 
as a diuretic (£j-ij night and morning, or oftener) is of great value (R.). Ela 
terium, unquestionably of value as a derivative, though many fear it (P.). 
yaborandi, produces good results (B.). Iodine, 3J of tincture injected in re- 
turning hydrothorax (B.). Sanguinaria, has been used with the best effects 
(Wa.). Blisters, when effusion has taken place, certainly seem to stimulate 
the absorbents to action (Wa.). Dry Cupping, over the chest, gives relief 
(DaCosta). Thoracentesis, if much distress. [Compare Dropsy.] 

Hypochondriasis. 

Arsenic, in the aged, gives great comfort, especially when combined with 
opium (B.). Ignatia, is useful. Tincture, best (P.). Cimicifuga, of singu- 
lar value in puerperal hypochondria, and in that accompanying spermator- 
rhoea, etc. (P.). Aurum, Chloride, gr. fa to fa ter die gives excellent re- 
sults, when depression, vertigo, cerebral anaemia (B.). Valerian, quickly 
relieves flatulence (B.). Asafcetida, especially indicated in cases marked by 
flatulence and gloom (B.). Potassium Bromide, especially among female 
town-dwellers, but also in male (R.) ; effects are variable, relieves some, not 
others (Wa.). Hyoscyamus, when syphiliphobia (P.). Opium, stimulant 
doses of the tincture are of great importance (B.). Caffeine, the citrate (gr. 
j-v) has been used as a cerebral stimulant with advantage (B.). Alcohol, in 
hypochondriasis gives temporary relief ; should never be given for its narcotic 
stimulant effects in these cases (W.). Cocaine, especially useful in cases 
marked by debility and nervousness, and in mental affections accompanied 
by depression ; the fluid extract of Coca may be used, either alone or in wine 
(Br.). Turkish Baths, are useful for town-dwellers, with soft, flabby tissues, 
and mental depression (R.). [Compare Melancholia.] 



HYSTERIA ICHTHYOSIS. 



643 



Hysteria. 

Ignatia, useful in many forms of hysteria, with feeling of suffocation, 
sensation as of a ball rising to the throat, convulsive crying, flatulence, 
etc. (P.). Camphor, in hysterical excitement (P-). Musk, for many anom- 
alous and distressing symptoms (R). Chamomile Oil, in the spasmodic 
and pseudo-neuralgic affections of hysterical women, a very excellent 
remedy (P ). Cimicifuga, in hysterical chorea, is rapidly curative (P.) ; 
for the headache (R.). Asafoetida, in hysterical convulsive affections, with 
flatulence and cough (P.) ; arrests paroxysm, valuable for flatulence (B.) ; 
removes headache, peculiar sensations in head, and flatulence (R.). Valerian, 
has great value, gss doses of fluid extract (B.) ; useful in most cases, espe- 
cially those of hysterical dyspepsia (P.). Zinc Valerianate, especially at the 
climacteric age, for hysterical symptoms which can be traced to no particular 
cause (R.). Ergot, with iron and other tonics (see formula below), in cases 
depending on sub-involution of the uterus, with indigestion and anaemia (B .). 
Nux Vomica, of great use in middle-aged subjects, with flatulence, weight on 
head, flushings and perspirations (R.). Atropine, for hysterical aphonia, gr. 
xio to irV m ° rnm g and evening (B.). Ether, for the flatulence, and for the 
hysterical paroxysm in sudden seizures (B.). Ammonia, the aromatic spirits 
for the acidity and eructations (B.) ; the fetid spirit for flatulent colic, etc., 
may be given with great advantage in doses of J^ss-j (Wa.). Potassium Bro- 
mide, gives control, and prevents paroxysms. When verging on nymphoma- 
nia large doses required (R.). Iron, a course often useful, especially when 
anaemia or uterine obstructions (R.). Phosphorus, in hysterical paralysis (R.). 
Arsenic, lessens mobility of nervous system, and improves nutrition (B.). 
Opium, gtt. j of laudanum with gtt. ij of tinctura nucis vomicae 3 or 4 times a 
day, for flushings, weight on head, depression (R.). Ovarian Compression^ 
has in many cases relieved recent hysterical contractions, and many other 
similar phenomena ( Bourne ville). Electricity, for aphonia, paralysis and 
anaesthesia, and to educate the nervous control. Electricity is the sworn 
enemy of hysteria. Accessory Measures. Occupation of mind and body. 
Removal from influence of friends. Complete abandonment of use of alcohol. 
The shower-bath, or cold bath, as an educator of the will, as well as to in- 
vigorate the body. Excitement to be avoided. The word " Hysteria " should 
never be applied to the case in the patient's hearing. Disorders of vision are 
often found at the bottom of hysteria ; look for hypermetropia and astigmatism. 



Prescriptions. 



R . Ext. Ergotae, 
Ferri Sulphatis, 
Ext. Nucis Vomicae, 
Hydr. Chlor. Corros., 
M. Fiant pil. no. xxx. 

pill thrice daily. 

tion and anaemia 



■ Zh 

, £SS. 

. gr. viij. 

. gr. ss. 

Sig. — One 

To improve diges- 

(B.) 



U. Tinct. Asafcetidae, 

Tinct. Valerianae Am- 
nion., 
Tinct Castorei, . aa ,^ij. 

Aquae Camph., . . . §vij. 
M. Sig. — A tablesp. or two every 
hour. 



Ichthyosis. 

Zinc, the ointment 'or glycerite of the oxide, especially the latter with a 
little camphor added to it, is a most useful application (Wa.) ; an ointment of 



644 IMPETIGO — IMPOTENCE. 

the sulphate, gj to gj, found very efficient (Wilson). Sodium- Bicarbonate, 
as ointment, gr. xv-xxx to gj, or lotion, ^ij-iij to Oj (Devergie). Copper 
Sulphate, gr. x ad gj Unguentum Sambuci, a useful application (Wilson). 
Ulmus, in decoction, used internally, has cured the disease (Wa.). Cod-liver 
Oil, applied locally with friction, has proved promptly curative. Warm Baths, 
may generally be employed with benefit (R.) ; alkaline and vapor baths, with 
sapo mollis; and inunctions of oil or simple ointment, to prevent Assuring of 
the new skin (Duhring) ; frequent alkaline baths, with internal and external 
use of oily preparations, as linseed and cod-liver oils, yield the best results 
(Bulkley). 

Impetigo. 

Arsenic, is very useful. [See Eczema.] The iodide in doses of gr. y^ has 
been employed with great success. Or Donovan's Solution, ""Iv-x (Wa.). 
Nitric Acid, internally, frequently benefits (Wa.). Glycerite of Tannin, an 
excellent application (B.) ; during day, with poultice at night to remove 
scabs (R.). Quinine, Mineral Acids, when from imperfect digestion (R., B.). 
Zinc, the ointment of the oxide, after subsidence from inflammation (R.). Sul- 
phur, internally, serviceable (R.). Calcium Chloride, gr. xv-xxx, daily, in 
some vegetable infusion, well spoken of (Wa.). Mercury. Citrine ointment 
dilute, locally, is an excellent application (Wa.) ; a very weak white precipi- 
tate ointment answers best in impetigo contagiosa, with a little carbolic acid 
lotion (1 to 20) if it does not yield (Bulkley). Calomel to cover the floor of 
the pustules, after opening, evacuating and washing them out (Da Costa). 
Laurel-water, relieves itching (P.). Grape-cure, has proved excellent (P.). 
Flexible Collodium, or liquor guttse perchae, to cover the pustules, if located 
where they are liable to irritation (Da Costa). [Compare Eczema.] 

Impotence. 

Phosphorus, no remedy more efficient. The pill of zinc phosphide the 
most convenient form (B.) ; gr. y 1 ^ thrice daily. Phosphoric Acid, full doses, 
with gr. ss of pulvis cantharidis, an effective combination, especially in 
impotence of old age (B.). Chloride of Gold, prevents decline of sexual 
power (B.). Cantharis, with iron, is beneficial (B.). In large doses (gtt. 
xx-xxx), with iron and phosphoric acid or nux vomica (R.). Of doubtful 
efficacy (Wa.). Cubebs, removes functional trouble (B.). Nux Vo?nica m 
Drop doses of tincture in atonic impotence (B.). In large doses when sper- 
matorrhoea (R.). Sanguinaria, has decided aphrodisiac properties, but use- 
ful only in functional form (B.). Serpentaria, in relaxation and feeble erec- 
tions, will often restore power. £ss doses of tincture bis in die (B.). Ergo- 
tin, hypodermically about the dorsal vein of penis, when its enlargement 
and too rapid emptying is the cause of impotence (B.). Cannabis Indica, is 
a useful remedy ; the best combination for functional impotence would be 
one of Cannabis, Nux Vomica and Ergot (B.). Polygonum Hydropiperoides % 
is a useful remedy in the functional form, erections feeble, semen watery and 
testes soft (B.). Arseniate of Iron, acts as a tonic to the organs, and in full 
doses often benefits cases of functional form (B.). Damiana, has been brought 
forward as a genital stimulant, and a remedy for impotence, but there is 
probably no ground for any confidence in such claims (Stille). [Compare 
Emissions, Spermatorrhoea, also List of Aphrodisiacs, ante, page 426.] 



INFLAMMATION. 



645 



R. Ferri Arseniatis, . 
Ext. Ergotae, 
Ft. pil. no. xxx. Sig.- 
daily. 



R. Ext. Cann. Indicae, 

Ext. Ergotae, . 

Ext. Nucis Vom., . 
Ft. pil. no. xx. Sig.- 
night and morning. 



Prescriptions. 

gr. v. R . Sanguinarinae, . . gr. ij. 

gr. xxx. Ext. Ergotae, . . . gr. xx. 

3ne twice M. Ft. pil. no. xx. Sig. — One 
pill thrice daily. 



R . Quininae Sulph., . 
Strych. Sulph., 
Ext. Ergotae, 
Mas. Ferri Carb., . 
M. Ft. pil. no. xxx. 

pill 2 or 3 times daily. 



. gr. x. 

. gr. xl. 

. gr. x. 

-One pill 



. gr. xxx. 
. gr. ss. 
. gr. xv. 
. gr. xlv. 
Sig. — One 



R. Tinct. Sanguinariae, . . £iij. 
Ext. Stillingiae Fl., . . gv. 
M. Sig. — 15 to 20 drops in water, 
thrice daily. 



ss. 



V J. 
xl. 



R. Phosphori, . . . gr. 

Ext. Nucis Vom., . gr. 

Mas. Ferri Carbonat., . gr. 

Ext. Gentianae, . . gr. xxx. 
M. Ft. pil. no. xxv. Sig. — One 
2 or 3 times daily. 



Inflammation. 

Aconite, especially in inflammation of respiratory organs, eruptive fevers, 
and all inflammatory states of high temperature and sthenic reaction. Not 
in adynamic states, or continued fevers, except for hyperpyrexia. May be ad- 
vantageously combined with opium (B.) ; gives most brilliant results in many 
forms (R.). Always indicated in early stages of simple inflammatory fevers, 
in all inflammation of serous membranes, pneumonia, tonsillitis, acute rheu- 
matism, erysipelas, etc. Is especially adapted to the uses for which bleeding 
was formerly employed (P.)- Arnica is antipyretic, large doses (^ss of tinct.) 
in sthenic, small doses (TUx) in asthenic inflammation (B.) ; in inflammation 
of serous membranes it has given good results (P.). Belladonna, in many 
forms no remedy more useful, notably scarlet fever, erysipelas, low fevers. 
Inflammation of eyes, boils, carbuncles, etc., by atropine externally, bella- 
donna internally. When much fever, may be combined with aconite (B.) ; 
both locally and internally in inflammation of the eye ; is effectual in inflam- 
mation which threatens to end in abscess (R.). In erysipelas, inflammatory 
sore throat, encephalitis, gouty and rheumatic inflammation, cystitis, pneu- 
monia, etc. (P.). Gelsemium, especially inflammations of lungs and pleurae, 
and in pneumonia (ntv-x of fl. extr. every two hours) (B.). In acute stage 
of acute gonorrhoea is valuable (P.). Bryonia, exceedingly valuable in 
pleurisy and other serous inflammations, especially pericarditis. After the 
aconite stage (P.). Veratrum Viride, when much delirium and arterial ex- 
citement, useful at beginning only (B.). In pneumonia, Veratrine is most 
valuable, also in acute rheumatism and generally as an antipyretic (P.). Tar- 
tar Emetic, in frequent minute doses, gr. T 2 g, renders incontestable service 
(B.). In pneumonia, tonsillitis, pleurisy, bronchitis, and other inflammatory 
affections (R.). Pulsatilla, in acute and subacute inflammations with muco- 
purulent discharges, especially of eyes, ears, and nasal passages (P.) ; also 
with aconite in epididymitis (Pf.). Mercury, in acute glandular inflammation 
of throat and neck, in ileo-colitis, iritis, syphilitic inflammations of serous 



646 INFLAMMATION. 

membranes, laryngitis (B., R.). Silver Alitrate, locally in strong solution, 
gr. clx to gj of distilled water, painted over surface and beyond, after thorough 
cleansing and drying ; no agent so safe, powerful or efficacious in subduing 
external inflammation (Higginbotham). A strong solution in* nitrous ether 
is a most efficient application to check inflammation in superficial parts, as 
boils, felons, orchitis, synovitis, erysipelas, erythema, eczema, etc. (B.). Iodine, 
as liniment in vicinity of local inflammation to produce vesication (R.). 
Sulphides, especially that of calcium (doses ^ gr.) appear often to arrest sup- 
puration. After formation of pus they hasten maturation and circumscribe 
inflammation. In boils, abscesses, and deep-seated suppuration, they improve 
the condition and promote healing (R.). Antipyrine, Kairine, and other 
antipyretics. See under the title Fever. Alkalies, especially ammonium 
and potassium salts, are very valuable in the stage of exudation (B.). As- 
tringents, locally in inflammations of mucous membranes (R.). Lead, the 
liquor plumbi subacetatis dilutus as a soothing and astringent application to 
inflamed and erysipelatous surfaces (Wa.) ; to eczema and other inflammatory 
diseases of the skin (Pf.). For Lead water and Opium formulae see page 
493. Digitalis, the German antipyretic, is especially useful in pneumonia, 
bronchitis, rheumatic fever and scarlet fever (B.). Aconite safer and better 
(R.); locally and internally is useful in inflammations, especially those of 
joints, of breast, erysipelatous and varicose : a fomentation of a teasp. of the 
dried leaves in half a pint of boiling water, or gj of tincture to the same 
quantity of water, applied by flannels to the part, will quickly subdue (Fair- 
bank). Quinine, in peritonitis (Tr.). It is indicated in most acute forms, 
unless objections occur (P.). Has power to arrest inflammation in formative 
stage. With morphine and in full doses (gr. xv-xx) may suppress many 
forms (B.). Chloral, excellent when temperature is high, much delirium; 
gr. v every 3 hours (B.). Opium, is important in most inflammations, but 
especially those of serous membranes ; a full dose (gr. ^ of morphine) at 
first, smaller doses after. Is especially curative in inflammation of intestines 
and peritoneum, and of cerebro-spinal meningitis, arachnitis, etc. (B., R.). 
Saline Purgatives, valuable as part of the denutrition treatment, and to di* 
minish arterial tension (B.). Salicylic Acid is antipyretic, especially in septi- 
cemic inflammation, and acute rheumatism, erysipelas, pneumonia (B.). Sali- 
cylate of sodium more soluble (R.)« Colchicum often exercises a happy in- 
fluence over certain acute inflammations, as bronchitis, conjunctivitis, etc., 
especially if occurring in gouty subjects (P.). Cocaine, locally in commenc- 
ing inflammations of mucous surfaces, to constrict the bloodvessels of the 
part (R.)« Pilocarpus gives good results in the exudative stage of pleuritis, 
iritis, keratitis, etc. (B.). Cold, by ice in bags, or cold water, a very useful 
agent. Heat, by hot water, fomentations, etc., often much better. Ice, in 
small pieces in a bladder applied to inflamed part (R.). Water, cold and hot 
baths and packing very useful in all inflammations (B.). Alcohol is constantly 
prescribed, and is of value in low states, if symptoms after its administration 
are ameliorated (B.). [See Fever.] Poultices, useful in many inflammatory 
states, but often abused (B.). To check formation of pus and assist in matu- 
ration (R.). Venesection, when puJse hard, strong, full and frequent, a pleth- 
oric state of the system and great intensity of morbid action ; if required the 
earlier it is done the better (Gross). Leeches very useful in many forms where 
sthenic reaction and plethora. Value of blood-letting probably due to de- 
rivative and counter-irritant effect (B.) : a remedy of great power for good or 
evil, now much neglected (Wa.). Local bleeding by leeches, cups, scarifica- 
tion, etc., should generally be preceded by some form of general depletion 



INFLUENZA. 



647 



(Gross). Aliment, when no inflammation of digestive tract, use milk and 
beef-tea alternately every 3 hours. No starches or fats. In intestinal inflam- 
mation, milk, eggs, animal broths, oysters, fish, but must be used -with great 
caution. Skim-milk treatment (B.). Cod-liver oil in many chronic inflam- 
mations, as of heart, lungs, kidneys, etc. (R.). [Compare the various titles, 
as Bronchitis, Pleuritis, etc., also the list of Antiphlogistics, on page 422.] 



Prescriptions. 



b. 



Tinct. Aconiti, . . . gj. 

Tinct. Belladon., . . ^ij. 

M. Sig. — Three or four drops in 

water every hour. (B.) 



R . Ammonii Chloridi, . . ^v. 

Acidi Acetici, 

Alcoholis, aa Tx. 

Aquae, . . q. s. ad gx. 

M. et fiat lotio. Evaporating and 
discutient lotion. 

[See pages 493 and 494 for Lotion and Liniment formulae.] 



R . Ant. et Pot. Tart., 


gr. ijss. 


Magnesii Sulph., 


3* 


Morphinae Sulph., 


g r -JK- 


Ac. Sulph. Aromat., 


3 SS - 


Tinct. Verat. Virid., 


3J SS - 


Syr. Zingiberis, 


■ P* 


Aquae Destill., 


zx. 


M. Sig. — Tablesp. every 2, 4, or 


6 hours. Antimonial and Saline Mix- 


ture. 


( Gross. ) 



Influenza. 

Sulphurous Acid, by fumigation or inhalation, a few drops on boiling water 
or as a spray, often controls (R.). Tartar E?netic has been recommended 
strongly, but is too depressant (Wa.). Quinine has been used beneficially 
throughout the disease, especially after the acute stage, for neuralgic pains 
( Wa.). Ammonium, the liquor ammonii acetatis, combined with nitric or 
chloric ether, is often of great service (Wa.). Sanguinaria, used with 
much benefit (Wa.). Cimicifuga has been given with much success (R.). 
Spiritus Etheris Nitrosi, in doses of £j-jss, in any convenient vehicle, is 
a popular and efficacious remedy (Wa.). Cocaine, a 4 per cent, solution 
snuffed up nostrils or applied by spray-producer, very efficacious in the early 
stage (R.)- Cubebs, gss or £j doses of the tincture in ^-glass of linseed 
tea thrice daily, for the subsequent cough, often curing like a charm (R.). 
Opium, best avoided in early stage, but later for the cough, with ipecac, 
gives great ease. Dover's powder, with nitre and lobelia is a good form 
(Wa.). Potassium Nitrate, nitre largely diluted, as lemonade, ^j-ij in the 
course of the day, proves highly useful (Wa.). Turkish Baths have been 
employed with marked advantage (Wa.). Hot Fomentations, for headache 
(R.). Benzoin, the compound tincture, ^ss-j, inhaled from a pint of hot 
water frequently (Da Costa). [Compare Bronchitis, Catarrh, Hay- 
Fever.] 

Prescriptions. 



R. Ext. Ipecac. FL, . . gij. 

Tinct. Opii Deod., . . giv. 

Tinct. Aconiti, . . 3). 

M. Sig. — Five to ten drops every 
two hours. For the bronchitis. 



R 



. Ext. Cimicifugae FL, . . ^ss. 

Tinct. Opii Deod., . . gj. 

Syr. Tolutani, . . . ^xj. 
M. Sig. — Teasp. every four hours. 



R . Ammonii Chloridi, . . ^jss. 

Morphinae Sulph., . . gr. ij. 

Tinct. Sanguinariae, 

Syr. Ipecac., . . aa ^iv. 

Mist. Glycyrrh. Co., 

Aquae, aa ^jss. 

M. Sig. — Teasp. as required for 
the cough. Each dose has of Morph. 
Sulph. gr. T V 



648 



INSOMNIA. 



Insomnia. 

Chloral, the best hypnotic (gr. xv-xx), quite unrivalled. Cautiously in de- 
lirium tremens, which see (B.). In many forms of sleeplessness (R.); acts 
best in cases which are of purely nervous type (Wa.) ; in combination with 
alcoholic preparations, especially if potassium or sodium bromides are present, 
it is apt to separate to the top as an alcoholate. See ante, page 136. Croton 
Chloral, gj may be given (R.). Potassium Bromide, when from cerebral 
overaction, gr. xv before each meal, and gr. xxx on retiring. Cumulative 
effect (B.). It increases hypnotic effect of hyoscyamus, belladonna, cannabis 
indica, ether and chloroform (R.). Hyoscyamus, an effective substitute for 
opium in children, ^ij-^j of tinct. necessary, and without danger (B.) ; when 
opium disagrees (R.). Belladonna, hypnotic in some morbid states, especially 
those marked by prostration, low arterial tension, contracted pupils. Atropine, 
gr. t \-q to -fa (B.). Paraldehyde, in doses of rrtxxx-1, is an efficient hypnotic 
with little or no depressing action on the heart (R.). Ignatia, for sleepless- 
ness from nervous erethism, better than morphine (Pf.). Gelsemium, in 
simple wakefulness (B.); and in that of drunkards, mania and over-excite- 
ment (R.). Coffee, insomnia from lowering of nervous power, and chronic 
alcoholism (P.). Opium, Morphine the best form, gr. */£-gr. ss, when pain 
(B.). Codeine and Narceine, also hypnotic, should be given to act at natural 
time for sleeping (R.). Sumbul, ttlxxx-xI of tinct. with a little chloric ether, 
very efficient in the insomnia of chronic alcoholism (P.). Tartar Emetic, 
and opium, very effective when due to cerebral congestion, and when opium 
stimulates (B.). Ether or Chloroform in a full dose (R.). Phosphorus, nutri- 
tion inactive. Insomnia of the aged (B.). Humulus, a hop-pillow effective 
(B., P.) ; tinct. lupulinae, gss-gss, as cerebral sedative (B.). Cocaine has been 
used with some success (Wa,). Chamomilla, try of the tinct. every quarter- 
hour, an excellent sedative for children (A. A. Smith). Cannabin Tannate, 
in 8-grain doses, a good hypnotic (Fronmiiller) ; very inefficient (W.). Can- 
nabis is very uncertain in its action (R.). Alcohol, if from cerebral anaemia, 
a full dose of whiskey or brandy ; or in some a glass of ale or beer answers 
better (B.). Water, a tepid bath just before retiring often effective. When 
head is hot, cold to it, and tepid bath to the body (B.). [Compare Nervous- 
ness; also the List of Hypnotics on page 403.] 

Prescriptions. 



R. Paraldehyde . . . zijss. 
Alcoholis (90 per cent.), . 3JSS. 
Tinct. Vanillae, . . zss. 
Aquae, . . . . % 

Syr. Simplicis, . ad giv. 

M. Sig. — A teasp. or two every 
hour until sleep is obtained. 

( Yvon's Hypnotic Elixir?) 



K . Potassii Bromidi, 

Chloralis Hydrat, 

Tinct. Asafoetidae, 

Syrupi, . 

Aquae, 

M. Sig. — Tablesp. every 2 hours 
until sleep is induced. In the insom- 
nia of hysteria. 




R. Chloralis Hyd., 


• &l 


R. Potassii Bromidi, 


Potassii Brom., 


• 3 n J- 


Chloralis Hydrat., . aa ^ss. 


Tinct. Opii, 


- Eh 


Syr. Pruni Virgin., . . ^j. 


Syr. Aurantii Cort., . 


. guj. 


Aquae, . . q. s. ad ^ij. 


Aquae, . 


ad%i]. 


M. Sig. — Teasp. in a winegl. of 


M. Sig. — Teasp. dose. 


May be 


water. Repeat in one hour if neces- 


repeated if necessary. 


(Kane.) 


sary. 



INTERMITTENT FEVER. 649 



Intermittent Fever. 

Cinchona. Quinine as prophylactic, gr. v-x each morning in black coffee ; 
begin with gr. v, add gr. j each week (R.). In ordinary intermittents give 6 or 
10 grain do^es up to 20 or 30 grains, so as to have it all in 4 or 5 hours before 
the expected paroxysm ; give the sulphate and in solution to get its full action 
(Da Costa). For acute ague, gr. x in sweating stage, and same 5 hours before 
next paroxysm, and gr. x-xv at the septenary periods, until the third has 
passed. In pernicious form, gr. xx-xl are required, by stomach, rectum or 
skin, to secure safety of patient. Best in combination w T ith morphine, and with 
continuous administration of arsenic during intermissions. May be given in 
solution by rectum, or hypodermically (B., R.). Is almost specific in inter- 
mittents when uncomplicated, and of recent origin (Wa.). Chinoidine may 
be used as a substitute for quinine in doses twice as large (B.). Cinchonine, 
Cinchonidine, Quinidine, the sulphates of these alkaloids are scarcely, if at all, 
inferior to quinine as therapeutical agents. (Report of the Madras Commis- 
sion, 1866.) Average dose of each, gr. x (Wa.). Salicylate of Cinchonidine, 
promises well as an antiperiodic (B.). Opium, as morphine, gr. ]/&-%. hypo- 
dermically, not only lessens the chill but aids the action of the antiperi- 
odic; is to be strongly urged (Da Costa) ; is useful in the pernicious variety, 
in combination with quinine (B.). Arsenic, the best remedy next to quinine, 
especially useful in long-standing agues, of quartan type (R.). Useful as 
adjunct to quinine daily, to prevent relapse. Most important in chronic ague, 
with iron; also as prophylactic small doses of Fowler's solution (B.). Capsi- 
cum, the resin of black and red pepper, as adjuvants chiefly (B.) ; promotes 
action of quinine (Pf.). Nux Vomica, has been used with success, but now 
used as adjunct to quinine (B.) ; good in convalescence (P.) ; has antiperi- 
odic virtue not inferior to quinine. Strychnine gr. ? ^, equals gr. j of quininae 
sulphas (Wa.). Hydrastine, stands next after arsenic; same indications as 
quinine (B.) ; in doses of gr. ij-ix is strongly recommended (P.). Pilocarpine, 
gr. y% of the muriate, in the cold stage, is strongly recommended by high 
authority, to excite profuse perspiration and thus lessen the attack (Da Costa). 
Apiol, when prejudice exists against quinine. Gtt. xv during an hour, in 
divided doses, 4 hours before paroxysm (B.); is one of the minor remedies 
which often prove successful in mild cases (Wa.). Salicin, as substitute for 
quinine, but inferior (B.) ; grs. x-lx, in mild cases (P.). Chloroform, to pre- 
vent an impending paroxysm; gj-^ij (?, ?) before the chill, or by inhalation 
(B.). Narcotine, gr. ij-v ter die, is eminently antiperiodic. No drug (except 
quinine) cures intermittents so rapidly and surely, or with more freedom from 
disagreeable effects ( Wa.) ; said to be superior to quinine (R.). Nitric Acid, 
full doses every 4-6 hours (B.). Sodium Chloride, in large doses during the 
apyrexia, gviij-xij, may occasionally prove efficacious (Wa.). Eucalyptus, 
during convalescence (B.) ; has been successfully used in treatment of ague, 
£j-ij of a tincture (Wa.). Carbolic Acid, in 4-grain doses with infusion of 
ginger, cured a series of 8 cases which had resisted quinine (Wa.) ; its value 
established; Ttiss-ij in mint-water; or gr. ^ in ttt,xx of water, hypodermically 
(Tessier) ; combined with iodine is of great value in chronic malaria, and in 
acute cases after quinine has stopped the paroxysm (B.). • Mercury, uncalled 
for in ordinary cases ; but hydrarg. cum creta, quinine and rhubarb of service 
in obstinate intermittents of children in tropical regions (Wa.). Sodium 
Hyposulphite, gr. xv-xx every two hours is said to cure (R.).- Cascarilla, 
Chamomile, Quassia, used (R.). Gentian, is valued chiefly as vehicle (P.). 



650 



INTERMITTENT FEVER. 



Emetics, may cure many cases ; one each morning will assist the action of 
quinine. Ipecacuanha preferred to antimony (R.) ; only at commencement, 
inadmissible if gastric irritation (Wa.). Antimony, at the onset, and continu- 
ously in mild, uncomplicated cases. Tartar Emetic, gr. y£-}4> every 2 hours, 
has been followed by complete cures (Moore). Antipyrine, is useless (Falken- 
heim). R esorcin, and similar agents, have no specific action, merely control- 
ling the pyrexia ( Wa.). Warburg* s Tincture is a remedy of great power, but 
produces such severe diaphoresis as to be dangerous to adynamic subjects 
(Prof. Maclean). Purgatives, in the intermission, before using the antiperi- 
odic, is good practice; podophyllum, colocynth or jalap (Da Costa). Iron is 
valuable in chronic cases ; the system should be thoroughly saturated with it 
(Da C). Ergot \ for the enlarged spleen (Da C). [Compare the title Mala- 
ria ; also the List of Antiperiodics on page 422.] 



Prescriptions. 



R . Quininae Sulph., . . gr. Ixxx. 
Mucil. Acaciae, . . gij. 
Syr. Eriodyctii Aromat. 

(Parke, Davis & Co.), vel 
Mist. Glycyrrhizae Co., vel 
Syr. Zingiberis, q. s. ad ^ij. 
M. Fiat emulsio. Sig. — A teasp. 
contains gr. v of Quin. Sulph. Sus- 
pension of the quinine without dis- 
solving it makes the bitter taste less 
perceptible (Squire), and the Syrup of 
Verba Santa covers the taste well. 

(Potter.) 



R. Ac. Carbolici, • . gj. 

Tinct. Iodi Comp., . giij. 

M. Sig. — 4 drops every 4 hours in 
sufficient water. (B.) 



R . Massae Ferri Carb., 
Ac. Arseniosi, 
M. Ft. pil. no. xx. Sig.- 
daily in chronic ague. 



• g r - J; 

-One thrice 
(B.) 



R . Quininae Sulphat., . gr. Ixxx. 

Ac. Sulph. Diluti, . q. s. 

Spt. Etheris Nitrosi, . %iv. 

Syr. Tolu, Aquae, ad Jij. 
M. Sig. — A teasp. contains gr. v of 
Quin. Sulph. {Da Costa.) 



R . Quininae Sulph., . . gr, xl. 

Ferri Sulph. Exsic., . gr. xx. 

Ac. Arseniosi, . . gr. j. 
M. Ft. pil. no. xx. Sig.— One thrice 
daily. (B.) 



R. Quininae Sulphat., . gj. 
Ac. Hydrobrom. Dil., . gij. 
Aquae, . . . gxiv. 
M. Sig. — A teasp. contains gr. iijj^ 
of Quin. Sulph. The acid directed pre- 
vents the unpleasant cerebral action. 

(B.) 



3 SS - 

ZSS. 



R. Quininae Sulph., 

Pulv. Acaciae, 

Syr. Zingiberis, . IJiv. 

M. Sig. — A teasp. contains one 
grain of Quin. Sulph. A good form- 
ula for children, the quinine being 
suspended, not dissolved. 



R . Quininae Sulph., . 

Capsici, 

( )pii Pulveris, 
M. Ft. pil. no. xxx. 
five pills as required. 



. gr. xxx. 

. gr. xv. 

. gr. iij. 

Sig. — One to 

(Piffard.) 



INTERTRIGO — IRRITABILITY. 65 I 



Intertrigo. 

Bismuth, nitrate or carbonate, as dusting powder (R., B.). Tannin, the 
glycerite, excellent (R., P.)- Camphor, added to dusting powders, to allay 
heat and itching (R.). Lime water, to obviate irritating urine (R.). Soap, free 
ablution with, when caused by acid secretions; use greasy applications after- 
wards (R.). Boracic Acid, as ointment, ^jss to gj of vaseline, a very useful 
application (Wa.). Glycerin, with tragacanth, etc. [See under Herpes for 
formula.] Calomel as ointment, gj to gj, is especially useful (Wa.). Zinc 
Carbonate. Calamine is a good dusting powder; so also is the oxide, or 
fuller's earth. 

Intestinal Obstruction. 

Opium, even y^ -grain doses every 4 hours, for 2-4 days, arrests dangerous 
symptoms, and brings a painless purgation (Brinton, P.). Morphine, endermi- 
cally (Wa.). Belladonna, often successfully employed (P.) : gr. %-% every 
few hours, when from want of tone and partial spasm (Tr.). Strychnine, occa- 
sionally beneficial; cautiously in acute cases (Wa.). Mercury. A full dose 
of calomel, followed in a few hours by castor oil, and a turpentine enema, affords 
relief (Wa.). Caffeine acts upon the muscular tissue and often proves of the 
utmost value (Wa.). Senna, the infusion, in doses of Jj-iij, forms an efficient 
purgative (Wa.). Purgation to be refrained from (Brinton). Enemata, 
insufflation and surgical measures are often necessary. [Compare Constipa- 
tion, Intussusception, Hernia.] 

Intussusception. 

Belladonna, gr. iv of extract in an enema, has been successfully used (Wa.). 
Opium, in full doses carried to narcotism, has been successful in many cases 
(Wa.); must be used freely to prevent inflammation (Macleod). Effervescent 
Enemata, have been employed with success (B.). Tobacco Enema, may over- 
come, and has proved exceedingly effective, but is dangerous. Produces most 
depressing nausea. Not safe to use more than giv of the infusion ; ^j-Oj (B.). 
Inflation of intestines with air {Hippocrates) seems a most reasonable mechan- 
ical remedy. Irrigation by hydrostatic pressure is resorted to with success. 
Requires care and gentleness (B.). Hot water (Wa.); ox-gall, gr. x-xxx in 
the solution used, is especially efficient in cases arising from partial paresis of 
the bowels (Hawkins). The knee-chest position is the best during irrigation 
or inflation. [Compare Hernia, Typhlitis.] 

Irritability. 

Ignatia, in small doses diminishes, in large doses excites irritability of 
cerebro-spinal axis. The remedy par excellence (Pf.). Chloral, gr. v, 2 or 3 
times a day, in irritability with nervousness and restlessness (R.). Chamomilla, 
is an excellent sedative for children, in doses of tti j of the tincture every ^ 
hour (A. A. Smith). Opium, gives calm to the nervous system if used in 
medium doses. Strychnine, in functional irritability of the nervous system. 
[Compare Insomnia, Nervousness.] 



6$ 2 IRITIS — JAUNDICE. 

Iritis. 

Belladonna, locally and internally (R.) ; Tn,v every 3 hours, also lotion (^j 
of extract to giv aquae), is of great value (P.). Atropine (solution gr. iv ad 
5j) has a wide field of utility, as mydriatic (B.) ; should never be omitted 
(C.) ; is essential in the treatment of every form, should be applied early in 
the case and persevered in throughout its continuance (Lawson). Merctiry, 
when of syphilitic origin, as it usually is (B.) ; the bichloride is of great ser- 
vice (R.). In plastic iritis of original severity, or in cases aggravated by im- 
proper treatment, mercury is imperative, gr. ij of blue pill twice a day, until 
blue line on gums (C). Duboisine, as substitute for atropine, is more rapid 
for effecting dilatation, less irritating to the conjunctiva, and has less perma- 
nent after-effects (B.). Turpentine, in so-called " rheumatic iritis " is very 
successfully used ; small repeated doses (P.). Opium, when much pain, an 
indispensable adjuvant. Morphine, hypodermically (C). Copaiba, ^ij in 
mucilage, thrice daily, gives excellent results in iritis and sclerotitis, diminish- 
ing pain in 24 to 48 hours, and restoring sight (Hall). Quinine and Iron, 
when the patient is feeble or anaemic. Irritants, or astringents should never 
be employed (C). Surgical. Paracentesis when increased tension. Core- 
lysis when only one or two adjacent adhesions. Iridectomy. Complete func- 
tional rest to the eyes, by atropine and a bandage with compression-pad, an 
absolute necessity during the whole period of treatment (C.). [Compare 
Syphilis.] 

Prescriptions, 

R. Ol. Terebinth., . . . *iij. 
Syr. Acaciae, . . . ^jss. 
Aquae Cinnamomi,. . . 5ss. 



R. Hydr. Chlor. Corr., . . gr. j. 
Potassii Iodidi, . . £j. 

Tinct. Calumbae, . . 5ij. 
Aquae Destil., . . adgv]. 
M. Sig. — A dessertsp. in a wine- 
glass of water, 2 or 3 times daily. 

[Lawson.) 



M. Sig. — A tablesp. 4 or 5 times 
daily. 

R. Extracti Belladon., . . £j. 
Ung. Hydrargyri, . . gvj. 
M. Sig. — For inunction to brow. 



Jaundice. 

Mercury, in attacks with depression, sickness and coated tongue, gr. l /e-}i 
of gray powder taken at onset, and repeated three or four times a day, very 
valuable (R.). As purgative in jaundice from both deficiency and excess of 
bile, singularly enough (B.). Gray powder with ipecac, followed next morn- 
ing by castor oil, is well adapted to the jaundice of infancy and childhood 
(Wa.). Mercurials and podophyllum are better avoided, especially in obstruc- 
tive jaundice, unless very marked indications for them exist (Da Costa). Cel- 
andine, was formerly employed as deobstruent (P.) ; energetically affects the 
liver (Pf.). Hydrastis, useful if continued for some time, in jaundice from 
catarrh of ducts (B.). Arsenic, has been used with success in jaundice from 
catarrh of bile ducts after catarrh of duodenum. Better for jaundice of ma- 
larial origin (B.). Nitro- Hydrochloric Acid, internally, and acid bath to right 
hypochondrium ; temperature of bath 96 , giij-gall. j (B.) ; when jaundice 
depends on torpor of the liver, or is catarrhal in origin (W.) ; during conva- 
lescence, Tn_v-x of the dilute acid in £j of a compound elixir of taraxacum 
before each meal (Da Costa). Quinine, when due to malarial miasm, or when 



JOINT AFFECTIONS. 653 

periodic (B.). Euonymin,2,n hepatic stimulant of especial power (B.). Po- 
dophyllum, in catarrhal and malarial jaundice (B.) ; when stools exhibit no 
trace of bile, one dose has cured (Wa.). Best avoided, unless markedly in- 
dicated (Da C). Sodium Phosphate, no remedy superior in jaundice from 
catarrh of gall-ducts; £j doses every four hours for adults; gr. x-Qj for chil- 
dren (B.). Manganese, in jaundice from malarial origin, or catarrh of biliary 
passages (B.). Aloes, for simple jaundice of an atonic kind (B.) ; when hypo- 
chondriasis (P.). Rhubarb, for above maladies in children; white or clay- 
colored pasty stools; skin jaundiced (B.). Saline Purgatives to depurate the 
upper bowel, as Rochelle salt ; with alkaline baths, diaphoretics and diuretics 
(Da C). Ammonium Iodide, gr. j-iij in water every 2 or 3 hours in catarrh 
of bile ducts and jaundice. Also Ammonium Chloride, with fluid extract of 
taraxacum (B.). The Chloride, in 20-grain doses every 4 hours, produces a 
decided change (Wa.). Stillingia, relieves jaundice and torpid liver follow- 
ing intermittent fever (B.). Dulcamara, employed with advantage (P.). Iris, 
in malarial jaundice and that from duodenal catarrh (B.). Alkaline Mineral 
Waters, especially in catarrh of duodenum or bile-ducts (B.). Potassium 
Salts. The Chlorate in chronic or asthenic jaundice. The Sulphate the most 
useful saline purgative in jaundice (Wa.). Aliment. No starches or fats. 
Milk, eggs, oysters, beef-broth, broiled or raw beefsteak, or whitefish (B.). 
Plenty of green vegetables at each meal, use cold water freely, avoid all high 
seasoning in food, and all liquors. [Compare Hepatic Cirrhosis, Hepatic 
Diseases, Calculi.] 



Joint Affections. 

Aconite^ for pains in inflamed joints (R.); the liniment locally in chronic 
arthritic swellings ( Wa.). Mercury, the oleate in chronic inflammation of the 
knee (R.)- Diluted Ung. Hydrarg. Ammoniat. £j to giv at first, then 3J to 
S» by g en tle friction 2 or 3 times daily, in chronic articular inflammations by 
far the best application (P.). Rhus Toxicodendron, internally and as lotion, 
is invaluable for subacute stiffness and aching of joints after acute rheumatic 
fever (P.). Iodine, giij-vj ad glycerini ^iij, aq. destil. ^iv, in numerous ob- 
stinate cases of joint affections consequent on rheumatism (Wa.). Ferric 
Iodide, with Iodine locally, in scrofulous affections of the bones and joints 
(Wa.). Iodoform has been used with satisfactory results in scrofulous affec- 
tions of the joints and bones by many continental authorities (Wa.). Arsenic, 
often serviceable in rheumatoid arthritis and nodosity of joints. Large doses 
continued necessary (R.). Alcohol, and water, equal parts, an excellent evapo- 
rating lotion (B.). Silver Nitrate, a strong solution in nitrous ether is the 
most efficient application to check inflammation in small joints if applied early 
to adjacent vascular parts (B.). Cod-liver Oil, in strumous subjects (R.j : the 
remedy on which most reliance may be placed in scrofulous joint affections 
( Wa.). Cold Douche, Galvanism, Turkish Baths, for stiff joints (R.). Digi- 
talis, as fomentation, £j of tincture to O^ boiling water, applied on flannel, 
has proved very efficient in acute inflammations of the joints (Fairbank). 
Turpentine, the liniment a serviceable application in chronic enlargement of 
the joints (Wa.). Sulphuric Acid, as irritant ointment, 3] of acid to gj of 
lard, very beneficial in chronic diseases of joints ( Wa.). [Compare Bursitis, 
Coxalgia, Gout, Rheumatic Arthritis, Rheumatism, Synovitis.] 



654 



KERATITIS — LABOR. 



Keratitis, 



Atropine, renders great service by contracting vessels (B.). Atropine by 
instillation, with enforced disuse, and a protective bandage, should be re- 
garded as measures of course (C). Mercuric and ferric perchlorides, with 
cod-liver oil, will accomplish all that medicine can do for interstitial keratitis 
in syphilitic subjects ( C). Calcium Sulphide, proves most useful in doses of gr. 
t X q to \, thrice daily, in sugar-of-milk trituration (Snell). Arsenic, Potassium 
Iodide ox Bromide, Iron or Quinine, for constitutional effects in vascular kera- 
titis. Also counter-irritation by iodine painted on the temples till soreness 
(C. ). Ferric Perchloride, successfully employed in panniform keratitis. A 
large drop of the solution dropped from a quill every second or third day 
(Wa.). Eserine, lowers intra-ocular tension (B.). Astringents or Irritants 
(as alcohol in any fonn, zinc sulphate, silver nitrate, etc.), are entirely inad- 
missible (C.). Iridectomy is often beneficial in severe vascular keratitis (C). 
Pressure- Bandage, in severe suppurative forms, limits extent. Water, cold 
when inflammatory symptoms marked: hot (90-100 F.) in non-inflammatory 
form, to excite inflammatory reaction; should be discontinued when marked 
injection. [Compare Corneal Opacities.] 

Prescription, 

Sig. — A teasp. in a winegl. of tepid 
water, to be applied frequently with a 
pledget of lint on the closed lids. In 
phlyctenular keratitis of children. 

( Turnbull.) 



R. Hydrarg. Chlor. Corr., . gr. j 

Ammonii Chloridi, . gr. vj. 

Tinct. Belladonnae, . t ^ij. 

Aquae Destillatae, . . ^viij. 
M. et fiat collyrium. 



Labor. 

E7'got, when uterine inertia, after the first stage passed. Is dangerous if 
any obstacle in front. Danger to child in paralysis of foetal heart (B.). Is 
best given when head has passed the brim of pelvis (Wa.). Ancesthetics, 
in protracted and painful labor; cautiously with primiparae (B.) ; increase the 
risk of post-partum hemorrhage (W.). Chloroform, not to complete anaes- 
thesia, lest uterine action be interrupted. Usually begin when os is dilated 
(Simpson). Chloral, of great value to relieve pain; does not interfere with 
the exhibition of chloroform ; should be given in 15-grain doses every ^-hour 
till effect produced (Wa.); the best of all remedies for rigid, undilatable cer- 
vix, gr. xv every 20 minutes for 3 doses, perhaps a 4th after an hour's interval 
(Playfair.). Ethyl Bromide, a rapid, sure and safe anaesthetic, particularly 
suited to labor cases (Levis). Opium, facilitates dilatation, promotes expulsive 
power of uterus, lessens hemorrhage, stimulates longitudinal and oblique fibres 
of the os (Wa.). Cimicifuga, exercises special action, similar to that of ergot ; 
is less dangerous to life of child and soft parts of mother (Wa.) ; for mental 
disturbance and suppressed lochia (K.); as partus accelerator in lieu of ergot, 
also to allay nervous excitement after labor, and to check post-partum hemor- 
rhage (P.). Morphine, for relief of pains and after-pains, or painful compli- 
cations (Wa.). Hypodermically in rigid os and cervix (R.). Belladonna, 
topically to uterus, of great service in long-protracted labors from rigidity of 
os and cervix (H.). Gelsemium, quiets the "nagging" pains of the first 
stage; requires physiological doses (B.); relaxes spasm in rigidity of the os 
(Wa.). Quinine, to strengthen uterine contractions; used by many in place 
of ergot (R.). Cannabis Indica, the tincture gtt. xxx, as stimulant to uterine 



LACTATION — LARYNGISMUS STRIDULUS. 655 

contractions, more prompt, less lasting, than ergot (Wa.). Ipecacuanha, after 
delivery ; to promote natural functions (R.). Cotton-root, as excitant of uterine 
contractions may be more energetic than ergot (P.). Althcea, the decoction, 
as vaginal injection in difficult labor (P.)- Sodium Borate, excites activity of 
the uterus, and is well employed in tedious labor, where there is deficiency of 
uterine contraction (Rigby). Amyl Nitrite, has acted admirably in a case of 
hour-glass contraction of the uterus ; seems to antagonize the action of ergot 
(Barnes). Oil of Eucalyptus is very valuable in effecting antiseptic midwifery 
(Wa.). Mercury. The bichloride, gr. vijss to a quart of hot water gives a 
TGlio s °l 1J tiori, probably the best of all antiseptics for this purpose. [Compare 
Abortion, After-pains, False Pains, Hemorrhage Post-partum, Lac- 
tation, Puerperal Convulsions, — Mania, — Fever, — Disorders.] 

Lactation. 

Belladonna, internally or externally or both in excessive lactation (R.). 
Atropine gr. iv-gj aquae rosae on lint around the breast to arrest secretion of 
milk. Remove when fauces become dry and pupils dilated (B.). Camphor, 
locally to arrest the secretion ; a saturated solution in olive oil or glycerin, is 
more efficient than belladonna (Wa.). Potassium Iodide, in 25 to 30-grain doses 
internally, for the same purpose, is very effectual (Rousset). Calcium Phos- 
phate and Hypophosphite, in debility from over-lactation (R., Wa.). Ammo- 
nium Chloride, for the intercostal neuralgia of suckling women ; gr. x-xx, 
every 3 or 4 hours (Wa.). Quinine, Tannin, are used to arrest the secretion 
(R.). Alcohol, as beer or porter, often useful in excessive lactation— not 
always (R.). [Compare Abscess, Agalactia, Mastitis, Nipples.] 

Prescription for Milk-Fever. 
R. Tinct. Aconiti, . . tti. xx. 



Antim. et Potass. Tart., . gr. lj, 
Spt. Etheris Nitrosi, 
Syr. Simplicis, . aa 3j. 
Aquae Aurantii Flor., . ^ij. 
M. 



Sig. — A teaspoonful in a wine- 
glassful of sweetened water, every 
two hours. 

(Fordyce Barker.) 



Laryngismus Stridulus. 

Aconite, checks the spasm and relieves the croupous breathing (R.). Bella- 
donna, promises to be of value (Wa.). Atropine, gr. yi^ in a goblet of water 
(60 doses), of which give a teasp. every hour or ^-hour, will give prompt 
relief (A. A. Smith). Bromides, when uncomplicated except with convulsions 
(R.). Full doses will suspend an attack, and moderate doses steadily contin- 
ued, will prevent recurrence (B.). Ipecacuanha, an emetic dose to cut short 
an attack (B.). Lobelia, has been employed (R.). Chloroform, quickly cures 
the paroxysm, a few drops on a handkerchief sufficient (B.) ; may often be 
used with advantage (W.). Nitroglycerin, will speedily allay the spasm (B.). 
Chloral, gr. v-xv to prevent or arrest (B.). Quinine, given between attacks 
to prevent (B.); a most valuable remedy, but in small, repeated doses (P.). 
Emetics. Tartar emetic; mercuric sulphate (gr. iij-v) safer and better (B.j. 
Conium, is valuable, carried to a point of physiological effect (B.). Water, 
wet pack to neck (B.) ; cold sponging twice or thrice daily more successful 
than anything else, with out-of-door exercise. Cautiously if hoarse voice indi- 
cates laryngitis (R.) [Compare Croup, Laryngitis.] 



656 



R . Potassii Bromidi, 
Chloralis Hydrat., 
Syr. Aurantii Cort., 
Aq. Menthae Viridis, . 
M. Sig. — A teasp. every 



LARYNGITIS. 


Prescriptions. 


. aft. 


R. 

Syr. Hypophosphitum 
Ferro, . 


aa §j. 
hour. 


Sig. — A dessertsp. to 
thrice daily. 



cum 

• gvj. 

a tablesp. 



Laryngitis, Acute Catarrhal. 

Aconite, very valuable (R.); especially indicated in inflammatory states of 
respiratory parts ; gtt. ss-j every half-hour till an impression is made on the 
fever, then every hour or two (B.). Antimony. Tartar emetic, gr. -£$, a very 
excellent remedy internally ; larger doses in oedematous laryngitis, gr. y 1 ^ with 
gr. iij of Dover's powder every 2 or 3 hours (Da Costa). Iodine, inhaled; 
also as counter-irritant painted over neck (B.). Morphine, small doses to allay 
cough (A.). Sulphurous Acid Spray, is vaunted (Wa.). Leeches to throat 
are valuable auxiliaries to general treatment in sthenic cases ; or cupping at 
the nape of the neck (Wa.). Rumex, has selective action on the laryngeal 
mucous membrane. See page 335. Zinc or Copper Sulphates, as emetics, in 
large quantities of warm water, where oedema slight (A.) ; a solution of zinc 
sulphate, gr. xx to ^j on sponge to larynx with aid of the laryngoscope if pos- 
sible to use it (DaC). Scarification, by Mackenzie's laryngeal lancet, of great 
service in the oedematous form (Da C). A Purgative and Diaphoretic, with 
mucilaginous drinks, if given at the start may be sufficient (Da C). Iron, 
Monsel's solution, 1 part to 2 or 3 of water and glycerin, an excellent local 
application ( Da C). Heat, by poultices or fomentations (A.). Hot-water stupes 
may succeed ( Wa.). Inhalations of hot steam, with benzoin, the comp. tinct. 
gtt. x-xv to gj, with gtt. x tinct. opii, or hops, or conium, of great service (Da 
C). Tracheotomy ought not to be delayed, if inhalations, leeches, and fomen- 
tations fail (A., Wa.) : is especially indicated in sudden attacks of oedematous 
laryngitis, as those occurring in Bright's disease (Da C). Ice, steadily applied in 
bags over the larynx, if tracheotomy refused, has succeeded in bad cases. Small 
pieces may be slowly swallowed (Da C). [For Croupous Laryngitis, see Croup, 
Membranous ; for Spasmodic Laryngitis, see Croup, Catarrhal ; for CEde- 
matous Laryngitis, see Glottis, (Edema. Compare also Laryngismus Stridu- 
lus, Pharyngitis.] 

Laryngitis, Chronic. 

Iodine, painted over neck as a counter-irritant, and inhalation of its vapor 
(B.). Sulphur. Sulphurous acid as spray in syphilitic or tubercular laryn- 
gitis, or a solution of sodium sulphite (^j to the oz.) in water (B.) ; by inha- 
lation, spray, or fumigation (R.). Carbolic Acid, where long-standing hyper- 
aemia with diminished secretion, ^j-ij to the ^ of glycerin is a most successful 
application (Morell Mackenzie). Silver Nitrate, powdered or in solution to 
chronically inflamed larynx, as in phthisis (R.) ; a solution of gr. x or xx ad 
3J, applied with a brush by the aid of the laryngoscopic mirror ( W.). Form- 
erly much used, but is objectionable (B.). Should be used with great caution, 
and only when a particular point can be seen for it with the laryngoscope 
(Da C). Ferric Perchloride, solution gr. lx-cxx ad gj glycerini as local 
application (A.). Zinc Chloride, gr. xx-xxx ad ^j, in glycerin. Alternation 
of topical applications, of great value (A.). Copper Sulphate, gr. xx to ^j of 
water, locally twice a week (Da C). Bismuth, the sub-nitrate by insufflation, 
is highly recommended in the worst forms of laryngitis, even in that accom- 



LARYNGOTOMY LEUCORRHCEA. 657 

panying phthisis (Tr., Wa.). Guaiacum, as lozenges, very useful in mucous 
laryngitis (A.). Althcea, as pectoral lozenges to relieve laryngeal irritation 
(P.). Cubebs, the berries chewed are very efficient in relaxation of the larynx 
following a cold or long speaking (Wa.). Cocaine, a 20 per cent, solution of 
the hydrochlorate by spray, mop, or brush, is very efficient in many laryngeal 
affections (Prosser James). Benzoin, in strumous laryngitis ( Wa.) ; in chronic, 
benzoin on hot coals, or inhaled from boiling water, of great service (Tr.): 
Tannin, in chronic catarrh and ulcerations, a solution (gr. x-^j-giv) applied 
by hand-ball or steam atomizer (B., A.). Inhalations, or spray, of the best 
agents very grateful (B.) ; air loaded with vapors of ammonium muriate by 
inhaler, 'said to be used successfully (W.); vapors from boiling tar, turpentine, 
etc., placed on hot water, or better by steam atomizer (Da C.) ; chloroform, 
hops, benzoin, etc., by atomization (Walker). Insufflation, substances to be in 
small quantity, mixed with bland powder (B.). Functional Rest of voice often 
requisite, especially in phthisical and syphilitic laryngeal ulceration (A.). 
Chronic Laryngitis includes many disorders of the larynx, which of late years 
have been differentiated, as — thickened vocal cords (chronic laryngitis proper), 
laryngeal ulcers, polypi, cysts, cauliflower growths, tubercular and syphilitic 
laryngitis, etc., in all the voice being similarly affected. Dysphagia, as a 
concomitant symptom, is constantly indicative of tubercular laryngitis (Da 
Costa). [Compare Cough, Phthisis, Syphilis, Dysphagia.] 

Laryngotomy. 

Laryngotomy is more quickly and easily performed on the adult than trache- 
otomy, being further from the lungs and less dangerous. It is usually directed 
to be performed by cutting longitudinally through the skin, then horizontally 
through the crico-thyroid membrane, which may be felt as a soft depression, 
an inch below the pomum Adami. In urgent cases, however, Prof. Wood 
recommends a narrow-bladed knife to be passed horizontally through both 
skin and membrane at once, and then to enlarge the opening laterally to the 
required extent. The advantage of having a horizontal incision in the skin is 
the greater openness of the wound when the patient throws up his head under 
a sense of dyspnoea (D.). In Laryngo-Tracheoto?ny, the deep incision is car- 
ried downwards from the crico-thyroid membrane, through the cricoid carti- 
lage and one or two of the upper rings of the trachea (CI.). 

Leucocythsemia. 

Alkaline Hypophosphites, have been used with more or less benefit (Wa.). 
Digitalis, in young subjects (B.). Nitro-muriatic Bath, should not be neg- 
lected, with tonics and nutrients (A.). Iron, is of little value (B.) ; large 
doses may do good in early stage, with careful diet, and Ergot to contract the 
spleen (Da Costa). Phosphorus, gr. -^ increased to gr. -J^, has proved suc- 
cessful in several cases ( Wa.). Arsenic, in as full doses as can be borne, may 
be of service though hitherto ineffectual (Gowers). Galvanization of the 
spleen causes improvement of the blood, increasing the number of its red cor- 
puscles (Gowers) ; is curative in uncomplicated cases (B.). 

Leucorrhcea. 

Hydrastis, the fluid extract, undiluted topically, quickly improves in uterine 
and vaginal leucorrhcea (B.). Pulsatilla, 5-drop doses ter die for a few 

55 



658 LICHEN. 

weeks ; also a teasp. in a pint of cold or tepid water, as vaginal enema daily, 
when pain in loins, depression of spirits, loss of appetite, etc. (P.). Silver 
Nitrate, in solution locally, also tampon saturated with 3J each of alum and 
bismuth, when leucorrhcea due to granular vaginitis (Parvin). Balsam of 
Peru and Tolu, internally (P;)» Glycerin, \s largely prescribed for vaginal 
leucorrhcea, and for erosions and ulcerations of the cervix uteri (B.) ; the 
best vehicle for other agents (E.). Borax, gj to Oj water as vaginal wash for 
the leucorrhcea of pregnancy (Parvin). Cimicifuga, is said to be useful (P.). 
Copaiba, has been used with success (P.). Cocculus Indicus, when sero-puru- 
lent discharge, pain in lumbar region (P.). Carbolic Acid, diluted, as injec- 
tion (B.) ; for vaginal leucorrhcea (R.). Bismuth, with mucilage, as injection; 
or with cocoa-butter as suppository (B.). Copper Sulphate, in solution, as 
injection (R.). Tannic Acid, in chronic cases serviceable as injection, gss of 
tannic acid in §viij of claret wine (B .). If os ulcerated, a suppository of 
tannin and cocoa-butter to mouth of uterus (R.). Iodo-Tannin, an excellent 
application, gj of iodine to §j of tannic acid, a sufficient quantity to be packed 
dry around the cervix (B.). Alum and Borax, makes a useful injection in 
vaginal leucorrhcea (R. ). Belladonna, with tannin as bolus where neuralgia 
or ulceration of os. When disease due to over-secretion of mucous glands 
about the os, and much pain present, inject sodii bicarbonas, gj ; tinctura 
belladonnae, ^ij ; aquae, Oj (R.). Potassium or Sodium Bicarbonate, gj to Oj 
aquae as injection, especially when discharge alkaline and copious (R.). Pa- 
reira, Uva Ursi, successfully used (P.). Siimbul, recommended in atonic 
form (P.). Myrrh, with iron or aloes, beneficial (P.). Ergot, said to be useful 
in some cases (R.). Potassium Permanga?iate, has no special advantage ; 
is used in solution (gr. ij-§j) (B.). Potassium Chlorate, gj to Oj of water 
as injection in simple cases (Parvin). Iron, the iodide, internally and exter- 
nally has proved serviceable ; the mistura ferri composita, when anaemia and 
general debility (Wa.). The styptic preparations, locally (B.). Phosphates, 
for the cachexia (B.). The calcium phosphate, gr. j-ij several times daily, 
of great value in checking profuse discharge (Wa.). Injections, water at 6o° 
F. to prevent recurrence (R.). Hot water injections best tonic to pelvic ves- 
sels: to relieve venous congestion use with elevated hips (E.)." [Compare 
Endometritis, Uterine Ulceration, Vaginitis.] 

Prescriptions. 
R. Aluminis, . . . 5£j. R . Liq. Plumbi Subacet., . ?jss. 

Ac. Carbolici, . . . ^ss. 
M. Sig. — One-fourth to be added 
to a pint of water and used as an in- 
jection. 

Lichen. 

Aconite, sometimes useful (R.). Mercury, calomel and nitrate of mercury 
oint. mixed (also tar oint. added), in patches of obstinate lichen (R.). Silver 
Nitrate, the nitrous ether solution painted every day or two over patch (R.). 
Baths, warm, or of sulphides (R.) ; sponging with alkaline lotions, diluted 
lead-water, fluid extract of grindelia well diluted, or solution of copper sul- 
phate, gr. x to the |j, in miliaria, or prickly heat (lichen tropicus) ; with dust- 
ing powders of lycopodium,zinc oxide or starch, singly or combined (Hughes). 
Potassium Citrate, or some other refrigerant diuretic, and light, unstimulating 
food (Da Costa). [Compare Eczema.] 



. Aluminis, 


• Eh 


Zinci Sulph., . 


• 3 SS - 


Sodii Boratis, . 


• gr- iv. 


Aq. Rosae, 


. gviij. 


M. Sig. — Injection. 


(B.) 



LITHJEM1A LUMBAGO. 659 

Lithaemia. 

Lithium Salts, especially the citrate, gr. xx thrice daily, is very efficient 
(Da Costa) ; the carbonate invaluable (Wa.). Arsenic, in small doses, is also 
useful (Da C). Nitric Acid, 10-minim doses of the dilute acid in half-glass 
of water thrice daily, with an occasional dose of pil. rhei compos, at bedtime, 
is the most efficient treatment for the class of patients who will not diet them- 
selves (Hughes). Purgatives, especially alkaline mineral waters, to clear the 
portal system (Da C). Sodium Phosphate, in laxative doses, gj thrice daily, 
gives good results. Alkalies, in biliousness ; also the continued use of al- 
kaline waters rich in potassium salts, for solution of calculi (B.). Acids, hy- 
drochloric often of great service; also lactic acid, when faulty digestion and 
assimilation (Br.). Potassium Permanganate, prevents calculi by converting 
uric acid into urea (B.). Buchu, combined with an alkali, has been a bene- 
ficial remedy (P.). Colchicum, 15111 doses of the wine, twice or thrice daily ; 
is very useful (Wa.). Chimaphila is believed to check the secretion of lithic 
acid (P.). Aliment, farinaceous vegetables and acid fruits are suitable (B.). 
Alcohol in any form is poison to a lithaemic (Da C). Succulent vegetables 
and fruits, occasional abstinence from animal food. High living, alcoholic 
liquors, and sedentary habits are injurious. Milk diet, and frequent draughts 
of pure water also recommended. Removal to a locality where pure soft 
water can be procured, is often curative. [Compare Calculi, Dyspepsia, 
Gout.] 

Locomotor Ataxia. 

Belladonna and Ergot are highly recommended by Brown Sequard (R.). 
Silver Nitrate, when motor disturbances are very marked. Improved I in 
20 (R.) ; gives the best results in doses of gr. % to g r - % thrice daily, with- 
holding it after a few weeks to prevent argyria. The Oxide may be used 
instead of the nitrate, in half-grain doses (Da Costa). Potassium Iodide, 
Corrosive Sublimate, or Chloride of Gold and Sodium, all in full doses, often 
retard the progress of the disease (Da C). Physostigma has proved beneficial 
(R.). Phosphorus, useful, but may not cure (B.). Hyoscyamine, ameliorative, 
gr. -g 1 ^ gradually to gr. T V (B.). Electricity, galvanic, relieves pain ; faradic 
stops wasting of muscles (B.) ; in stage of irritation the constant current (as- 
cending) through spinal column (R.). Water, one of the most efficient 
agents ; friction with a cloth dipped in water of 60-65 F. , a cold com- 
press to head ; 4-8 minute bath of 70-75 gradually lowered to 6o°, then 
shower-bath, frictions (R.). Rest, as complete as possible, must be insisted 
on; with good, nutritious diet, milk being very desirable (Da C). Pilocar- 
pine produces general improvement if given in the incipiency, gr. j to ^j of 
water, of which rrixxx twice daily (B.). Strychnine, gr. ^ in gj of syr. hy- 
pophosphitum, thrice daily, when the system is saturated with silver (Da C). 

Lumbago. 

Cimicifuga, said to be more effectual than any other remedy (R.) ; has 
sometimes wonderful success ; no indications can be given for it ; ^ss-ij of 
fluid extract (B.). Curative (P.). Rhus Toxicodendron,^ subacute muscular 
or tendinous rheumatism, worse at night; completely relieves some cases 
(Pf.). Veratrum Viride, the tincture useful (R.). Aconite in %^\. doses of 
tincture every two hours, with linim. aconiti locally (Wa.). Iodides, if refer- 
able to syphilis, mercury, copper, tin, or lead poisoning (B.). Morphine, hy- 



660 LUNG DISEASES. 

poderm. to relieve pain (B., R.) ; gr. £ with Atropine gr. Jq, hypodermically, 
will frequently cure lumbago in two or three hours (Da C). Capsicum, a 
strong infusion applied on lint, and covered with oiled silk, very efficient in 
recent lumbago (R.); a capsicum plaster is a very efficient application. Po- 
tassium Nitrate, in ten-grain doses hourly or every two hours, when urine 
scanty and high-colored (R.). Belladonna, as plaster, very valuable for per 
sistent lumbago remaining in a small spot (R.). Turpentine, in doses of 
Tn.xx-xxx (carefully, lest strangury and nephritis), of greatest value when the 
bowels regular and urine clear and abundant (Wa.). Ether Spray, externally 
as freezing mixture (R.). Guarana, xv-xl-gr. doses removed severe chronic 
(Rawson). Chloroform Liniment, affords relief (Wa.). Canada Balsam, gr. 
v-xx, is useful, or Burgundy Pitch, as plaster (P.). Acupuncture, occasion- 
ally gives instant relief (B.). Not when high fever (R.). Aquapuncture, has 
been employed with extraordinary success (B.). Heat, by hot douche to seat 
of pain (B.) ; or by very hot poultices for three hours, then the. skin covered 
with flannel and oiled silk; or a hot flat-iron (R.). Galvanism, the constant 
current (B.) ; is highly useful ; faradization almost as successful as acupunc- 
ture (R.). Strapping from the thigh upwards, with layers of adhesive plaster 
which overlap each other. Nothing is so instantaneously beneficial. Diet, 
should t»e generous and nutritive. Lemon-juice as a beverage. Absolute 
rest is of great importance. [Compare Rheumatism.] 

Lung Diseases. 

Aconite, is indicated in most acute congestions (P.) ; is especially indicated 
in inflammatory states of respiratory organs (R.); Belladonna, in ""l doses 
of the tincture frequently, is of great benefit in pulmonary oedema, to retard ex- 
udation of serum and to counteract the failure of the heart (A. A. Smith). Ve- 
ratrum Viride renders important service in acute parenchymatous congestions 
(B.) ; gr. ]/(> of resin in pill when temperature and pulse are high. It tends to 
induce prostration, collapse, etc. (A.). Blisters. Flying blisters to chest, and 
perhaps along pneumogastric nerves in hypostatic congestion (R.). Copaiba, 
exercises a powerful influence over the pulmonary mucous membrane, and is 
beneficial in lung diseases generally, when attended with excessive secretion 
( Wa.). yaborandi, is serviceable for the attacks of breathlessness attendant 
on lung affections, but must be watched lest collapse ensue (Berkart). Liquor 
Potassce, in doses of ttt,x-xv added to an ordinary expectorant mixture, is 
o ten attended with good results in congestions of bronchi and lungs, chronic 
bronchitis, plastic bronchitis, etc. (Walshe). Cimicifuga, is a useful sedative 
in many irritative affections of the lungs and bronchial tubes, relieving cough, 
improving appetite, and ameliorating the general condition (Wood). Croton 
Oil, as liniment, is a highly useful counterirritant in many chronic lung dis- 
eases, and even in the bronchitis of infancy (Park). Cubebs, in small and 
oft- repeated doses, is efficient in chronic bronchitis and other lung affections 
of old persons, checking the excessive secretion and gently stimulating the 
system (Wa.). [Compare Bronchitis, Emphysema, Hemoptysis, Phthisis, 
Pleuritis, Pleurodynia, Pneumonia.] 

Lungs, Gangrene of. 

Creasote, by inhalation, to obviate the fetor (R.). Carbolic Acid inhalations, 
are used with marked benefit (Wa.). Mineral Acids, especially nitro-hydro- 
chloric, with Quinine, the main reliances in chronic pulmonary gangrene 



LUPUS LYMPH ANGEITIS. 66 1 

(A.). Stimulants, as malt liquors, with general tonic treatment, are necessary 
(A.). Ammonium Carbonate, one of the most reliable remedies ; is best 
given in decoctum cinchonae (Wa.). Eucalyptus, the oil with alcohol, equal 
parts of each, of which gj as inhalation by steam atomization, is useful ( Wa.). 
Turpentine, the spirit on boiling water inhaled for fifteen minutes every two 
hours, successfully employed (Skoda). [Compare Pneumonia, Phthisis.] 

Lupus. 

Arsenic, in chronic cases, not of syphilitic origin (B.). Arsenious acid as 
caustic (R.). The best remedy in lupus of head and face (Wa.). The oleate 
of arsenic, in ulcerating forms, constantly applied, will destroy cell-infiltra- 
tion in a mild and comparatively painless manner ; is also well employed in 
the tubercular variety (Wa.). Iodine, useful, whether syphilitic or scrofulous; 
the tinct. or a glycerin solution (B.); as tincture or liniment to edges and 
around (R.). Mercury, as ointments in erythematous lupus, calomel ointment 
in scrofulous and tubercular lupus of children (R.). Calomel int., gr. j-ij in- 
creased to iv, will quickly check ( Wa.). Emplastrum hydrargyri very efficient 
in lupus erythematodes and allied affections (Kohn). Cod-liver Oil, internally 
and locally (B.). Lead, liq. plumbi, with one or two parts of glycerin, ap- 
plied warm after removal of crusts, in milder forms (R.). Ca?'bolic Acid, as 
a mild escharotic (B.). Zinc Sulphate, dried, as caustic, freely dusted over 
surface, and a poultice to remove slough (B.). Jeriquity, a most useful ap- 
plication (Shoemaker). Sodium Ethylate on absorbent cotton, is the best of 
all caustics, followed by the Oleopalmitate of Bismuth as a soothing and astrin- 
gent application (Shoemaker). Chromic Acid, an efficient local application. 
Gr. c-^] aquae destil. (B.). Phosphorus, as substitute for arsenic (B.) Silver 
Nitrate, a weak solution, gradually strengthened, in superficial forms (R.). 
Cauterization, with the actual cautery at white heat, after sera} ing out as much 
as possible of the diseased parts, so as to destroy the lupus cell. Seek to re- 
place the lesion by a cicatrix, to prevent relapse in situ, and the development 
of the disease elsewhere. Internal remedies only useful for the general 
health. 

Prescriptions. 
R . Iodi, R . Hydrargyri Bromidi, . ^jss. 

Potassii Iodidi, . . aa ]|ss. Adipis, .... ^v. 

Glycerini, . . . ^j. M. ft unguentum. Sig. — To cover 

M. Sig. — Locally in Lupus. the part affected, using cod-liver oil 

[Mc Call Anderson.) freely, and the following solution in- 
ternally. In tubercular lupus of the 
face. [Hardy.) 



R. Ung. Arsenici Oleat., . ^ij. 

Ung. Simplicis, . . . gj. 
M. ft. unguentum. Sig. — Use con- 
stantly over the affected surface. If 
pain sets in Opium may be added. 

[Shoemaker.) 



R. Potassii Iodidi, . . gr. lxxv. 

Sodii Chloridi, . . 5ss. 

Aq. Destill., . . gviijss. 

M. Sig. — Tablesp. before meals, 

night and morning. (Hardy.) 



Lymphangeitis. 

Belladonna, the extract softened with glycerin, freely applied, is of great 
service; when pain is severe a poultice may be applied over the extract for a 



662 



MALARIA, CHRONIC. 



few hours only (Wa.). Lead, liq. plumbi subacet. dil., as an external appli- 
cation, constantly applied, to soothe and restrain the inflammation (Wa.). 
Iodine, in strong tincture, around glands, to prevent suppuration (Roberts). 
Quinine, or Salicin, with alcoholic stimulants freely, in septic cases (Roberts). 
[Compare Bubo.] 

Malaria, Chronic. 

Quinine is less curative than when the infection is recent, but in periodical 
affections depending on the malarial cachexia it is of specific value, large 
doses being required (B.). Salicylates of quinine and cinchonidine are es- 
pecially effective in chronic malarial disease (B.). Arsenic plays an important 
role in chronic malarial disease (B.); diminishes splenic engorgement, and 
combined with iron is rapidly curative of many affections due to the paludal 
miasm (Boudin) ; is a powerful prophylactic against malaria, and in chronic 
malarial poisoning, with frequent return of fever and neuralgia, the continued 
use of arsenic is of great benefit (Fayrer). Iron, the sulphate has decided 
antiperiodic power, and is particularly successful in anaemic subjects and in 
those with enlargement of the spleen (Wa.); it improves the anaemia of 
chronic malaria, and should generally be combined with arsenic (B.). Iodide 
of Iron and Manganese, the syrup in doses of "ttlxx-xxx, is a successful rem- 
edy for chronic malarial infection, and the Sulphate of Manganese gives ex- 
cellent results in jaundice of malarial origin (B.). Cornus, Calumba, and 
other bitters, are highly efficient, especially the first-named, in chronic malarial 
poisoning, and in convalescence after malarial fever (B.). Carbolic Acid and 
Iodine combined, are of great value in chronic malarial infection ; both are 
highly antiperiodic, and the latter is the best substitute for quinine and the 
most active reducer of splenic enlargement (Gimwell). Eucalyptus is of 
high utility to reconstruct the damages in the organs of assimilation (B.). 
Baths, the vapor-bath and Turkish baths are efficient aids to medicinal treat- 
ment in breaking up chronic cases, and may of themselves cure such by in- 
ducing profuse perspiration (Da Costa). [Compare Intermittent Fever, 
Remittent Fever.] 

Prescriptions, 



R. Cinchonidinae Salicylat, £ij. 

Ac. Arseniosi, . . gr. j. 

Ferri Sulph. Exsiccat, . gr. xx. 
M. ft. cachets no. xx. Sig. — One 
wafer thrice daily. 



R. Cornus, 

Calumbae, 

Liriodendri, 

Pruni Virgin., . . aa §vj. 

Eupatorii, 

Capsici, . . . aa §iv. 
Pulv. et misce. Sig. — A teasp. in 
cold or warm water, three or four 
times daily. A good tonic tincture 
may be made from the above combina- 
tion. (B.) 



R. Ac. Arseniosi, . . . gr. j. 
Mas. Ferri Carb., . . gj. 
M. ft. pil. no. xx. Sig. — One pill 
thrice daily. 



R. Quininae Sulph., . . gr. xl. 

Ferri Sulph. Exsic, . gr. xx. 

Ac. Arseniosi, . . gr.j. 
M. ft. pil. no. xx. Sig. — One pill 
thrice daily. 



R. Tinct. Iodi, . . . g§ m 
Ac. Carbolici, . . . gj. 
M. Sig. — Two to three drops three 
or four times a day in water. 



MANIA MASTITIS. 663 

Mania. 

Stramonium, of value ; allays irritation and induces tranquil sleep ; wild 
and furious delirium, but intermittent; also in nymphomania (P.). Many 
facts seem to confirm its reported value (Tr.). Datuj'ine, gr. t Jq- -g 1 ^ hypo- 
dermically in acute mania, but is less useful than atropine or hyoscyamine 
(Wa.). Duboisine, gr. -^ hypodermically in acute mania (Gubler). Bella- 
donna, is useful, especially in monomania, with fixed hallucinations, though a 
large dose causes a temporary insanity (Tr.); one of the very best remedies 
in all hypergemic conditions of the brain (P.). Hyoscyamus, in violent inter- 
mittent forms, to procure sleep and calm violent delirium (R.) ; delirium with 
hallucinations but not congestion ; milder and less inflammatory forms ; also 
in hypochondriacal monomania (P.). Veratrum Viride, successfully combats 
the excitement in acute mania (B.). Camphor, has been used successfully; 
its action is uncertain (P.). Opium, and tartar emetic are satisfactory for 
many cases; also morphine hypodermically to induce sleep (R.) ; narcotic 
effect of doubtful utility; better in insanity with depression (P.). Cannabis 
Indica, %] of tinct. with t ^j of potassium bromide, is recommended (R.). 
Bromides are used in puerperal mania, that of pregnancy, nymphomania and 
other forms (R.). The combined use of potassium bromide and tinct. of 
cannabis indica, in equal parts, ^j of each thrice daily for weeks and months, 
has proved very efficient in acute and periodical mania, senile mania, and 
other forms (Clouston). Chloral, as calmative, hypnotic, has induced mental 
improvement, gr. v-xx (B.). Conine, most suitable to acute mania, quiets 
muscular action (ni^-iij, orhypoder., commencing with TTLy 1 ^). Very suc- 
cessful with morphine conjointly injected (B., R.). Digitalis, gss-^j of tinct., 
valuable in acute and chronic mania, especially when complicated with general 
paresis and epilepsy (Maudsley). Caution! watch the pulse for any marked 
intermittence (B.). A very valuable palliative in acute mania (Van derKolk). 
Ergot, large doses, ^ss-j of fluid extract, to reduce excitement, shorten at- 
tacks, widen intervals between them, and prevent exhaustion, hence is very 
useful in recurrent and epileptic forms, and in chronic mania with lucid in- 
tervals (Crichton Browne). Iron, as a restorative, is frequently used in chronic 
mania with benefit, the tincture of the chloride in 5-10 minim doses (B.). 
Gelsemium is more useful than conium in mania with great motor excite- 
ment and wakefulness; large doses required, TTixv-xx of tincture. Croton 
Oil, as a purgative, TH-X - /^ ever y hour, as revulsive in mania from cerebral 
congestion (R.). Cimicifuga is often efficiently used in cases of mania occur- 
ring during the puerperal or pregnant condition (R.). Galvanism of the 
head and cervical sympathetic, has produced distinct improvement (B.). Pa- 
raldehyde, as a hypnotic, in doses of TTlxxx-1, is often decidedly useful (R.). 
Cold Douche, in maniacal delirium, the patient being in a warm bath during 
the application of the douche to the head (R.). Removal from home, from 
sympathetic friends, and from surroundings connected with the origin of the 
malady, is a prime necessity to a cure. [Compare Delirium, Puerperal 
Mania.] 

Mastitis. 

Belladonna, Atropine locally (see Lactation), or combined with morphine 
and chloral, when much pain (B.). Especially as liniment to check secretion 
of milk when inflammation imminent (R.) ; or when distended by milk (P.). 
When inflammation has set in, continuous application of Belladonna for 24 
hours often arrests it. It is also useful when an abscess has formed. Fomen- 



664 MASTODYNIA — MEASLES. 

tations useful in addition, but skin must be dried well before the belladonna 
is rubbed in (R.) ; Titv-x of tinct. internally as well (P.). Camphor, a saturated 
solution in glycerin, locally, in mammary congestion threatening abscess 
(Wa.). Phytolacca, has power to arrest inflammation of the mammae and to 
prevent suppuration; the fluid extract in 10-minim doses internally, and the 
solid extract on a cloth to the inflamed breast (B.). Coniu?n, the extract in 
small doses several times a day, of striking benefit in mastitis and impending 
abscess of breast ( Wa.). Calcium Sulphide •, internally in abscess, occasionally 
increases pain (R.). Hyoscyamus, as plaster, to relieve painful distension 
from milk (P.). Stramonium, fresh leaves as cataplasm to discuss indurated 
milk (P.). Iodine, tinct. and ointments to remove indurations of breasts af- 
ter inflammation (B.). Mercury and Morphine, the oleate locally in mam- 
mary abscess (R.). Tobacco, leaves as poultice in abscess (R.). Digitalis, 
the infusion locally as fomentation in severe inflammation of the breasts, 
causes it to yield speedily (Fairbank). Ammonium Chloride, gj ad Oj spt. 
rosmarini, as lotion on linen rags, kept constantly to the part, especially in 
induration, after abscess has suppurated ( Wa). Tartar Emetic, in small and 
frequent doses, given early, is beneficial ( Wa.). Oil frictions in first stage of 
inflammation of breasts, from circumference towards the nipple (L.). Rest, 
by supporting mammae with strips of plaster, and bandaging the arm to the 
side, to prevent motion (T.). Sponging with alcohol (over proof ) until part 
is cold ; renewed if heat return. Heat, applied by a basin lined with flannel 
saturated with hot water, to relieve pain and prevent suppuration. [Compare 
Abscess, Lactation ] 

Mastodynia, 

Dr. Tanner advises non-interference in simple cases of enlargement and 
tenderness, which will spontaneously subside if let alone. In severe cases 
support by strips or bandage, if breast pendulous ; belladonna ointment or 
liniments ; amputation of mamma has been necessary. Conium has specific 
anodyne action on the mammae and generative organs. Cifnicifuga relieves 
infra-mammary pains of uterine origin in spinsters. Olive Oil, 2 parts, to 1 of 
tinct. opii, may be used by gentle friction to painful breasts after parturition 
(Parvinj. 

Measles. 

Aconite, for febrile symptoms, and especially to arrest the catarrhal pneu- 
monia (R.) ; a valuable remedy (P.) ; the best drug when fever is very high, 
^-drop doses of the tincture every 2 hours (Da Costa), jfaborandi, with a 
hot bath, as diaphoretics, in cases of delayed eruption (Da C). Asclepias, an 
infusion or decoction freely as a diaphoretic, to promote the eruption (W.) 
Veratrum Viride, has been employed (R.). Pulsatilla, for the catarrhal oph- 
thalmia, nasal and intestinal catarrh; gj-ij of tincture to t ^iv water as wash 
(P.). Ammonhtm Carbonate, dissolved in a solution of the acetate, is much 
vaunted. When feeble circulation, cyanosis, delirium, gr. v-x to .^ss-gj liq. 
ammonii acetatis (B.) ; gr. iij-vj or vij, every hour or two, in cinnamon- water 
or milk ; one of the reliable remedies (Wa.). Camphor, the mixture, with 
liq. ammon. acetatis, excellent when cough and catarrh the most urgent symp- 
toms (A.). Ipecacuanha, for cough and catarrh, gr. j-ij every 4 or 6 hours 
(A.). Antimony, preferred to ipecac by some (A.).. Quinine, in small doses 
for the adynamia (gr. j-iij), or large (gr. xv) for hyperpyrexia, and catarrhal 
pneumonia, etc. (B.). Carbolic Acid, has been employed in several hundred 



MELANCHOLIA — MENINGITIS. 



665 



cases with decided advantage ; most useful at early stage (Wa.). Cod-liver 
Oil and Iron, to scrofulous children, a long course of such medication after 
convalescence (Da C). Purgatives, must be given with caution (R-); the 
milder purging salts, as magnesium sulphate, to be preferred (A.). Mustard, 
as bath on sudden retrocession of rash (R.); often increases the fever with- 
out benefiting the pneumonia and other complications (A.). Water, cold affu- 
sion at commencement ; packing, especially when retrocedent (R.) ; hot foot- 
baths for convulsions (A.) ; tepid bath with cold douche to head, if cerebral 
symptoms are severe (Da C). Oil Inunctions, cocoa-butter very grateful, 
and reduces temperature. Also in roseola (B.). Hands and feet to be rubbed 
with a firm fat to remove heat and tightness produced by rash (R.). Aliment, 
low diet and slops; no animal food during whole course (A.). Hygiene, <S.zx\l 
room, complete disuse of eyes, strict cleanliness (A.). [For Sequelae see 
Bronchitis, Cough, Ophthalmia, Otorrhcea, Pneumonia, etc.] 



Prescriptions. 



R 



Ac. Carbolici, 
Ac. Acetici, 
Tinct. Opii Deod., 
Spt. Chloroformi, 
Aquae, . . q. 

M. Sig. — A tablesp. every 4 hours, 
until fever abates. {Keith.) 



Zh 

ad iviij. 



r. 

Tinct. Tolutanae, . . gij. 

Syr. Senegae, . . . Iss. 

Ac. Acetici, . . . 3Jss. 

Syr. Pruni Virg., . ad Jiv. 
M. Sig. — A teasp. as required for 
cough after convalescence. 



Melancholia. 

Aurtim, gives excellent results ; gr. -fo to -fa of chloride ter die, especially 
when cerebral anaemia coexists (B.). Bro?nides, sometimes afford relief which 
no other agents will; no indications (B.). Potassium Bromide for townspeo- 
ple, especially women with unendurable despondency (R.). Cocaine, a. useful 
tonic, especially beneficial in nervous affections accompanied by depression 
(Br.). Cimicifuga, in puerperal or uterine despondency, of singular value 
(P.). Ignatia, has soothing effect in great mental depression (P.). Arsenic, 
in melancholy of aged persons gives great comfort. Best with small doses 
of opium. Fowler's solution, gtt. ij ; tinctura opii, gtt. iij-v, ter die (B.). Opium, 
in stimulant doses of tincture, gives good effects (B.) ; especially when parox- 
ysms of acute anguish and despair, or when suicidal impulse (Wa.). Mor- 
phine hypodermically is of great benefit in some persons who have a peculiar 
idiosyncrasy therefor (R.). Camphor has been highly recommended (R.). 
Musk and Castoreu7?i are employed in melancholia with benefit (R.). Can- 
nabis Indica, sometimes relieves (B.). Phosphorus, depression from over- 
work (R.). Chloral, as hypnotic, has been followed by marked amelioration 
and cure (Wa.). Valerian, in hysterical or suicidal melancholia, is often 
beneficial (Wa.). Caffeine has been useful (B.). Iron, as restorative. Tinc- 
ture of chloride (B.). Water-cure, shower-bath, 15-20 seconds, or warm- 
bath, 95 Fah. for 30 minutes; the shower or cold douche may be usefully 
employed in certain cases where reaction takes place after it (Wa.). [Com- 
pare Hypochondriasis, Hysteria.] 

Meningitis, Cerebral. 

Aconite, is as serviceable in this as in the other acute inflammations; during 
the stage of excitation, the tincture, gtt. ij with gtt. v of deodorized tincture 

56 



666 MENINGITIS, CEREBROSPINAL. 

of opium, every 2 hours, gives admirable results (B.). Belladonna, in all 
hyperaemic conditions of brain and spinal cord one of the very best remedies, 
especially during the period of excitement (P.). Hyoscyamus, valuable in sub- 
acute form (P.); for nervous irritability during convalescence (A.). Gelse- 
mium> extremely useful ; irtv of fluid extract every 2 hours (B.). Mercury, as 
ointment gives good results in children (A.) ; Calomel in small, frequent doses, 
so as to bring the system under it quickly, a most valuable remedy apart from 
its purgative effects (Wa.). Potassmm Iodide, has cured (Neimeyer , espe- 
cially valuable in the tubercular form (B,). Ergot, the fluid extract in jjss 
doses, with gss of potassium bromide, every 4 hours, to diminish the vascular 
excitement (B.). Potassium Bromide, in the convulsions following simple 
meningitis (R.). Opium, in small doses; by clinical evidence proved to be 
the best treatment, especially for the acute stage before exudation, or during 
the stage of excitation (B.). When collapse, may sustain powers of life; 
with tartar emetic has proved most beneficial, but should be used with great 
caution, as it may do great harm (Wa.). Bryonia, exceedingly valuable for 
serous inflammations in stage of effusion (P.). Pulsatilla, valuable in the 
acute form (B.). Purgatives, as soon as possible, unless exhaustion. Calo- 
mel and jalap the most active and searching (A.). Croton oil as a derivative 
and revulsive ; also locally to the shaven scalp, productive of the best results 
in tubercular meningitis (Wa.), Venesectio?z, or arteriotomy (temporal artery) 
gives good results (B.); when high cerebral excitement and vascular action 
(A.). Blisters, on nape of neck if coma, after active symptoms are subdued 
(A.). Water. Cold water for hyperpyrexia (C.) ; pounded ice in bag or 
bladder, as a cap to the head (R.). [Compare Hydrocephalus.] 

Meningitis, Cerebro-Spinal. 

Opium, no remedy so effective in small doses. Utility ends when effusion, 
stupor, and coma ensue (B.); large doses (Valleix), gr. j every hour in very 
severe cases (S.) ; has been used in France and Germany with much success 
(Tr.) ; is the best remedy of all, gr. j every hour for 4 days; even such doses 
will not narcotize (Da Costa). Aconite, useful combined with opium (B.) ; 
affects the cranio-spinal axis from 3d nerve to phrenics, the region where this 
disease is most manifest (Harley). Gelsemiu??i, extremely valuable, ttiv of 
fluid extract every 2 hours, to maintain constant physiological effect (B.); 
efficient for the delirium. Belladonna, in all hypersemic conditions of brain 
and spirfal cord, especially during stage of excitement (P.). Iron, the tincture 
of the chloride, in 20-30 minim doses, every 2 hours, suggested by the simi- 
larity of the disease to erysipelas, has made many successful cures without 
leaving any sequelae (Klapp). Bromides to guard the opium and enable the 
latter to be pushed, 20-grain doses every 4 hours (Da C). Hydrocyanic Acid, 
dilute, mj-ij, with gr. iij-v of sodium bicarbonate, every 3 or 4 hours, for 
severe vomiting (Delafield). Quinine in large doses at the commencement 
(B.) ; has been exhaustively tried in this disease and failed (Da C). Potas- 
sium Iodide for the sequelae, a long course of iodides during convalescence is 
the best treatment (Da C), Cold to the spine, the most satisfactory treatment 
(Radcliffe) ; to head and upper spine for 5 minutes only at a time, for the 
headache and tetanic symptoms (Da Costa). Venesection, or arteriotomy 
(temporal artery), probably of service, but cautiously (B.) ; leeches at back of 
neck and on temples, to relieve the terrible headache, if patient is strong and 
vigorous (Da C). Digitalis, in early stage (Rummel). Ergot, one of the best 
remedies (B.). Turpentine i enema, as derivative (B.). Stimulants, in small 



MENINGITIS, SPINAL — MENORRHAGIA. 667 

quantities (A.). Counter-irritation, by actual cautery freely applied to back, 
alleviates pain (A.). Water, cold baths or wet pack for hyperpyrexia; warm 
bath in uraemia (B.) ; hot-water bottles or sand-bags to trunk and extremities 
to keep up warmth. Bath of 102-106 for short time only, then wrapped in 
blankets (A.). Heat to the body, except the head and neck (Da C). Ali- 
ment, nutritious and suitable food at short intervals, day and night (A.) ; tonics 
with fresh air and good diet during convalescence (A.). Ventilation of 
dwellings, the best sanitary precaution when the disease is epidemic (Simon). 

Prescriptions. 



R . Morphinae Sulph., . . gr. ss. 
Ac. Sulph. Aromat., t . jj. 
Elix. Cinchonae, . ' ad$v]. 
M. Sig. — Tablesp. every 2 hours, 
for a boy of 12 years old. 

{Meigs & Pepper.) 



R . Potass. Iodidi, . . . spv. 
Tinct. Gentian. Comp., 

Syr. Sarsa. Co., . . aa Jfj. 

M. Sig* — Teasp. thrice daily, to 

promote absorption during convales- 
cence. 



Meningitis, Spinal. 

Aconite, is very useful (B.) ; with Ergot and an Opium impression to reduce 
the amount of blood in the vessels of the cord (Da Costa). Potassium Iodide, 
see below. In the chronic form, with the bichloride of mercury when a 
specific history present (Hammond). Belladonna, strongly to be relied on, 
even when brought on by external violence (P.). Bryonia, in serous inflam- 
mations, when effusion, is extremely valuable (P.). Purging, by magnesium 
sulphate, combined with tinct. hyoscyami (A.). Quinine, when paralysis 
occurs, in 3-grain doses thrice daily, with ^ -grain doses of extract, bella- 
donnae, or 20-30 grain doses of potassium iodide, and flying blisters along the 
spine (Da Costa). Opium in some form must be used for pain (Bastian). 
Mercury, gr. T J g of the bichloride, with increasing doses of potassium iodide, 
to promote absorption of inflammatory products, if the inflammation subsides 
(Bastian) ; a mercurial impression often benefits the paralysis (Da C). Cold, 
by ice to spine is deemed necessary, and no doubt alleviates the pain, though 
heat would be a more rational application for the inflammation (Bastian). 

Menorrhagia. 

Ipecacuanha, in full emetic doses ( Wa.) ; is excellent (B.) ; Ergot is better 
(P.). Savine, enlarged, relaxed, and passively congested uterus (B.). In 
5-10 drop doses of tinct. in water every half- hour to three hours, has proved 
useful (P.); when due to want of tone in uterus (R.). Ergot, large spongy 
uterus : bromides better (B.). Ergotin gr. j or ij in glycerin and water, un- 
doubtedly efficacious as hypodermic injection (P.); all forms (R.) ; minim- 
doses of the fluid extract are very beneficial (A. A. Smith). Hamamelis, has 
decided influence on venous system; of high repute (Pf.). Arsenic and Iron, 
when from anaemia (B.). Cannabis Indica, often successful (R.) ; gtt. v-x 
of tinct., thrice daily, productive of extraordinary success ( Wa.) ; has a stimu- 
lant action on the uterine muscular fibre, and may be given in combination 
with Ergot (B.). Iron, when dependent on anaemia (B.). Rue, low vascular 
tonus; should never be used in the pregnant state (B.). Oil of Erigeron, 
in io-drop doses, is efficient (Wa.). Gossypium, a favorite uterine hemostatic 
in many hospitals, in 30-minim doses of the fluid extract every four hours 
(Parvin). Quinine, has been recommended (R.) ; after Ergot it is the very 



668 MENSTRUAL DISORDERS — MENTAGRA. 

best agent, in 6-grain doses every 3 hours (Parvin). Digitalis, very useful, 
especially when from heart disease, in plethoric subjects (B., R.); gj-jss of 
infusion as dose will arrest menorrhagia when unconnected with any disease 
(P., R.). Aloes, debilitated and relaxed subjects, with Iron(B.). Cimicifuga, 
passive, coagulated and dark (P.); for accompanying headache (R.). Gallic 
Acid, is very efficient (R.)- Potassium Chlorate or Bromide, in doses of gr. 
xv thrice daily, combined with Ergot, has an almost infallible influence over 
uterine hemorrhage, unless caused by cancer, polypi, adherent placenta, or 
other similar affections (Tait). Bromides, usually arrest promptly (B.). That 
of potassium most useful in young women if loss occur at natural period 
only; commence bromide a week before and discontinue when discharge 
ceases till a week before next time. If loss occurs every two or three weeks 
give bromide continuously, 10-grain doses, but more when organic changes in 
womb (R., Wa.). Ammonium Chloride, for headaches (R.). Calcium Phos- 
phate, in anaemia from excessive menstruation (R.). Magnesium Sulphate, 
very small doses with a little dilute sulphuric acid and syrup, is exceedingly 
useful (Wa.). Oil of Cinnamon, in drachm doses (R.). Water, hot- water 
bag to lower dorsal and lumbar vertebrae (R.); cold sitz-bath, feet in warm 
water, especially valuable. 6o°-65° Fahr. for 5-15 minutes, patient then 
quickly dried and put to bed. [Compare Metrorrhagia.] 

Prescriptions. 



R. Ext. Ipecac. Fl., . . gi}. 

Ext. Ergotae Fl., . . giv. 

Ext. Digitalis Fl., . . gij. 

M. Sig. — A half-teasp. to a teasp. 
as required until emesis. (B.) 



R. Ext. Ergotae (Squibb's), gr. xij. 
Ext. Cannabis Ind., . gr. iv-vj. 

M. et div. in pil. no. xij. 

Sig. — One pill every hour, in pro- 
fuse menstruation of atonic type. 



Menstrual Disorders. 

Aconite, gtt. j every half-hour to hour promptly restores discharge when 
sudden suppression from chill (P., B., R., Wa.); as emmenagogue (Tr.). 
Pulsatilla, often of the greatest value when menses scanty or delayed, or sup- 
pressed by fright or chill (P., B.). Ignatia, in suppression of hysteria (P.). 
Savine, a powerful uterine tonic ; as emmenagogue certain, powerful, safe 
(P.). Ferrum, in anaemic subjects (B.). Aloes, as emmenagogue [vide Amen- 
orrhea]. Cocculus Indicus, for irregular menstruation with colicky pains 
and scanty discharge. Should be given for a few days prior to and during 
period (P.) ; "rnjj-iij of a saturated tincture thrice daily. Opium, in suppres- 
sion from violent mental emotions, a valuable remedy ( Wa.). In many men- 
strual disorders opium proves invaluable, but must be cautiously administered 
lest the habit be formed. Cimicifuga, relieves heat and pains in the head, 
flushings of the face, pains in back and limbs, etc^ when occurring as the 
result of menstrual perversion ( Wa.). [Compare Amenorrhea, Dysmenor- 
rhea, Menorrhagia, Climacteric Disorders.] 

Mentagra. 

Mercury, the oleate, or the bichloride, gr. ij to 5j water, applied as lotion 
after each epilation (R.). Citrine oint. extensively employed (Wa.). Sul- 
phurous Acid, with an equal part of glycerin, is an efficient application ( Jen- 
ner). Arsenic has a more or less powerful influence, used internally in doses 
of tti v °f liquor arsenicalis thrice daily (Wa.) ; the oleate of arsenic is an 



METRITIS MUSCE VOLITANTES. 669 

efficient local application. Sulphur Iodide, as ointment £j to ^jss, is efficient, 
with Donovan's solution internally (Sir E. Wilson). Copper Sulphate ', as 
lotion, 3J to gxyj of water, with gss of zinc sulphate, and gjss of aquae lauro- 
cerasi (B.). 

Metritis, Acute. 

Opium, locally, in suppositories or enema is more effectual than if admin- 
istered internally (Wa.). Aconite, is invaluable in early stage of simple in- 
flammatory fevers (P.). [Compare Puerperal Fever.] Heat, to the feet, 
and by large poultice to the abdomen. Also hot water vaginal injection 
literally for hours, if possible ; repeated at short intervals, from a Davidson 
syringe. The only means of aborting an attack of cellulitis (E.), which is 
the condition generally present in cases which are usually supposed to be 
ones of acute metritis (Playfair). Turpentine, as hot epithems ; few measures 
are more generally serviceable (Wa.). Linseed Poultices, produce great relief 
to pain and favorably affect the course of the disease (Duncan). Leeches, to 
the hypogastric region, may be required in patients of full habit. [Compare 
Puerperal Fever, Puerperal Metritis.] 

Metrorrhagia. 

Ipecacuanha, possesses considerable energy in arresting flooding (P.) ; in 
full emetic doses, gr. xx in evening, followed by an acidulated draught in the 
morning (Wa.). Hamamelis, when persistent oozing (R.). Ergot, the most 
valuable; full doses, repeated every hour or so (R., P.). [See Menorrha- 
gia for formula.] Savine, 5 to 10-drop doses of tincture in cold water every 
^ hour to 3 hours (P.). Iron, styptic preparations as injections (B.). [See 
Hemorrhage, Post-Partum.] Cannabis Indica, often arrests, especially 
when at climacteric; tincture gtt. v-xx ter die (P.); has had extraordinary 
success in number and rapidity of cures (Wa.). Sulphtiric Acid, sometimes 
very effective, especially when due to fibroid or polypus. Ac. sulph. dil., gtt. 
v-xx, well diluted (B.) ; long extensively prescribed (Wa.). Cinnamon, is 
used with good effect (P.); has a specific action on the jiterus (T.). Digi- 
talis, in plethoric subjects. The infusion best, a tablesp. bis die (B., P.); the 
effect is prompt and decided (Wa.). Magnesium Sulphate, often succeeds 
(B.). Senegin, in 2-grain doses, successfully employed (P.), [Compare 
Amenorrhcea.] Ice, to abdomen, or within the uterus (B.) ; ice in every 
form first thing to try (Wa.). Rest, absolutely necessary. Dry cupping over 
sacrum is found useful (R.). [Compare Menorrhagia, Uterine Tumors.} 

Miliary Fever. 

Aconite, for the hyperpyrexia (R., P.). Cooling Drinks, purgatives and anti- 
phlogistics, in mild cases ; malignant ones sometimes occur, and are dangerous 
(A.). Lime-water, applied by sponging, is very useful; or a lotion of zinc 
oxide suspended in lime-water, gr. xl to gj, painted on the affected parts of 
the skin, and permitted to dry thereon (E. Wilson). 

Muscse Volitantes. 

Potassium Iodide, very effectual in curing muscae depending upon hepatic 
derangement (Wa.). Valerian, often found curative (Wa.). Muscce Voli- 



6/o 



MYALGIA — MYELITIS — MYOPIA. 



tantes are due to shadows cast on the retina by fibrillge floating in the vitreous 
body, and are most visible to myopic persons. They do not merit attention 
unless very abundant, or steadily increasing (C). Rest of the eye necessary. 
Neutral-tint glasses may be worn to render the muscae less visible, if trouble- 
some. 

Myalgia. 

Arnica, the best agent for contused muscular fibre ; also for shake, concus- 
sion, shock. Trtv-x every 2 or 3 hours in water (P.) ; a few drops of tinc- 
ture internally removes stiffness, after packing with cold, wet sheet (R.). 
Cimicifuga, often succeeds wonderfully, as often fails ; no indications for its 
use (B.) ; general bruised sensation (R.). Ammonium Chloride, in 10 to 20- 
grain doses, the most efficient remedy (Anstie) ; is effective (R.). Veratrine, 
the ointment externally may control (B.). Belladonna, as liniment, is often 
successful (R.). Gelsemium, frequently cures but large doses are necessary, 
ni v-xx of the fluid extract every 3 hours (B.). Coca, to relieve the sense of 
fatigue (P.). Opium, by frictions or poultices (R.). Iodine, ointment for pain 
and tender muscles of the chest, when skin may be pinched without pain (R.). 
Xanthoxylum, externally and internally, has a deserved reputation (B.). Chlo- 
roform Liniment, with friction, often affords great relief (Wa.). Firing, 
sometimes very beneficial (B.). Packing, with dripping wet sheet (R.). 
Counter-irritation 1 by firing, aquapuncture, acupuncture (B.). Electricity, the 
constant current (B.). Baths, Turkish, in aching muscles, from over exertion 
(R.). Poultices, very hot, followed by applications of lint and oilskin (R.). 
Rest, is the remedy of course (Wa.). Rest and support to weak muscles im- 
portant till they regain their tone ; especially in painful muscular affections 
following prolonged or excessive exertion, or in the soreness or stiffness 
which occur during convalescence from any long illness, or accompanying 
general debility. These are generally better after repose, but increase with 
fatigue. [Compare Pleurodynia, Lumbago.] 

Myelitis. 

Belladonna, is decidedly effective, especially when brought on by external 
violence (P.). Ergot, most successful; large doses are necessary (B.). Elec- 
tricity, in chronic, not in recent form (B.). Silver Nitrate, in chronic inflam- 
mations of the cord, one of the few remedies which are ever of service ; gr. 
X - /^ (W.). Phosphorus, of marked benefit in myelitic paraplegia from 
excessive venery (W.). Water-cure, ice-bag to spine, feet in hot-water; or 
better, hot douche to spine (B.). Cold, externally, by ice-bags, along the spine, 
with cupping or leeching if much localized pain or tenderness ; spoon diet 
and a sparing amount of stimulants, also copious warm enemata to relieve 
the bowels and act as derivatives. Little, if anything, is to be done with 
mere drugs. Posture should be prone, or on side ; absolute rest (Bastian). 
[Compare Meningitis, Spinal.] 

Myopia. 

Atropine, by daily instillation, systematically, for the purpose of sacrificing 
either the convergence or the accommodation, in cases where failure of the 
internal recti occurs, the disability assuming the form of muscular asthenopia 
(C). Glasses, properly adjusted, should be worn from the commencement. 



NiEVUS NAUSEA. 6j I 



Nsevus. 

Ferrum Perchloride, injected, is effectual ; but dangerous when applied 
thus to naevi about the head(Wa.). Creasote, pencilled over twice a day, 
may remove naevi (Wa.). Chromic Acid, as escharotic, or local application, 
gr. c ad ^j aquae destil. (B.). Electrolysis, or galvano-cautery, to remove naevi 
(B.). Nitric Acid, strong, as escharotic for small superficial naevi, followed 
by ol. olivae (B.). Zinc Chloride, Iodide and Nitrate, locally, especially the 
first named (R.). Setons, threads passed across the growth in various direc- 
tions, to produce suppuration ; when pus appears the threads should be re- 
moved. Sodium E thy late, prepared by adding the metal sodium, piece by 
piece, to absolute alcohol in a wide-mouthed bottle ; the crystalline substance 
found deposited after effervescence ceases is an excellent caustic for naevi ; 
painted over them it causes a rapid eschar, and usually gives but little pain 
(Richardson). Mercury, the Acid Nitrate an excellent caustic for removing 
moles from the face (Thomas). 

Nails, Ingrowing. 

Liquor PotasscE, a solution (.^ij-.^j) on cotfon-wool in ingrowing toenail, to 
margin of nail at ulcerated surface, to soften the nail ( B.). Glycerin, or Silver 
Nitrate, on a fold of lint, to the ulcerated surface (C.) Lead Carbonate, a 
piece softened between the fingers, and applied as plaster beneath the fungous 
cushion, cures in a few days (Tr.). Paring the nail, after softening in warm 
water, and cutting a V-shaped incision in centre of nail ; the ingrowing por- 
tion should not be cut. 

Nasal Affections. 

Ammonia, by inhalation, in pain and inflammations of nose and frontal 
bones (R.). Potassium Iodide, large doses (gr. xxx-lxxv daily), valuable in 
syphilitic affections of the nose (Wa.). Glycerite of Tannin, to excoriations 
of inside of nose after measles, scarlatina, etc. Also for impetiginous erup- 
tions of inside, most severe where hair grows, epilation sometimes needful. 
Also in discharge of greenish, black, stinking mucus (R.). Glycerin of Starch, 
or Zinc Ointment, applied often, a good supplementary application (R.). Hy- 
drastis, in chronic catarrhal conditions and nasal ulcers, used internally and 
externally, with great benefit (P.). Pulsatilla, may be employed both inter- 
nally and externally in nasal inflammations (P.), and in acute inflammation 
of nose (B.). Cod-liver Oil, for chronic discharge (R). Injections, by nasal 
douche, are used with benefit in catarrhal states (Wa.). Zinc Chloride, gr. 
ij to the %, or the Sulpho-carbolate, gr. v to the g, as solutions locally by 
cotton-wrapped probe to diminish sensibility of the nasal mucous membrane 
(Sajous). Cocaine, has many applications in treatment of nasal affections; a 
4 per cent, solution by mop or spray will empty the engorged venous sinuses, 
and is very useful in acute catarrh, hay fever, etc., also in posterior and an- 
terior rhinoscopy (R.). [Compare Acne, Catarrh, Epistaxis, Hay Fever, 
Influenza, Oz^na, Polypus, Sneezing.] 

Nausea. 

Ipecacuanha, has no rival in sickness of pregnancy, scarcely less useful in 
that of chronic alcoholism. Very small doses, gr. ^ equals Try of wine (P.). 



672 NECROSIS NERVOUS AFFECTIONS. 

Pulsatilla, in dyspeptic nausea, with coated tongue, flatulence, sick headache 
(P.). Cocculus Indicus, in cephalic nausea, violent but ineffectual efforts at 
vomiting (P.). Calumba, in nausea of languid stomach with flatulence, has 
considerable reputation (P.). Cinnamon or Cloves, will check nausea (P.). 
Nutmeg, the simple powder in wine (P.)- Pimenta, Pepper, Peppertnint, 
relieve (P.). Tartaric Acid, as effervescing draught, with a few drops of 
tinct. opii, tinct calumbae, or hydrocyanic acid added, when from morbid gas- 
tric irritation (Wa.), Cold Compress or Ice-bag, over the stomach very useful. 
Bis?nath Subnitrate , or the Liquor Bismuthi, when the salt in substance dis- 
agrees, is a remedy of established value in nausea and vomiting arising from 
gastric disorders; may be combined with Hydrocyanic Acid (Wa.). [Com- 
pare Vomiting, Vomiting of Pregnancy, Seasickness.] 

Necrosis. 

Sarsaparilla, a very useful medicine in diseases of the bones (P.). Rest, 
in a " Salter's swing," with poultices, water-dressing, or stimulating lotions, 
to aid work of repair (CI., Hilton). Tonics, nutritious food, baths, good hy- 
giene, all are necessary adjuncts to local treatment (Andrews). Acid Solu- 
tions, of no use as solvents, may, be employed with benefit for detergent and 
alterative effects to expedite the sloughing and restorative processes (Gross). 
Operation to remove sequestrum is generally necessary ; or resection of the 
devitalized bone, the latter in young subjects greatly exhausted, where delay 
would endanger life (Gross). Potassa cu?n Cake introduced into fistulae, to 
convert them into large openings, permitting the removal of diseased bone 
(Kirkpatrick). [Compare Caries, Bone Diseases, Syphilis, Scrofulosis.] 

Nervous Affections. 

Arsenic, of especial value in nervous affections resulting from malaria, in 
which large doses are required ; tti x of Liq. Arsenicalis, increased to rri xxx 
thrice daily (Wa.). Asafcetida, is a remedy of much value in nervous affec- 
tions connected with uterine derangement, also in dyspeptic hypochondriasis 
and other nervous affections ; may be combined with bitter tonics and mild 
aperients (Wa.). Potassium Bromide, takes precedence in epilepsy, epilep- 
tiform convulsions, hysterical convulsions and spasms, tetanus, etc., is of great 
value in chorea, insanity, acute mania, insomnia, delirium tremens, some 
forms of neuralgia, and the numerous symptoms of vaso-motor disturbance, 
such as — numbness, coldness, deadness, pricking sensations, indefinable but 
distressing sensations in abdomen, hypogastrium or epigastrium ; feelings 
similar to rigors, with anxiety, palpitation or fluttering of the heart, — all due 
to interference with the local circulation (Reynolds). Valerian and Valeri- 
anates, are thought to exercise some special influence over nervous affections, 
especially the Valerianate of Zinc, in half-grain to grain doses in pill, or the 
Ammoniated Tincture of Valerian, from which every good that can be expected 
from the valerianates will be more certainly obtained (Wa.). Sumbul, acts as 
a nervous stimulant, and is especially efficacious in neurotic migraine, also in 
hysteria and the obscure paralytic affections associated therewith (Wa.). Caf- 
feine, is of signal value in neuralgia, hemicrania and other nervous affections 
(Shafter); grain-doses in solution hypodermically, afford great relief in 
dorso-intercostal neuralgia attending shingles, insomnia, etc. (Anstie). Co- 
caine is a powerful nerve stimulant, destroying the sense of fatigue, and often 



NERVOUS EXHAUSTION NERVOUSNESS. 673 

evincing marked analgesic power in neuralgise. Is effective in melancholia, 
hypochondriasis, etc., as well as locally in nerve pain over a limited area. It 
acts as an excitant upon the central nervous system (R.). Opium is a remedy 
of marked value in insanity, melancholia, mania, and all nervous affections 
accompanied by pain (Wa.) ; gives general repose to both body and mind, is 
of decided value in diabetes, and produces marked improvement in melan- 
cholia and despondency (R.). Lupulin, is peculiarly useful in nervous affec- 
tions when Opium cannot be tolerated, especially in chronic hysteria attended 
with morbid vigilance, 10-grain doses every 6 hours afford great relief, with- 
out causing any unpleasant symptoms (Eberle). Santonin, in convulsions, 
epileptiform seizures, and affections regarded as choreic, etc., the result of 
reflex irritation from worms (Wa.). Phosphorus, of occasional utility in affec- 
tions of the nervous system induced by mental exertion or over-excitement. 
Danger from its use is its liability to produce fatty degeneration of the internal 
organs (Wa.). Phosphate of Silver is regarded as of special value in myelitis 
with disturbance of bladder and rectum, and in sclerosis of the nervous sub- 
stance (Wa.). Nitrate of Silver, the only remedy which has done good in 
progressive locomotor ataxia; gr. jq-? two or three times daily, with Hypo- 
phosphite of Sodium, both to be discontinued when blue line appears on 
gums ( Althaus). Cola 7 Shower Baths, are often beneficial in nervous diseases 
unconnected with disease of the brain. [Compare Hysteria, Melancholia, 
Mania, Diabetes, Locomotor Ataxia, Hemicrania, Neuralgia, Ner- 
vousness, Insomnia, Hemiplegia, Paralysis, Spinal Paralysis, etc.] 

Nervous Exhaustion. 

Ammonia, the Aromatic Spirit proves very serviceable ; ^ss-j in water 
thrice daily (Wa.). Hypophosphites of lime or sodium, or iron, are actively 
tonic in cases of nervous depression and torpor, with occasional shooting 
pains ( Wa.). Strychnine Acetate, a remedy of great promise, when combined 
with a rigid system of diet, mental discipline, etc. (Marshall Hall). Oxide 
of Zinc, often excellent as a tonic and sedative, in nervous irritability and 
depression from anxiety, over-study, etc. (Wa.). Phosphorus, of occasional 
utility in nervous break-down from over-study, etc. (Wa.). Caffeine, gr. j or 
more in a cup of coffee, to relieve brain weariness and nervous exhaustion 
(Wa.). Cocaine, in ^-grain doses proves serviceable in nervous exhaus- 
tion (R.). 

Prescriptions. 



R. Strychninae Acetatis, . gr. j. 
Ac. Acetici Diluti, . . TTixx. 
Alcoholis, . . . gij. 
Aquae destill., . . £vj. 

M. Sig. — Ten drops thrice daily. 
{Marshall Hall.) 



R. Ac. Phosphorici Dil., 

Elixir Calisayse(U. S. Disp.), 
Elix. Ammonii Valerian.,. 
Glycerini, 
Vini Xerici, . . q. s.adQ). 
M. Sig. — Uj thrice daily. 



Nervousness. 

Aconite, gtt. j of tinct. at bedtime, repeated if needful, for restlessness and 
" fidgets " of men as well as women (R.). Ignatia, in small doses better than 
morphine for mental excitement and nervous erethism (P.) ; for the nervous 
exaltation of cinchonism (Pf.). Caffeine, for restlessness due to great lower- 
ing of nervous power (P.). Chamomile lowers reflex excitability (P.) ; minim 



674 



NEURALGIA. 



doses of the tincture every 15 minutes an excellent sedative for children (A 
A. Smith). Potassium Bromide, especially for women who are despondent* 
irritable, and sleepless, from overwork, grief, worry, etc. ; often connected 
with migraine ( R.) ; gr. ss-j of any bromide every i^-hour, is very efficient for 
the nervous disturbances of children (A. A. Smith). Strychnine, affords re- 
lief in functional irritability of the nervous system, manifested by restlessness 
and wandering neuralgic pains (B.); especially useful as atonic in nervous- 
ness from over-use of tobacco (H.). Valerian, extremely useful as a sedative 
to reflex excitability, calms nervousness, does much good in fevers where rest- 
lessness, fidgets, anxiety, etc. (P.). Musk^ serviceable in nervous affections 
when from uterine derangement (Wa.). Opium, calms the nervous system 
and gives general repose to both body and mind (R.). Sumbul, often inval- 
uable in restlessness of pregnancy ; rr^xxx-xl of tinct. with a little Chloric 
Ether as draught (P.). Camphor, a powerful subduer of reflex excitability 
(P.). Chloral, where restlessness, debility (R.). Chloroform, the spirit of 
chloroform internally (R.). Hops, the hop-pillow is deserving of trial. Lu- 
pulin, peculiarly useful when opium cannot be tolerated (Wa.). Water, warm 
sponging to induce sleep and calm restlessness in convalescence. Also, cold 
sponging (R.)- [Compare Insomnia, Irritability.] 



Prescriptions, 



r. 



Strychninae Sulphatis, . gr. j. 

Quininae Sulphatis, . . gj. 

Tinct. Ferri Chloridi, . gv. 
Ac. Phosphor. Dil., 

Syrupi Limonis, . aa J|ij. 

M. Sig. — A teasp. in water thrice 

daily. (H.) 



R. Potassii Bromidi, 
Ext. Guaranae Fl., 
Syr. Tolutani, . 
Aquae, 
M. Sig. — Teasp. to 

three or four times daily. 

nervousness. 



. 5jss. 
. -fiij. 

. q. s. ad%v]. 

a dessertsp. 

To relieve 



Neuralgia. 

Morphine, hypoder. in the neighborhood of the affected nerve, the best 
treatment. Caution ; morphine-habit (B.) ; gr. ^ to J often relieves and fre- 
quently cures after a few repetitions (P.). No remedy promises more speedy 
and permanent relief than morphine by subcutaneous injection in sciatica, 
lumbago, tic douloureux and other neuralgic affections (Wa.). Aconite, when 
arterial excitement (B.) ; in congestive neuralgias, and acrodynic, at extremi- 
ties ; has important r6le (P.) ; as ointment or liniment, especially when fifth 
nerve affected; also in neuralgic headache (R.). A remedy of great value 
(Wa.) ; a perfect physiological remedy against neuralgia, especially those 
forms which are based on congestive or sub-inflammatory affections; but 
its action is often slow, so that Morphine must be given with it as a pallia- 
tive. Aconitine, with Veratrine as an ointment locally, a good application 
(Da Costa). Belladonna, must be persisted in with full doses ; gr. -^ of atro- 
pine, or gr. ^ to J-q hypodermically, in vicinity of nerve, has special utility in 
tic douloureux and sciatica; also in peri-uterine and dysmenorrhceal neuralgias 
(B.). Tnj of solution of gr. j-.^ij of water hypodermically (P.). Spinal irrita- 
tion, intercostal neuralgia. The liniment or ointment of atropine in facial (R.). 
Gr. 0.15 of the extract every hour till giddiness, then lessen dose. Continue 
for several days (Tr.). Veratrum Viride, tincture, said to be very useful (R.). 
Veratrine, the ointment for face and sciatica (R.). Oint. fgr. viij-gj) frequently 
of much benefit (P.). Nux Vo??iica, is most useful in visceral neuralgiae, as 
gastralgia, hepatalgia, etc., the tincture with carminatives in the former affec- 



NEURALGIA. 675 

tion ; or strychnine, gr. r J^ to ^ twice or thrice daily. In all forms of neu- 
ralgia this remedy should be used in small doses (P.). Arsenic, cures by 
its influence on bodily nutrition ; directly so in neuralgias of malarial origin, 
though inferior to quinine (B.). In various neuralgias, also in angina pec- 
toris (R.). Phosphorus, gr. -^ every few hours, has made very effective cures 
(B.). Gr. j^q to -5*2 every 3 hours. Very useful in all forms, especially when 
uncomplicated (R.) ; always a good remedy except for cases due to cold or 
inflammation, and those not depending on depraved nutrition (H.). Quinine, 
large doses (gr. v-xx, in sherry), just before attack in periodical neuralgia, 
whether malarial or not. Useful also in small, frequently repeated doses in 
other types, especially of supra-orbital nerve (P.). Sumbul, for certain types, 
of more value than any other remedy. Facial, sciatic, or ovarian, in women 
of nervous constitution, often yield to it at once (P.). Cimicifuga, in neuralgia 
of the 5th from cold, and in ovarian neuralgia (B.). Gelsemium, successful 
in neuralgia of 5th (B.), especially dental branches (R.); of value in trige- 
minal, ovarian, etc. (W.) ; in suitable cases small doses answer as well if not 
better than large ones (Pf.) ; Tri_iij of the tincture every y z hour often succeed 
miraculously with no ill results in neuralgia? about the head and face (A. A. 
Smith); no better remedy in tic douloureux, but must be given in large doses, 
rn_x-xv of a strong tincture or fluid extract (H.). Zinc Valerianate, extremely 
beneficial in neuralgia from reflex irritation of female pelvic organs (B.). 
Spigelia Anthelmia, useful in facial (P.). Ammonium Valerianate, or Zinc 
Vol. in neuralgia of face or head (R.) ; the latter in nervous cases, and uterine 
(Wa). Chamomile, in neuralgia of 5th nerve (R.). Staphisagria, internally 
and externally often curative in obstinate facial and cervical neuralgia (P.). 
Ignatia, in hysterical and intercostal neuralgia, with nervous erethism, is valu- 
able (P.). Ergot, much employed in visceral forms, especially gastralgia 
(P.) ; said to be useful (R.). Ammoniated Copper, in neuralgia of the 5th, lately 
used by Fereol with remarkable success ; y z -grain doses pushed. Eserine, 
very efficient in neuralgia of the eye-ball, a solution of gr. ij to the ^ by instil- 
lation. Cocaine, as a hypodermic injection, a 4 or 5 per cent, solution is very 
effective if administered in the vicinity of the aching nerve ( R. ) ; also by instil- 
lation in neuralgia of the eyeball, and whenever it can be applied to a mucous 
surface in the vicinity of the pain. Cannabis Indica, %-%-g?- doses of ex- 
tract 2 or 3 times a day; especially for neuralgic headache (P.); found useful 
(R.). Cod-Liver Oil, when low nutrition, faulty assimilation (W.). Iron, when 
from anaemia. Tincture of chloride (111 xxx-xl ter die), also chalybeate waters 
(B.). Moderate doses only required (R. ). In chlorotic subjects, of whom 
nearly all will have neuralgia (Tr.). Iodides, for neuralgia of fifth, dependent 
on syphiloma of the nervous system, pain nocturnal chiefly (B.). Bromides, 
benefit some kinds, especially ovarian (B.) : potassium bromide occasionally 
relieves (R.). Ammonium Chloride, half-drachm doses in facial and other 
neuralgia?, is much used (R.) ; a very efficient and diffusible stimulant, gr. xx 
-^j at first, repeated every hour during the attack (H.). Chloroform, as anaes- 
thetic to relieve pain, is occasionally useful locally, also as spray for uterine 
neuralgia (R.) ; by deep injection into vicinity of affected nerve, rrtv-xv of 
pure chloroform, a very efficient method of dealing with long-standing cases 
(B.) ; used in one case it caused symptoms so severe as to imperil the life of 
the patient (W.). Caffeine, hypodermically has been found useful, especially 
in cervico-brachial neuralgia (P.). Croton Chloral, very effective, especially 
in tic douloureux and sciatica, gr. ij-v every hour till gr. xv are taken (B.) ; 
in facial, that from carious teeth, that of neck and back of head, tic douloureux, 
etc. (R.). Gr. j every y^ hour is a very efficient dose (A. A. Smith) ; rarely of any 



676 



NEURALGIA, 



value, but when used is best given in 20-grain doses twice daily (H.). Chloral 
and Camphor , partes aequales, triturated together, and painted over surface 
(B., R.) ; also with morphine (B.). Aquapuncture, strangely relieves pain in 
a superficial nerve, so much so, that some hold the curative effects of morphine 
injection to be due to the water (B.). Counter-irritation. Mustard poultices 
in neuralgic pains (P.). Blisters to a posterior branch of the spinal nerve- 
trunk from which painful nerve issues (Anstie). Amyl Nitrite, inhaled in 
dysmenorrhceal neuralgia (B.) ; and when of 5th nerve (R.). Nitro-glycerin, 
has often afforded great relief ( Wa.). Carbonic Acid Gas, injected into vagina 
for neuralgia of uterus (R.). Digitalis, is strongly recommended in sciatica, 
also locally in earache (P.). Valerian, serviceable in facial neuralgia of hys- 
terical type (P.). Biburu Bark, in intermittent forms (P.). Py7'ethrum, root, 
is chewed with benefit in facial neuralgia (P.). Capsicum, a. strong infusion on 
lint covered with gutta-percha (R.). Coccus Cacti, has been very successful 
in 20-30 minim doses of a ]/%X\\ tincture twice daily, the larger dose in the par- 
oxysm ( W.). Peppermint, Oil of, painted over the part in facial neuralgia 
(R.); especially the Chinese oil which contains a large excess of Menthol, a 
very useful application in superficial neuralgiae (W.). Turpentine, has cured 
tic douloureux and sciatica (B.) ; often of wonderful service (P.). Potassium 
Chlorate, for facial neuralgia (B.). Alcohol, with much volatile ether; care 
must be taken in prescribing it (R.)- Piscidia, almost specific in many forms, 
useless in many cases ( W.). Tonga, is efficient in facial neuralgia, nxx-xx every 
two hours (H.). Osmic Acid, a one per cent, aqueous solution with glycerin 
to prevent change, of which 5 to 10 drops hypodermically, has made striking 
cures of inveterate neuralgiae, with no ill effects resulting (Shapiro). Wet 
Pack, is of great benefit, especially in sciatica. Galvanism of the affected 
nerve, one of the most important curative measures ; a continuous current of 
4 to 8 cells down the nerve generally answers best, though some cases are 
helped more by a rapidly interrupted faradic current. Electricity is of no 
value in cases dependent upon organic lesions, and in any individual case is 
purely experimental (W.). Diet. Animal fats necessary, as cod-liver oil, butter, 
cream, etc., in as large quantity as can be digested. Rest vixen, needed, with 
protection from cold and damp, flannel clothing, bathing and shampooing. 
[Compare Gastralgia, Hepatalgia, Sciatica, Tic Douloureux, Hemi- 
crania, etc.] 

Prescriptions. 



Local Use. 
]J. Chloroformi, 

Tinct. Aconiti, . aa Jss. 
Linim. Saponis, . . 3J. 
M. Sig. — Apply on flannel and 
cover with oiled silk, for superficial 
neuralgia. 



B . Aconitinae ( Duquesnel), 

Veratrinae, . 

Glycerini, 

Cerati, .... 
M. Sig. — To be rubbed 
part, avoiding any abraded 



carefully. 



gr. iv. 
gr. xv. 

m : 

over the 

surface 

{Da Costa.) 



R 



Internal Use. 
. Phosphori, . . gr. ss-jss. 

Alcoholis, q. s. ad solv. 
Spt. Menthae Piperitae, q. s. 
Glycerini, . q. s. ad ^iv. 

M. Sig. — A teasp. after each meal. 

(H.) 



I£. Cupri Ammonio-sulphat., gr. j-iv. 

Syr. Aurantii Flor., . gj. 

Aquae Destil., . . 311J. 

M. Sig. — One-third as a dose, 

thrice daily. {Prof. Fereol.) 



NIGHT-MARE — NODES. 



677 



Local Use. 
R . Veratrinae, . . . gr. xl. 

Adipis, vel Unguenti, . ^j. 
M. Sig. — Local use. {Da Cos/a.] 



R. Menthol, .... gj. 
Alcoholis, . . . . gij. 
Solve. Sig. — Paint over the painful 
area. 



Internal Use. 
R . Quininae Sulphatis, . 
Ferri Pyrophosphatis, 
Strychninae Sulphat., 
Ac. Phosphor. Diluti, 
Syr. Zingiberis, 
Aquae, 
M. Sig.— A 
daily. 



3h 

gr. ss. 

§§■ 

q. s. ad ^iv. 
tablespoonful twice 



Night-Mare. 

Potassium Bromide, in night-mare of adults; and children's attacks of 
night-screaming often associated with squinting. Digestive organs may 
also require attention (R.). Camphor-water, a teaspoonful or two the most 
suitable medicine (H.). Sleep, in abundance, may prevent (H.). Diet, 
light; avoid late meals. 



Nipples, Sore, Fissured. 

Benzoin, an admirable local application (P.); the tincture locally for slight 
erosions (Parvin). Arnica, the cerate, or Glycerin of Starch, or glycerin, 
I to 2 of eau de cologne (R.). Silver Nitrate, touched lightly ; effectual (Wa.). 
Sulphurous Acid, solution neat or diluted, constantly applied, or with equal 
quantity of glycerin as lotion (R.). Collodion, sometimes used (R.) ; useful for 
protection (P.); as coating (B.). Alcohol, brandy and water as lotion before 
delivery and after each suckling to prevent cracking (R.). Borax, saturated 
solution, beneficial (Wa.). Iron, the solution of the subsulphate diluted with 
3 parts of glycerin, and applied with a camel's-hair brush, an effective applica- 
tion for fissured nipples (B.). Tannin, the glycerite, one of the best applica- 
tions to fissured nipples (B.). Lead Nitrate, in glycerin, or ointment ^j-^j, 
in fissured nipples (B.). Zinc Shield, constantly worn (R.). Balsam of Peru 
or Tolu, valuable as application, with oil of almonds, gum arabic, and rose- 
water (P.). Rhatany, as wash or cerate, has had great success in fissure 
(Tr.) ; I part of extract to 15 of cocoa butter (Wa.). Nipple- Shield, to give 
the nipple rest while the child sucks, gives great comfort. [Compare LACTA- 
TION, Mastitis.] 

Prescriptions. 



R. Balsam. Peruvian., . . gij. 

Olei Amygdalae, . . £jss. 

Mucil. Acaciae, . ^ij. 

Aquae Rosae, . . . q. s. 

M. Sig. — Apply to the nipples after 

each nursing. {Phillips.) 



R . Liq. Plumbi Subacet. Dil., 

Ext. Opii Aquosi, . 

Aquae Rosae, . 

M. Sig. — Lotion, to be used after 

a bread-and-milk poultice, for inflamed 

nipples. {F. Barker.) 



gss. 
5iijss. 



Nodes. 

Mercury. The oleate of mercury and morphine externally, is very valuable 
(R.). Potassium Iodide, as ointment in conjunction with internal use, in syph- 
ilitic nodes of children ; also in non-syphilitic periosteal thickenings (R.). In 



678 



NYMPHOMANIA ODONTALGIA. 



syphilitic nodes it holds the first place, especially when pains are worse at 
night, and by heat of bed (Wa.). Stramonium leaves, locally, relieve (Wa.). 
[Compare Exostosis, Periostitis.] 



Nymphomania. 

Potassium Bromide, when from plethora ; not useful when relaxation, or 
from cerebral lesion (B.) ; large doses required, at least gr. xx ter die (R.) ; an 
abundance of evidence testifies to its value (W.) Tobacco , to nausea, effect- 
ually cures, but is horribly depressing (B.). Camphor, in considerable doses 
said to control inordinate sexual desire (R.) ; at present not much relied on 
(Wa.) Lupulin, seems worthy of fair trial (Wa.). Sulphur, or dilute sul- 
phuric acid, internally, when arising from hemorrhoidal congestion, not an 
infrequent cause (Wa.). 

Obesity. 

Banting Dietary is alone sufficient to improve the condition. Its chief fea- 
ture is the exclusion of two elements — starch and sugar — from the food. There- 
fore bread (except toast, or the crust of a common loaf), potatoes, sweet roots, 
butter, sugar, cream, beer, porter, and champagne, should be avoided. In one 
year, on this diet, Mr. Banting reduced his weight 46 pounds, and his girth about 
12 inches; at the same time, his numerous corporeal infirmities were greatly 
mitigated or altogether removed. Cannot be recommended indiscriminately. 
This was the method of Hippocrates, avoiding all fats, starches, and sugars ; 
in fact, all roots or vegetables grown underground (B.). Alkalies. Solutions 
of oxides or bicarbonates (R.) ; alkaline mineral waters, with exercise and 
dietary (B.) ; serviceable (Wa.). Liquor potassse £ss in milk, thrice daily, of 
established value (W r a.) ; generally fails (R.). Ammonium Bromide, sets up 
gastric catarrh (B.) ; but lessens corpulency (Wa.). Sulphurous Waters, espe- 
cially Blue Lick, giv before each meal (B.). Potassium Permanganate, for 
attendant dyspepsia and flatulence; also useful for the obesity ; gr. ^-j ter 
die, in aq. dest. (B.). Vinegar, only successful at expense* of serious injury 
to the body (R.). Fucus Vesiculosus, has power to reduce adipose tissue. 
An extract is sold under the title " Antifat" as a proprietary medicine (W.). 
Exercise, daily, in the open air is necessary, and if carried on sytematically is 
the most efficient and least injurious method of reducing an excess of adipose 
tissue. 

Odontalgia. 

Aconite ointment or liniment for facial neuralgia due to diseased teeth, will 
succeed quickly if at all (R., Wa.). Arsenic, gr. ^, as escharotic to destroy 
pulp, when used for pain may be mixed with opium. It sometimes at first 
aggravates pain (R., W.). Staphisagria, the alcoholic solution dropped into 
the cavity (P.)« Alum, a solution in nitric ether (gij-^vij) is said to be an 
effectual application (B.). Alum and salt powdered and placed in the cavity, 
excellent when nerve exposed. Chloral, rubbed up with equal weight of 
camphor, rubbed or put into cavity (R.). Chloroform or Croton-Chloral, equal 
parts of the former and creasote, a good application ;R.). Tannin, a solu- 
tion in ether is a good application to a carious tooth (B.). Creasote, with 



ONYCHIA AND PARONYCHIA. 679 

tannin or opium or chloroform, placed in the cavity of a decayed tooth, often 
gives relief (R.). Cocaine, a 5 per cent, solution of the hydrochlorate on cot- 
ton applied to a cavity will often bring instant relief. Conine, solution in alcohol 
placed into a hollow painful tooth (R.). Collodion and Carbolic Acid, equal 
parts as jelly for stopping carious teeth (R.). Opium, mixed w T ith tannin or 
creasote inserted in cavity of painful tooth (R.). Morphine, hypodermically 
for severe toothache (R.). Oil of Cloves, inserted into cavity (B., P.). Camphor, 
with morphine and flaxseed, as a cataplasm to the cheek (B.). Xanthoxylum, 
a domestic remedy (B.). Capsicum, a strong infusion on lint (R.). Gelse- 
mium* useful in some forms (R.). Zinc Chloride, to destroy exposed painful 
pulp (R.). Ginger, Mezer eon, Pyrethrum,2xz useful masticatories in tooth- 
ache (P.). 

Prescriptions. 



R. Linim. Aconiti (B. P.), 

Chloroformi, . . aa giij. 

Tinct. Capsici, . . . 3J. 

Tinct. Pyrethri, 

Olei Caryophylli, 

Pulv. Camphorae, . aa £ss. 
M. Sig. — A few drops to be placed 
on a pellet of cotton and applied to 
the cavity. 

{Mason.) 



]£ . Morphinae Sulph., . . gr. iv. 

Atropinae Sulph., . . gr. j. 

Aquae Destill., . . §j. 
M. Sig. — A few drops on cotton, 
placed in the cavity. (B.) 



K . Ac. Tannici, . , . gr. xx. 
Mastiches, . . . gr. x. 
TEtheris, . . . gss. 

M. Sig. — On cotton to cavity. (D.) 



CEsophagus, Affections of. 

Belladonna, the liniment with frictions to the sternum, often very useful as 
a palliative in stricture of the oesophagus ( Wa.). Conium, in spasmodic Con- 
tractions, with crampy pains of stomach, flatulence, and globus hystericus, 
has proved very serviceable (Wa.). Hyoscya?nus, or Conium, in stricture of 
oesophagus, if much irritability ; with occasional leeching to relieve exacerba- 
tions of pain or spasm (D.). Silver Nitrate, in stricture of the oesophagus, 
a weak solution on sponge probang (D.). Anesthetics, should be used only 
to meet temporary indications (W.). Nutrient Enemata, in stricture of the 
oesophagus, when swallowing impossible (R.) ; may, in some cases, even pre- 
serve life (Wa.). [See Enemata.] Bougie Dilatation, in non-spasmodic 
(structural) stricture, the only appropriate treatment (H.). [Compare Dys- 
phagia, Choking.] 

Onychia and Paronychia. 

Silver Nitrate, a strong solution in nitrous ether, painted over the adjacent 
tissue, will abort if applied early (B.); frequently causes resolution of the 
inflammation (Wa.). Lead Nitrate, dusted over night and morning (R.); 
relieves pain, and hastens healing process (B.). Turpentine, applied on a 
piece of lint or other absorbent material, stops the pain at once, and seems to 
kill the felon. Mtrcury, as ointment, for 10 minutes in every hour; poul- 
tices in interim (R.). Arsenic, gr. ij ad ^j Adipis, as ointment, almost specific 
in onychia maligna (Wa.). Tartar Emetic, will shorten course, and render 



68o OPHTHALMIA. 

it milder (R.). Iodoform , oint. or powder dusted on (B.) ; or I part to 9 of 
Ether applied by a dropper in syphilitic onychia (Fox). Iodine, a strong al- 
coholic solution locally will often subdue the disorder (Wa.). Chloral, a 
solution locally, as antiseptic, and to promote healing (B.). Sodium Chloride, 
common salt roasted until chlorine is driven off, equal parts of this, castile 
soap and Venice turpentine, as a poultice, is a very efficient application. Car- 
bolic Acid, to benumb surface during incision (R.) ; which should be carried 
down to the bone, especially in tendinous whitlow (D.). Cocaine, hypoder- 
mically, will accomplish the local anaesthesia more thoroughly, if delivered 
deeply into the tissue. Morphine, powdered, as local application to relieve 
pain. Heat, by poultices, is very useful. 



Ophthalmia. 

Silver Nitrate, a strong solution (gr. xx ad ^j) in granular lids; cautiously 
when corneal ulcers exist (B.) ; solid stick diluted with 2 to 4 parts of potas- 
sium nitrate, applied lightly and quickly, or a solution (gr. ij-x ad gj) painted 
over everted lids, which should be washed with a solution of common salt, 
and then with water before being replaced (C.) ; in solution, gr. v ad ^j aquae 
destillatae, locally once a day in purulent ophthalmia of the new-born, washed 
off with a weak solution of common salt (Noyes) ; in solution, gr. iij'to the ^ 
to abort the discharge in catarrhal ophthalmia (Fox). Boro-Glyceride, in 
many catarrhal affections, especially ophthalmia neonatorum, is a most effica- 
cious application, the solutions used being of 10, 25 and 50 per cent, strength 
(Fox). Alum, gr. viij ad ^j aquae, applied every % ox y 2 hour in purulent 
ophthalmia of children ; success depends on the frequency of the application 
(R.); a crayon formed of a crystal of alum, a mild and occasionally useful 
application (C). Mercury. Calomel dusted over membrane in phlyctenular 
ophthalmia ; or after detaching scales rub in brown citrine ointment every 
night for eczema of margin of lids (B.), Pulsatilla, as lotion to conjunctiva 
8 or 10 times in 24 hours, also internally (P.) ; much used by homoeopaths 
(B.). Spigelia, useful in rheumatic ophthalmia (P.). Antimony. Tartar 
emetic, gr. ^ to ^, three or four times a day in strumous ophthalmia, with 
sharp purgation at commencement (R.). Belladonna, or Atropine, locally, 
of great service in strumous ophthalmia to relieve pain ; constitutional treat- 
ment also required (Wa.). Atropine, gr. ij of neutral sulphate to the g of 
aqua destillata, twice or thrice daily, as soothing application (C.). Arsenic, 
invaluable in inveterate cases of strumous ophthalmia, especially when com- 
plicated with cutaneous eruptions (Wa.). Copper Sulphate, gr. j ad ^j aquae 
camphorae as collyrium in purulent ophthalmia of infants ; in substance to 
inner part of lids in granular conjunctivitis (Wa.). Tannin, powdered (or in 
solution gr. j-x ad gj) produces remarkable results (B.). Lead Acetate, gr. j 
ad ^j aquae destillatae, applied by camel's-hair pencil to surfaces of everted 
lids, washed away before the lid is replaced. Or the Tannate of Lead \y2 ad 
3 parts fine oil, and I of fresh lard, a very small piece as ointment to lid (C). 
Carbonic Acid Gas, said to relieve the pain and photophobia of strumous 
ophthalmia when locally used (R.). Physostigma, to reduce pupil and shut out 
the light (P.). Iodine, is employed in scrofulous ophthalmia, locally for its al- 
cerative stimulation (W.). Iodofor?n, in gonorrhoeal ophthalmia, and purulent 
conjunctivitis, of very great value locally, but should be pulverized very finely 
(Grossmann) ; does not bear out the claims made for it (Keyser). Zinc Chloride, 
gr. j ad Jj aquae as collyrium, in gonorrhoeal ophthalmia, used with marked bene- 



OPIUM HABIT. 68 I 

fit; also a stronger solution (gr. ij-iv ad gj), effectually arrests the muco-puru- 
lent discharge remaining after subsidence of purulent ophthalmia, and has suc- 
ceeded admirably in diphtheritic conjunctivitis and pustular ophthalmia (Wa.). 
Zinc Sulphate, as collyrium, gr. j-iv ad gj, is very serviceable in ophthalmia 
of infants or adults; liquor plumbi added improves (Wa.). Staphisagria, 
especially in tarsal ophthalmia (P.). Colchicum, when gouty diathesis (P.). 
Cod-liver Oil, in strumous subjects, tends to remove the manifestations of the 
disease (R.). Cold Wet Compresses, or iced, are held to be essential in early 
stage of acute purulent and gonorrhceal ophthalmia (C). [Compare Ble- 
pharitis, Conjunctivitis, Keratitis.] 



Opium Habit. 

Capsicum, very serviceable from its power as a stimulant to the stomach, 
and its sedative action on the cerebrum (B.) ; removes the sinking sensation 
at the pit of the stomach experienced by alcoholics, when trying to break off 
that habit (R.). Cocaine, or the fluid extract of Coca (Erythroxylon), has 
been used to relieve the depression caused by the withdrawal of the drug 
(B.); has been, by many careful observers, pronounced of great benefit, re- 
storing appetite, inducing sleep, promoting digestion, while soothing the 
brain and inducing a feeling of contentment and calm (R.). Bromide of So- 
dium in large and increasing doses, £j twice daily, increased by 20 grains 
each day, to a maximum of 100 to 120 grains twice in twenty-four hours, 
with simultaneous gradual reduction of the opiate dose, so that from the 8th 
to the 10th day it is entirely abandoned. Each dose of the salt should be 
given in 6 or 8 fluid ounces of cold water (Mattison). Cannabis Indica, may 
be required in full doses, for restlessness after withdrawal of the opiate, 
g-doses of Squibb's fluid extract, repeated every hour or two, as required (M.). 
Galvanism, is very efficient for the neuralgic pains in various parts ; a strong 
faradic current sometimes acting better (M.). Baths y if hot, 105 to 1 1 2° F., 
are of great value to relieve disquiet ; warm baths are worthless (M.). Chloral, 
as a hypnotic, fails in the first few days of abstinence ; later in full doses, 45 
grains at once, rather than three 15-grain doses, alone or with a bromide, it 
can be relied on (M.). Hyoscyamine, Merck's amorphous, gr. T ^ to \ hypo- 
dermically, or more, is useful as a hypnotic, and perfectly safe, in patients of 
good general condition, in whom the disuse of Opium produces unusual in- 
somnia and motor activity (M.). Lupulin, with Phosphoric Acid (see formula 
below), helps to sustain the patient, lessens the force of his suffering, and 
shortens its duration (Fleming). Zinc and Iron as blood tonics, given for a 
month at least, are valuable, and are best given on alternate days (see formula 
below) (Fleming). Piscidia Eiythrina, has been proposed as a substitute, 
and highly commended, but is worthless, as are also Avena sativa and many 
other falsely termed substitutes (M.) ; there is no remedy for the opium-habit 
(Da Costa). Zinc Oxide, for the vomiting and diarrhoea, beginning with gr. j 
once daily and increasing to tolerance (Da C). Withdrawal of the drug sud- 
denly and completely, is the method of Levinstein and other Germans, and 
is preferred when we can have absolute control and surveillance of the pa- 
tient (Da C.); entails horrible suffering, and is utterly inexcusable (M.). A 
more gradual reduction is the method usually employed, taking off one-third 
the first day, one-fourth the second day, and then gradually reducing the 
amount until the sixth or seventh day, when it is entirely withdrawn. 

57 



682 



ORCHITIS. 



Prescriptions. 



R . Tinct. Capsici, . . . £iv. 

Potassii Bromidi, . . ^iv. 

Spt. Ammohiae Aromat., . 5iij. 

Aquae Camphorae, . adgv). 
M. Sig. — A dessertsp. several 
times daily, in the depression of al- 
coholism and opium-habit. Instead 
of the bromide, Fowler's Solution 
(Liq. Potas. Arsenitis), Tn_l, may be 
added; or Tinct. Nucis Vomicae £ij, 
or Tinct. Aurantii Amari £v. 

{Ringer.) 



R . Acidi Phosphor. DiL, . fix. 
Tinct. Lupulini, . . gxx. 
M. Sig. — A dessertsp. in a wine- 
glass of water every 4 hours, 1 hour 
before food. {Fleming.) 



R. Zinci Valerianatis, . gr. xxiv. 

Quininae Sulph., . gr. xij. 

Ext. Lupuli (B. P.), . q.s. 
M. ft. pil. no. xij. Sig. — One pill 
morning and evening, every second 
day, alternating with the Iron Mix- 
ture. {Fleming.) 



R. Strychninae Sulphatis, . gr. ss. 

Tinct. Belladonnae, 

Tinct. Capsici, . aa giij. 
M. Sig. — Ten drops every three 
hours, increasing three drops daily. 



gr. ss-j, 



R. Strychninae Sulph., 

Tinct. Gentianae Co., 

Tinct. Cinchonae Co., . aa ^ij. 
M. Sig. — Teasp. before each meal, 
as a stimulant to the appetite and 
nervous system. 



R . Tinct. Cannabis Ind., . "ntxl-lx. 

Spt. yEtheris, . . £j. 

Aquae, . q. s. ad Jj. 

M. Sig. — One dose, if insomnia is 
very protracted. {Fleming.) 



R . Syr. Ferri Phosph. (B. P.), ^xiv. 
Ac. Phosphor. Diluti, . ^vj. 
M. Sig. — A teasp. in a winegl. of 
water, after meals, twice daily everj 
second day, alternating with the Zinc 
pill. [Fleming.) 



Orchitis. 

Pulsatilla, mj or less, every hour, relieves pain rapidly, though not the 
oedema (St.). Belladonna, int. and as oint. (extract j ad iij adipis) when in- 
flammation has subsided (Wa.). Iodine, tinct. locally to remove swelling after 
the acute stage has passed (B.). Mercury, the oleate locally (B.); Calomel 
gr. iij with Ipecac, gr. x at once, followed by a saline next morning, and 
smaller doses of calomel and ipecac, every 6 hours, with morphine hypoder- 
mically, gr. %, into cellular tissue of scrotum (McElroy). Ammonium Chlo- 
ride, makes a good evaporating lotion, in solution with alcohol and water 
(B.). Silver Nitrate, a strong solution to the scrotum, with gentle pressure 
(Wa.). Tartar Emetic, in acute orchitis (R.). Digitalis, locally, is found 
most useful (P.). Alcohol, with equal quantity of water, as evaporating lotion 
(B.). Ice, benefits and relieves pain (B.). [Compare Epididymitis.] 

Prescriptions. 



R. Ammonii Chloridi, . gr. xl. 

Alcoholis, Aquae, . aa ^ij. 
M. Sig. — Lotion, to be applied on 
cloths to the part. 



R. Hydrarg. Ammoniat., . zj. 

Cerati Simplicis, . . )fj. 

M. ft. unguent. Sig. — Apply lo- 
cally, with gentle friction. 



OTALGIA — OVARIAN NEURALGIA. 683 

Otalgia. 

Aconite and Opium, equal parts of the tinctures, a few drops well down the 
external meatus, will often subdue the pain. Blistering Fluid, or Croton Oil 
Liniment, behind the ear often relieves earache (R.). Glycerin, for dryness 
of meatus (R.) ; or oil for accumulation of wax in external meatus, dropped 
in every night, gentle syringing in the morning with warm water (CI.). Opium, 
Morphine in solution, gr. iv to the ^, with gr. j-ij of Atropine, is an excellent 
application (B.). Atropine, gr. fa in jxx of water, a teasp. every three hours 
for a child in the acute otitis media of children from coryza, very successfully 
used to abort the otitis, and relieve the earache (Miot). Pulsatilla, internally 
and externally, is often used with advantage (P.). Cocaine, a 4 per cent, so- 
lution sprayed over the tympanic membrane through the external meatus, and 
forced into the Eustachian tubes by inhaling the vapor and then expanding 
the tubes by Valsalva's method ; this repeated every three minutes, is a very 
sure method of curing otalgia (R.). 

Otitis. 

Pulsatilla, in inflammation of external auditory canal; in otitis, as lotion 
warmed and applied by syringe, three or four times a day (P.). Aconite, 
quickly relieves the pain (R.) ; should be used internally and locally. Atro- 
pine, in the acute otitis media of children, is very efficient. See Otalgia, 
above. Blisters, behind ears, either kept discharging or repeated, often very 
useful (Wa 4 ). Leeches, behind the ear, afterwards a small blister upon the 
same place, when leech-bites have healed (H.). Warm Douche frequently, 
to the ear (Roosa). [Compare Otorrhcea.] 

Otorrhoea. 

Mercury, in chronic cases, the brown citrine ointment (B.). Lead lotions 
much employed (B.). [See Gonorrhoea, for formula.] Potassium Per- 
manganate, as injection or spray, gr. j-gj aq. destil. (B.). Silver Nitrate, 
locally, a solution of gr. iv. to the J (B.) ; gr. x to the fy (Roosa). Copper 
Sulphate, gr. j-v to the § | Roosa). Tannin, the glycerite, locally, is suc- 
cessful (B.) ; especially in children (Wa.) ; Zinc Sulphate, locally, in solu- 
tions of gr. ij-viij to the % (B.) ; gr. j-v to the ^ (Roosa). Cadmium, gr. ij- 
^j rose-water (B.). Liquor Soda Chlorates, m_xv-xxx ad ^j aquae when dis- 
charge fetid: is highly useful as injection (Wa.). Quinine, with sulphuric 
acid, advisable in otorrhcea after scarlatina (Wa.) Boracic Acid, finely pul- 
verized, as astringent and disinfectant application ; may be mixed with pulv. 
Alum, and just enough powdered Lycopodium to keep it dry ; — this packed 
carefully through speculum, after washing with a weak and tepid alkaline 
solution. Absorbent Cotton on holder, may be used every few hours by patient 
to keep pus removed from the canal. Syringing with warm salt water, once 
daily, as absolute cleanliness is essential in the treatment. Politzer Bag is a 
useful adjunct in keeping secretions out of tympanum and breaking up adhe- 
sions (Roosa). [Compare Otitis.] 

Ovarian Neuralgia* 

Atropine, subcutaneously, the best remedy for pain in the pelvic viscera 
(Wa.). Ammonium Chloride, gr. xxx with gtt. ij— y tinet, aconiti, repeated in 



684 



OVARITIS — OZ^ENA. 



^-hour if necessary to remove pain (W.). Camphor, with Cannabis Indica, of 
great service in relieving ovarian pain, especially when spasmodic in character 
(Wa.). Opium, often the cause ; if use stopped entirely improvement may 
ensue (E.); one of the best remedies in ovarian pain of non-inflammatory 
character (Graily Hewitt). Hot Water, vaginal injections, night and morn- 
ing; sunlight baths, fresh air (E.). Ether, the compound spirit, in doses of 
nixxx-xl as a palliative (Anstie). Gelsemium, deserves a trial; its power is 
great but not certain (Wa.). Leeches over the groin, or inside the thigh, where 
ovarian pain persistent, or tenderness and aching ( Wa.). Surgical. Battey's 
operation as a last resort (E.). [Compare Dysmenorrhea.] 



Ovaritis. 

Turpentine Epithems, may be applied hot over the seat of the disease (Wa.). 
Tartar Emetic, as ointment for counter-irritation over seat of disease, in sub- 
acute ovaritis; at same time a pill of opium, hemp and camphor. See for- 
mula below (Hewitt). Opium, in suppository or enema, more effectual than 
internally (Tilt). Mercurial Ointment, combined with camphor and bella- 
donna, over the seat of the disease by friction (West). Blisters, in subacute 
ovaritis are often of great service, placed over the region or to the cervix uteri 
(Wa.). Enemas, of warm water, simple or medicated, in subacute ovaritis, 
are warmly recommended ; they should be retained as long as possible ( Wa.). 
Ergot, is valuable in chronic ovaritis, with rest and Potassium Bromide (Tait). 
Ice, in bag, over seat of pain, when intolerable, and patient too much reduced 
to bear leeches ; is often of benefit (Wa.). Poultices of Linseed meal, as light 
as possible, often produce great benefit in ovarian inflammation. 



Prescriptions. 



R. Ext. Opii, . . . gr. iij. 

Ext. Cannabis Ind., 

Camphorae, . . aa gr. vj. 

M. ft. pil. no. vj. Sig. — One pill 

twice daily. ( Graily Hewitt.) 



H. Ung. Hydrargyri, 

Camphorae, 

Ext. Belladonnas, 
M. ft. unguent. Sig.- 
in twice daily. 



• 3 V J- 
. gr. xl. 

-To be rubbed 
{West.) 



Oxaluria. 

Mineral Acids, when eructations of sulphuretted hydrogen (R.). Nitro- 
muriatic Acid, is of important service (B.) ; especially in the condition show- 
ing general malaise, weakness, and depression of spirits, with oxalate crystals 
in the urine (W.) ; also in sciatica and other forms of neuralgic rheumatism 
accompanied with oxaluria, full doses (rrtyj-x) of this acid, with an occasional 
brisk purgative, and cold douche, followed by friction (Wa.). Zinc Sulphate, 
often very serviceable in irritability of the nervous system, associated with 
dyspepsia and oxaluria (Bird). Lactic Acid, aids imperfect digestion (B.). 



Ozaena. 

Gold, the auric salts are very serviceable in syphilitic ozaena (B.). Mercury, 
ointment of the nitrate in syphilitic form; the white or red precipitate with 58 
times its weight of sugar snuffed after clearing the nose in non-syphilitic forms 
(R.). Potassium Permanganate, 3J-OJ solution as injection or spray (B.). 
Hydrastis, the fluid extract locally (B.) ; ^j-^viij solution as lotion with vtyy 



PAIN. 685 

of the tincture thrice daily internally (P.). Bromine, as inhalation (see form- 
ula below ; or Iodine with Carbolic Acid, or the latter in one per cent, solution, 
as inhalations (B.). Carbolic Acid, inhaled, 1 per cent, solution ^B.). Silver 
Nitrate, applied behind veil of palate; — gr. v-xx ad §j (B.) Alum, solution 
(~j_Oji for irrigation (R.). Glycerite of Tannin, by irrigation (R.). Sali- 
cylic Acid, in very weak solution (I to 500), as cleansing, astringent, and dis- 
infectant wash, used by retro-pharyngeal syringe, and followed by applications 
of Calomel, in powder, to the ulcerated portions of the mucous membrane 
(Massei). Cubeba, the oleo-resin, gtt. xv-xx on sugar after each meal, to 
restrain the secretion and perhaps modify its character (Cohen). Chloride of 
Lime, gr. xxx-lx with gj decocti krameriae; of which ^ij-iij, diluted with an 
equal quantity of water, should be injected twice daily after cleansing with 
salt and water (Cohen). [Compare Catarrh, Chronic Nasal.] 

Prescriptions. 
R. Tinct. Iodi, . . . giv. R. Sodii Carbonatis, 

Ac. Carbolici, . . . ^j-ij- Sodii Boratis, . ii ^ij. 

M. Sig. — Use on sponge in a Liq. Sodae Chloratae, . ^ss-^ij. 

tvide-mouthed bottle as inhalation. Glycerini, . . . 5j. 

{Potter.) Aquae, . . q. s. ad ^vj. 

M. Sig. — Apply by means of a 
hand-spray apparatus. ( Thornton.) 

R. Bromi, .... gss. 
Alcoholis, . . . 555. 
M. Sig. — Inhalation when vapor- 
ized bv heat of the hand. 



R . Acidi Carbolici, . . rt] xx. 
Aquae Calcis, . . Oj. 

M. Sig. — Use as wash or spray. 



Pain. 

Opium, is universally used to quiet pain. Morphine, hypodermically, in 
vicinity of nerve, is curative when not so by stomach. Morphinae acetas vel 
sulphas gr. \-\, with atropinae gr. T ^ to ^\^. Caution, morphine habit (B.). 
Sometimes a single injection curative of sciatica and neuralgia. Poultices con- 
taining laudanum useful in inflammation. Linimentum opii by friction, relieves 
pleurodynia, neuralgias, etc. Opiates soon lose their influence in any certain 
dose, requiring increased quantities to keep up analgesic influence, so in chronic 
cases it is best to exhaust all other means before resorting to it (R.)- Chloral, 
has no direct pain-relieving power, except in dangerous doses. To relieve pain 
and promote sleep, the best agent is a combination of chloral and morphine, 
cautiou-'y, if heart trouble, or to old drunkards; gr. xv-xxx— gr. ft (B.). Some- 
times relieves neuralgia, chronic rheumatism, gall-stones, colic, gastralgia, and 
even cancer R.). Aconitine, locally over seat of pain; one of the most certain and 
powerful palliatives in neuralgic, rheumatic, and gouty affections (Wa.) ; espe- 
cially seviceable in neuralgia of 5th nerve (B.). Belladonna, the best remedy 
for every kind of pain in pelvic viscera (Anstie). Atropine hypodermically in 
local pain, neuralgia, sciatica, glaucoma, etc. When it succeeds, has more 
lasting effect than morphine (R.) ; sciatica, tic douloureux, etc. (B.). Iodides, 
are magical in syphilitic nocturnal pains of head (B.). The iodide of ammo- 
nium, gr. iij ad gj ol. olivae, with friction ; causes the disappearance of noc- 
turnal syphilitic pains (Wa.). Cimicifuga, relieves many kinds; neuralgia of 
5th, rheumatic headache, ovarian neuralgia, dysmenorrhcea. Inferior to 
ergot in labor-pains or after-pains, ^j doses (B.). Conhrm, in cancer, rheu- 



686 PARALYSIS. 

matism, neuralgia, etc. (R.)- Chloroform, locally, inferior to other local anaes- 
thetics, two or three drops on cotton into the ear for faceache or toothache ; 
vapor on raw surface of cancers, neuralgia of uterus, photophobic eye, etc., by 
inhalation in renal and biliary colic, and to produce general anaesthesia, which 
see (R.). Ether, spray for local anaesthesia; inhaled for general anaesthesia 
(R.). Carbolic Acid, as local anaesthetic (R.). Cocaine, as a local anaesthetic to 
mucous surfaces, or hypodermically for minor operations involving a small area, 
as circumcision, eye operations, etc., has no equal ; a 4 per cent, solution of the 
hydrochlorate is generally employed (R.); has many applications, as odon- 
talgia, otalgia, neuralgia of superficial nerves, etc., etc. Iodoform, as supposi- 
tory in painful diseases of the rectum or bladder (R.). Stramonium, is used 
as ointment (R.). Duboisine, used instead of atropine (B.). Rhatany, 
relieves the pain of ulcerative disease of mucous membranes, pain of burns, 
ulcers, and especially of blisters (Tr.). Cannabis Indica, formerly used (B.). 
Aquapuncture (B.). [See Neuralgia.] Galvanism, of an affected nerve 
gives certain relief. Positive pole on point of emergence ; negative over supe- 
rior ganglion of cervical sympathetic (B.). Heat, if pain is without fever or 
inflammation (B.) ; warm injections soothe the pain of cystitis, prostatitis and 
abdominal pains generally (B.). Cold, when pain is inflammatory (B.). [See 
After-pains, Anesthesia, Boils, Chest-pains, Colic, Gastralgia, Head- 
ache, Hepatalgia, Inflammation, Lumbago, Myalgia, Neuralgia, 
Odontalgia, Otalgia, Rheumatism, etc.] 



Paralysis. 

Strychnine, gr. gL- to -J^ [gr. -^ to T L (R.) ]; also hypodermically into 
the affected muscles, — for hemiplegia, paraplegia, local, mercurial, paludal, 
rheumatismal, facial, infantile, and diphtheritic paralyses ; in that of spinal 
muscles, of bladder and all local forms (B.) ; often of use in hysterical (P.) ; all 
forms, except, according to Barwell, in cerebral and spinal paralyses (R.). JVux 
Vomica, in hysterical, and in that from lead-poisoning ; only in chronic cases 
(P.) ; in paraplegia from softening and wasting of cord (Brown-Sequard). 
Hyoscy amine, gr. -^ gradually increased to j x 5 'm par. agitans, locomotor ataxia 
(B). Rhus Toxicodendron, certainly efficacious in cases depending on rheu- 
matism (P. ). Ammonium, the iodide and carbonate to aid in absorption of 
thrombi and thus promote cerebral nutrition in cases of incipient hemiplegia, 
due to endarteritis deformans reducing the lumen of the vessels in the brain 
(B.). [See formula below.] Arnica, paralysis of the bladder, and many forms 
(P.). Phosphorus, with cod-liver oil in paralysis agitans, small doses; also in 
the paralysis of white softening of the brain (B,) ; in hysterical paralysis (R.) ; 
in myelitic paraplegia from excessive venery ; the only drug which really 
affects the nerve-centres (W.). Belladonna, when depending on chronic 
inflammation of the cord (R.) ; externally as ointment along spine, with Ergot 
internally (Brown-Sequard). Physostigma, into the eye in ocular paralyses 
(B.) ; in general paralysis of the insane, also in progressive muscular atrophy 
without much mental disorder, long-standing hemiplegia, paraplegia, loco- 
motor ataxia (R.). Conine, in some cases of paralysis agitans (B.). 
Ergot, in paralysis of bladder from over distension (B.) ; paralytic dys- 
uria, sensation of but partial emptying of bladder (P.) ; said to be useful 
in paraplegia (R.) ; in paraplegia complicated with menstrual irregularity 
and forms of paralysis arising from spinal congestion (Wa.); has cured 
cases of constipation of the paralytic when all the most powerful cathartics 



PAROTITIS PEMPHIGUS. 687 

failed (Curran). Cocculus Indicus, valuable in hemiplegia, paraplegia, and 
paralytic stiffness (P.). Ignatia, in paralysis of lower extremities (P.). Can- 
nabis Indica, for retention of urine from spinal disease (R.). Capsicum, in ^ 
to 2-grain doses every 4 hours as general stimulant (P.). Colocynth, in cere- 
bral paralyses, sometimes seems to act favorably upon principles of revulsion 
or counter-irritation (P.). Mustard, as an emetic to stimulate failing heart in 
certain forms of paralysis (P.). Senega, in rheumatic, is a powerful help (P.). 
Nutmeg, the oil as external stimulant (P.). Oil of Bay, has been given; is 
obsolete (P.). Cajuput Oil, efficacious in palsy (P.). Counter-irritation, by 
blistering fluid in peripheral paralysis of the 7th nerve (R.). Cod-liver Oil, 
Anstie insists on it when low nutrition and faulty assimilation (B.). Galvan- 
ism, in hemiplegia and many forms (B.). Electricity, faradization of the muscles 
affected. Localized electricity probably of more importance in confirmed 
spinal paralysis than medicinal treatment. Massage, in infantile paralysis, 
given with lacto-phosphate of calcium and cod-liver oil. Strychnine injected 
into the muscles (B.). [Compare Hemiplegia, Locomotor Ataxia, 
Tongue.] 

Prescriptions. 

R. Ammonii Iodidi, . . gj. 
Ammonii Carbonatis, . ^ij. 

Liq. Ammonii Acetatis, . gvj. 
M. Sig. — A tablesp. thrice daily. 

See Ammonium, above. (B.) 



R. Strychninae Sulph., . . gr. ij. 
Aquae Destillatae, . . Jj. 

M. Sig. — For hypodermic admin- 
istration : m_v = gr. ^g of strychnine 
sulphate. 



Parotitis. 

Aconite, in febrile conditions (R.). Mercury. y z grain of gray powder, 3 
or 4 times a day very useful, relieving pain and swelling (R.). Poultice of 
flaxseed meal, a good local application for gland. Leeching, often gives speedy 
relief, when pain is great and resists hot fomentations ( Wa.). Care to avoid 
chilling, important. Incision, when suppuration occurs. Stimulants and 
Tonics internally are very necessary in symptomatic parotitis, occurring as a 
complication or sequel of other diseases, with adynamic symptoms. 

Pediculi. 

Mercury, Citrine ointment or wash of corrosive sublimate, for lice on all 
parts of body. The oleate destroys lice immediately, and also kills the ova 
(R.). Cocculus Indicus, destroys pediculi (P.). Staphisagria, as oil or oint- 
ment of the powder (R.) ; "lice-bane" (P.); the tincture a very efficient 
application, and much more cleanly than an oil or an ointment. Tobacco, a 
decoction of the leaf is an efficient application, but requires care, especially 
if the surface is abraded (Wa.). Essential Oils, will kill, as rosemary, anise 
(P.); or powdered pyrethrum (R.). Cleanliness, cannot be dispensed with, 
and in many cases may alone be sufficient. Boil underclothing. Isolation 
of person, and of brushes, towels, etc., to prevent infection. 

Pemphigus. 

Arsenic, is curative, especially when chronic (B.) ; largest dose, n\v liquor 
arsen. 3 times a day, on full stomach (R.) ; exercises a powerful influence 



688 PERICARDITIS PERITONITIS. 

(Wa.). Mercury. Citrine ointment is largely used (Wa.). Potassium Iodide, 
improves the condition in pemphigus (Wa.) ; with good, simple diet; quinine, 
cod-liver oil, etc. Silver Nitrate, in pemphigus, after the bullae have burst, 
and excoriations remain (gr. ij ad ^j aquae) (Wa.). Water Dressings, on 
lint, covered with oiled silk, constantly, in pemphigus and rupia ( Wa.). Cod- 
liver Oil, with nutritious diet, is a powerful auxiliary to treatment (Wa.). 
Puncturing the blebs and evacuation of their contents is necessary as soon as 
formed. Then dusting-powders of zinc oxide, starch, or buckwheat flour, or 
lotions of liquor plumbi subacetatis dilutus. 

Pericarditis. 

Aconite, when violent throbbing and extreme pain (R.) ; of great value, if 
given early (P.); proves in the highest degree serviceable, when object is to 
diminish vascular excitement or irritability (Wa.). Spigelia Anthelmia , useful 
in rheumatic pericarditis (P.). Digitalis, when rapid and feeble heart, cyan- 
osis and dropsy (P. N.) ; in second stage when heart flags, a tablespoonful of the 
infusion every 4 hours is beneficial. Bryonia, exceedingly valuable in sec- 
ond stage, that of exudation; fully equals any remedy in pericarditis (P.). 
Opium, regularly in grain doses, every 3, 4, 6, or 8 hours, is very beneficial 
(Wa.). Veratrum Viride, extract made by inspissating the juice of the root, 
of which gr. ij, with j of calomel, every 2 hours, valuable (Waring-Curran). 
Quinine, gr. xv-xx may suppress an acute attack, if given at critical mo- 
ment (B.); may be used as an antipyretic. Counter-irritation, has been 
much abused ; useful at commencement, but not in acute inflammatory stage 
(B.). Iodine painted over the cardiac region, or flying blisters in the second 
stage. Iron, the tincture in full doses may be required in the second stage. 
Poultices, large, hot, often renewed (R.). Ice may be used instead of poul- 
tices in the early stage. Paracentesis by aspiration may be required in the 
second stage. [Compare Endocarditis.] 

Periostitis. 

Mezeteon, in the rheumatic and scrofulous form (P.). Mercury and Mor- 
phine. The oleate externally (R.). Potassium Iodide, in syphilitic children, 
also in non-syphilitic periosteal thickening (R.) ; holds the first place for syph- 
ilitic affections of the bones (Wa.). Ammonium Iodide, cures periostitis most 
readily when syphilitic (Wa.). Staphisagria, when long bones affected (P.). 
Iodine, the tincture, or blisters locally, of great service in chronic form (R-); 
under the external use of Iodine it often rapidly improves (Wa.). Poultices, 
after an early and free incision, when suppuration takes place (C.). Incisions, 
carried deeply, should be made without waiting for fluctuation, when great 
tension exists and there is a tendency to suppuration. The sides of the abscess 
should then be brought together with compresses and a bandage (Gross). 
Tonics and stimulants, as milk-punch, quinine, iron, and opium, in full and 
sustained doses, are imperatively demanded in many cases (Gross). [Com- 
pare Nodes, Onychia.] 

Peritonitis. 

Aconite, of great utility when sthenic reaction; see Opium (B.) ; should 
be given early in all inflammations of serous membranes (P.). Bryonia, ex- 



PERSPIRATION. 689 

ceedingly valuable in second stage, when exudation (P.). Mercury \ when 
tendency to fibrinous exudations, is employed with good effect (W.). Opium, 
to quiet intestinal movements R. 1; by far the best agent (P., B.). Morphine, gr. 
l / 2 hypodermically, will often abort, if given early. Aconite and Opium, the 
tinctures, gtt. ij of the former with gtt. vj of the latter, in water every hour or 
two ; a larger dose of opium if pain is severe (B.). Large doses easily borne 
in this affection (Wa.). Cocctilus Indicus, for tympanites; a few doses will 
often remove the pain and relieve distension 1 P. ). Quinine, strongly urged 
by Trousseau ; is naturally indicated in most inflammations (P.). Turpentine, 
for tympanites (P.); turpentine stupes, v-xv drops of turpentine on flannel 
wrung out of hot water during acute stage, then blisters for a short time (B.). 
Leeches, to abdomen, if patient plethoric, and sthenic reaction, relieve pain 
(B.). Purgatives, are inadmissible when from perityphlitis or inflammation 
of appendix vermiformis (Bj. Poultices, large hot, and frequently renewed. 
Should be thin, and covered with cotton-wsol (R-). Ice, to abdomen (B.). 
Cold relieves 1 W.). Water, hot fomentations to relieve pain, sometimes cold 
compress better. Ice, sucked or swallowed, to assuage the vomiting ; sips of 
cold water. Diet, after acuteness of attack passed, should be mild and unstim- 
ulating. [Compare Puerperal Peritonitis.] 



Perspiration. 

Belladonna, as liniment locally, also the tincture internally, especially in 

weakly children who sweat profusely (RA Atropine, gr. ^-^ to y^-j hypo- 
der. (or in exceptional cases even gr. -^ in pill) in sweating of phthisis and 
exhausting disea-es R.); gr. -^ at bedtime for sweats of phthisis f'B.). Ja- 
borandi, gr. fo of pilocarpine, thrice daily, checks profuse perspiration (R., 
Pf.). Quinine, in exhausting diseases. In many, a night-draught of quinine, 
sulphate of zinc, and sulphuric acid, useful (R.). Opium, as Dover's pow- 
der, may succeed in profuse colliquative sweating (R.); a fact, though hard 
to account forit(Wa.j. Aromatic Sulphuric Acid, to check sweats of phthisis. 
Bad for digestion (B.). Muscarine, has been used with great success in the 
sweats of phthisis and of other morbid states (R.). Sage, an infusion at 
bedtime, for the night-sweats of phthisis 1 Da Costa). Zinc Oleate, rapidly 
controls excessive and offensive sweating on slight exertion in the axillae and 
groins, also the night-sweats of phthisis iMurrell). Zinc Oxide gr. iij, with 
gr. ss of ext. belladonnae, in a pill at bedtime for the sweats of phthisis (R.)« 
Gallic Acid, is very useful for the same condition, and may be combined with 
extract of belladonna (B.). Tannic Acid, may also be used with benefit. 
Aluminium, the oleate, checks hyperidrosis and antiseptizes the sweat, thus 
forming a useful application to the axillae and groins of children (Wa.). Po- 
tassium Permang., gr. j-^j, for fetid perspirations of axillae, feet, etc. (B.). 
Salicin, profuse sweats of hectic fever (Wa.). Salicylic Acid, in solution with 
borax, the most agreeable and efficient deodorant for fetid perspirations (B.). 
Carbolic Acid, 2 parts to 3 of glycerin and water, twice daily for fetid sweat 
(Wa.). Oils, rubbed into the whole skin to prevent sweating accompanying 
exhausting diseases, as phthisis ; but sponging with a weak acid w r ash better 
(R. 1. Ergot, said to arrest sweating (R. ). Sponging, with acidulated water, 
or very hot sponging in phthisis (R.J. [Compare Feet.] 

58 



690 



PERTUSSIS. 



Prescriptions. 



R . Acidi Gallici, . . gr. xxx. 
Ext. Belladonnas, . gr. ij. 

M. ft. pil. no. x. Sig. — Two pills 
at bedtime (B.). For sweating of 
phthisis. 



R. Acidi Tannici, 
Pulv. Digitalis, 
Ext. Cinchonas, 
M. ft. pil. no. xx. 

at bedtime. 



. gr. xxx. 
. gr. xv. 

. q.s. 
Sig. — One pill 



Pertussis 



Aconite, in all acute congestions (P.) ; as a preventive or abortive remedy 
very efficient, when associated with ipecac, and cherry-laurel water (Der- 
vieux). See formula below. Amyl Nitrite, with Carbolic Acid, in steam 
atomizer, has proved a very efficient inhalation (Bayliss). Ipecacuanha, use- 
ful in many cases (R.) ; nij for 5 years of age, every hour or two, with the 
greatest relief (P.) ; when bronchitic or pneumonic complications, combined 
with ammonium bromide (Wa.). Pulsatilla, gr. \~) of anemonine (P.). 
Belladonna, obviously of value in febrile stage, is of special use when denti- 
tion is in progress ; relieves the congestion of air-passages and also the deter- 
mination of blood to the head (P.) ; good when profuse bronchial secretion; 
best in spasmodic stage. Children bear this drug well ; ntx of tinct. may be 
given hourly to a child 2 or 3 years old (R.). Benzoate of Sodium is highly 
efficient. See formula below. Conium, or the Hydrobromate of Conine, in 
doses of gr. -^ to gr. \ according to age, a very efficient remedy (W.). Dro- 
sera, small doses are very effective (Murrell). Chamomile Oil, a very useful 
remedy (P.). Coccus Cacti (Cochineal), in doses of gr. y^ thrice daily for 
infants, has been highly recommended (W.) ; proves very effective in most 
cases. Hydrocyanic Acid, very serviceable in cough by habit, after cessation 
of whooping-cough proper, or in nervous sympathetic cough of mothers (B., 
P.). Opium, in convulsive stage, to produce and maintain slight heaviness 
(R.). Bromides, relieve spasmodic element (B.); that of ammonium will 
readily cure many cases; gr. ij or iij ter die for infants (Wa.). Lobelia, in 
spasmodic stages ; well tolerated by children ; mx of tinct. every hour for 
child 2 years old ; also additional dose when cough is imminent (R., P.). 
Alum, when acute stage over and no complication, gr. ij-vj every 3 hours, or 
less every hour in glycerin or honey (R.). Chloroform or Ether, to lessen 
severity of the paroxysms; as inhalations (R.). Chloral, gr. v-x in spas- 
modic stage, relieves quickly (B.) ; gr. iij-viij every 4 hours (Porter). Car- 
bolic Acid, as vapor, with steam atomizer; found to be very beneficial (J. L. 
Smith). Castanea, a decoction of chestnut leaves has been used with much 
success; dose ad libitum (B.); the fluid extract, in ^-doses, exercises a re- 
markable influence over the cough (W.). Valerian, said to control the par- 
oxysms (R.). Nitric Acid, well diluted m sweetened water, after the subsist- 
ence of the catarrhal stage (B.). Gelsemium, in spasmodic stage(B.). Mono- 
bromide of Camphor, gr. v in mucilage and syrup, tolu. 3 or 4 times a day, 
has been very serviceable (B.). Zinc Sulphate, gr. %-) with ext. belladon. 
gr. ye-yii nas varying degree of success (B.). Lactucarium, the syrup as 
vehicle for cough-mixtures (B.). Quinine, in solution, locally to fauces 
(Dawson); the tannate with sodii bicarb, of each 5, and pulv. acaciae 100 
parts, used with an insufflator (Pollack). Petroleum, on rags around head of 
the bed, is recommended highly by Hildebrandt. Silver Nitrate, when acute 
Stage passed (Tr.) ; probably inferior to alum (Wa.). [Compare Cough.] 



PHARYNGITIS. 



69I 



R. Chloralis, . 


• Eh 


Potassii Bromidi, 


• 39- 


Syr. Pruni Virgin., 




Aquae, 


• 3J- 


M. Sig. — A teasp. thrice daily for 


infants in the convulsive 


\ stage. 




{Dessau.) 


R. Ext. Aconiti, . 


• g r - J- 


Syr. Ipecacuanhas, . 


. mxiv. 


Aquae Laurocerasi, 


. ffj. 


Mucil. Acaciae, 


. 5vjss. 


M. Sig. — A teasp. 


to a tablesp. 


according to age, every 


hour. 




{Dervieux.) 



Prescriptions. 

B 



R . Olei Morrhuse, 

Mellis Despumat., 

Succi Limonis, . . aa p. aeq. 
M. Sig. — A teasp. or two as re- 
quired. {Sir Wm. Gull.) 



Sodii Benzoatis, . . gr. lxxx. 
Aquae Menth. Pip., 
Aquae Destillatae, aa^x. 

Syr. Aurantii, . ^ij. 

M. Sig. — A dessertsp. every hour 
or two. {Letzerich.) 



R. Acidi Carbolici, . . s^ss. 

Potassii Chloratis, . . ^ij. 

Glycerini, .... giv. 

Aquae, . . q. s. ad^\). 

M. Sig. — Use with steam atomizer 

thrice daily. {J. Lewis Smith.) 



R. Amyl. Nitritis, . . . ^ss. 

Acidi Carbolici, . . ""1 x. 

Glycerini, 

Alcoholis, . . aa ^ss. 
M. Sig. — Use by inhalation with 
steam atomizer. {Bayliss.) 



Pharyngitis. 

Aconite and Belladonna, for acute attacks (B.); when high temperature 
(R.). Belladonna,'^ very useful, relaxes the pharyngeal muscles (W.). Cap- 
sicum, as gargle, £j ad 0}4, aquae, in very early stage only (R.). Alum, gar- 
gles, in chronic inflammations (R.). Silver Nitrate, gr. v-xx ad §j, on sponge 
probang, successful if systematically applied (B.) ; in early stage of inflamma- 
tion; also in chronic on brush, or as spray (R.). The solid stick to each dis- 
eased follicle, after scraping (A.). Am?tionium Chloride, gr. ij with tti,xv of 
tinctura cubebae, every half-hour, often controls acute pharyngitis ; when a 
gouty diathesis exists add mx of the ammoniated tincture of guaiac, and give 
every hour (A. A. Smith). Xanthoxylum, a decoction of the bark locally to 
throat, and tti.x-xxx of the fluid extract thrice daily, a very successful remedy 
for chronic pharyngitis (B.). Tannin, insufflation to affected surface (B.). 
Cubeb s, powdered, locally, useful (B.). Glycerin, pure, locally, with tannic 
acid, very serviceable (B.) ; in chronic inflammation of the throat (R.). Hy- 
drastis, the fl. extr., locally, and gtt. v-x per stomach (B.). Alcohol, dilute, 
gargle in relaxed throat (R.). Cimicifuga, when pharynx dry and spotted 
over with inspissated mucus (R.). Ipecacuanha, the wine as spray in non- 
inflammatory sore throat, with hoarseness from congestion of vocal chords 
(R.). Pomegranate Bark, as gargle (P.). Potassium Chlorate, as lozenge to 
stimulate the follicular secretions to a healthy condition (A.). Iron, Quinine, 
and Strychnine, as tonics, are mainly indicated (A.). Zinc Sulphate, as gargle, 
occasionally employed in relaxed throat (R.). Inhalation of vapors, or of 
pulverized fluids, by the atomizer, found very beneficial (Wa.). Food, of 
piquant kind, spices, pepper, mustard, etc., should be strictly prohibited. All 



692 



PHIMOSIS — PHLEGMASIA. 



fluids should be used at a moderate temperature (A.). Water, by throat com- 
press, relieves ; also in daytime, in obstinate cases. Rest to voice, and culti- 
vation of beard, are useful aids. 



r. 



Prescriptions. 



Tinct. Aconiti, 
Tinct. Belladonna, . aa £ss 
Tinct. Guaiaci Ammon., . ^v. 
Syr. Limonis, . 
Aquae Cinnamomi, . ad ^iv. 
M. Sig. — A teasp. every 3 hours 
for acute pharyngitis. 



ss. 



R. Tinct. Aconiti, . . ^ss. 

Ac. Hydrocyan. Dil., . tti xl. 

Liq. Ammonii Acetat., . ^iv. 
M. Sig. — Teasp. every 2 or 3 hours 
according to the severity of the case. 
In acute and subacute pharyngitis. 



R. Aluminis, . . gr. xxx-^ij 

Sodii Boratis, . £jss. 

Glycerini, . ^ij. 

Tinct. Myrrhae, . sjij. 

Aquae, . q. s. ad %iv. 

M. Sig. — Use as an astringent gar- 
gle, 4 or 5 times a day. 



R. Acidi Tannici, . . gr. lx. 

Alcoholis, . . . Titxxx. 

Aquae Camphorae, . . ^iv. 

M. Sig. — An astringent gargle, to 
be used several times a day. 



Phimosis. 

Belladonna, as ointment, extract vij-ad xx of lard, has proved effectual (Wa.). 
Lupulin, 5-15-gr. doses, of advantage after operation, to keep penis at rest. 
(Wa.). Surgical. Division of the prepuce by a bistoury and director; circum- 
cision (D.). Cocaine, a 4 per cent, solution injected at several points around 
edge of prepuce, as local anaesthetic during the operation of circumcision. 
Chloroform, or Ether, may be used as anaesthetic in paraphimosis, before at- 
tempting reduction (Wa.). 

Phlebitis. 

Hamamelis, has as decided an influence on the venous system as Aconite 
on the arterial (Pf.). Mercury, in frequent and liberal doses, to early and 
decisive constitutional impression, the best form being Calomel, or Calomel 
and Blue Mass (Gross). Rest, fomentations, poultices, early incision of ab- 
scesses, aperients, opium to relieve pain and insure quiet of mind and body 
(D.). Blister, over course of an inflamed superficial vein(R.). Diet, nu- 
tritious, and wine, especially if great loss of blood (D.). Stimulants, as 
Quinine and Iron, especially the tincture of the Chloride, also milk-punch, 
are needed to combat the depression which is sure to arise. The disease is 
always dangerous and often fatal (Gross). Incisions, must be freely made if 
abscesses form, and the internal organs watched for multiple abscess. Ulcera- 
tion, if it occur, must be watched for hemorrhage, which should be arrested 
by compression and styptics (Gross). [Compare Phlegmasia, Varicosis.] 



Phlegmasia Alba Dolens. 

Belladonna, and Mercury, equal parts, as ointment, often of much benefit 
(Wa.). Hamamelis, has specific action on venous system (P.) ; extolled by 
Dr. Preston (R.). Blisters, in early stage: are extremely useful if judiciously 



PHLEGMON — PHTHISIS. " 693 

employed (L.). Ammonium , Carbonate often valuable where great prostra- 
tion ; full doses (Wa.). Creosote, injections daily ( Wa.). Hydrochloric Acid, 
3} of dilute acid in Oij of barley-water, with gss of potassium chlorate, to be 
taken daily (Mackenzie). Opium, large doses internally, with leeches and 
anodyne ointments (Wa.) ; laudanum, if pain severe, sprinkled on hot fomen- 
tations (L.). Leeches, of great service during the acute inflammatory stage 
(Wa.). Bandaging, when the more acute symptoms subside; at first with 
flannel, afterwards with ordinary roller bandage (L.). Regimen, should be 
tonic (L.). Water, compresses in active stage; douches, hot and cold in 
chronic form. 

Phlegmon. 

Aconite, ox Belladonna, are certainly efficacious. Aconite best (R.). Sul- 
phides, to abort, or, if inevitable, to promote ; gr. ss-j every hour or two of Po- 
tassa Sulphurata (B.). Silver Nitrate, strong solution may check if applied 
early in the vicinity (B.). Carbolic Acid, injections; a 2 per cent solution 
(B.) ; used with great success (W.). Iodine Injections, after evacuation (B.). 
[Compare Erysipelas.] 

Photophobia. 

Atropine, a neutral solution of the sulphate, gr. j ad ^j, for adult, dropped 
into the eye every 4 hours (C). If much lachrymation, so as to dilute the 
solution, it may be applied more frequently. In some cases belladonna irri- 
tates and has to be abandoned (Wa.). Conium, in scrofulous photophobia, 
gr. ss of Conine in ^j of Ol. Amygdalae, locally twice or thrice daily ; or the 
vapor of Conine (Wa.). Mercury, Calomel by insufflation (C). Cantho- 
plasty, for the spasm of the orbicularis in severe photophobia (C). Glasses 
of cobalt blue, the best (R.) Arsenic, in the condition described by old 
writers as strumous ophthalmia, with its attendant photophobia, is very valu- 
able as an internal remedy (C). Chloroform, the eye exposed to the vapor of 
a few drops in severe photophobia will be speedily relieved (Jones). Croton- 
Chloral, gr. v-x, in young people and those suffering from syphilitic corneo- 
iritis (Bader). Potassium Chlorate, internally, is most useful in some cases 
(Vernon). Cocaine, a solution of the hydrochlorate, from 2 to 4 per cent., a 
few drops upon the conjunctiva, will be found promptly efficient in most cases. 

Phthisis. 

Calcium Phosphate, in diarrhoea, and in chronic forms of phthisis, with 
little or no fever (R. ). Iodine, should be more used than it is; the compound 
solution, gtt. j-iij thrice daily, or when anaemia and not much fever use Iodide 
of Iron, gr. xv of the syrup pushed to £j ter die (Da Costa) ; as inhalation 
in chronic phthisis ; to lessen expectoration and cough ; also as liniment 
painted under clavicles, to allay harassing cough, and to check secretion (R.). 
Cimicifuga, useless in tuberculosis, but in phthisis it relieves cough, improves 
appetite, lessens intercurrent bronchitis, and so improves the patient's general 
condition (Wa.). Arse?iic, valuable in chronic forms as is no other remedy ; 
but not in caseous, or where much hectic ; may be given by stomach or fumi- 
gation (B.). [See under Asthma.] As cigarettes, useful in the diarrhoea, 
probably diminishes temperature; caution required (R.); of great value in 
early stage, in later stages it is of no avail. Arsenious Acid, gr. ■£-§, or TTLiij 



694 



PHTHISIS. 



of Fowler's solution, thrice daily (Da Costa). Cocaine, locally, for the throat 
symptoms, to be applied just before meals are eaten (Da C). Cinchona, for 
the hectic and sweats, gr. xv-xx quinine (B.) ; if small doses fail, a dose of 6 
or 8 grains at once, or in portions repeated hourly (R.). Ipecacuanha, spray 
to throat when bronchial asthma and emphysema combined with fibroid 
phthisis (R.). Cod-liver Oil, holds first rank as a remedy and food in the 
chronic forms ; a teasp. after meals ter die is enough ; when not well borne 
may be combined with aqua calcis, comp. tinct of gentian ; or, when not 
digested, with ether (B., R.) ; is of great utility by improving nutrition, and 
by affecting the tubercle ; give ^ss thrice daily one hour after meals, with 
rn,x-xv of Ether, or an equal quantity of malt or whiskey ; do not give it in 
hot weather (Da C). Terebene, with Thymol and Carbolic Acid, equal parts 
of each, and £ss to a pint of hot water as an inhalation. Creasote, tar or car- 
bolic acid, to check expectoration (R., P.); Creasote is often curable in many 
forms, gr. iij in a pill with Bals. Tolu., three or four times daily, the dose being 
increased until urine is darkened ; or it may be inhaled with Iodine from hot 
water (B.). Sanguinaria, helps expectoration, and revives the enfeebled 
stomach (P.). Chlorofor?n, with glycerin or honey, for the cough in fibroid 
phthisis (R.). Ferrum, often prescribed ; has no especial influence on deposit 
(B.). Prescribed in tuberculosis (Tr.). Liquor Ferri Perchloridi, £j ad^j 
aquae, the most serviceable local application in laryngeal phthisis, diminishing 
irritability of the mucous membrane, and quieting cough (Mackenzie). Mer- 
cury, gr. jfo of corrosive sublimate every two or three hours, for the diarrhoea 
(R.). Benzoin, as inhalation, to lessen cough and expectoration (R.). Acids, 
Mineral, for the indigestion. The acidum muriaticum dilutum (B.). Prunus 
Virginiana, the wild cherry has a domestic reputation, probably due to its 
influence over cough; the syrup is much used as vehicle for cough-mixtures 
(B.). Hypophosphites, are very useful in chronic cases (B.); have no special 
effect (Da C). Digitalis, as antipyretic ; deranges intestinal canal, therefore 
injurious in phthisis (B.). Opium, or morphine, in a viscid vehicle for cough, 
or morphine lozenges when cough due to inflamed throat (R.) ; must in time 
be given for the cough, which is an irritative one. Codeine, gr. y% to ^ in 
simple elixir, is useful and does not constipate (Da C). Sulphurous Acid, 
inhalation, spray, or fumigation, in chronic phthisis (R.). Alcohol, an im- 
portant remedy; maybe given with cod-liver oil; or spts. frumenti 5j-Jij 
with some bitter, immediately after meals, or the stronger wines. If it dis- 
agrees, it harms. Curiously, it induces an intractable form of phthisis (B.). 
Verbascum, the Mullein-plant, has long been a popular remedy in phthisis ; 
it facilitates expectoration, improves the general condition, and palliates the 
cough. Copper Sulphate, gr. -j 1 ^, or Silver Nitrate, gr. \, or Bismuth, gr. xx, 
for the diarrhoea (Da C). Baths, sea-bathing, if chronic, little or no fever, 
without active deposition of tubercle, or scrofulous pneumonia ; Turkish 
baths for the cough (R.). Grape-cure, is serviceable (B.). Aliment, should 
be nutritious and digestible, malt liquors better than wine or spirits. Extract 
of malt, cod-liver oil, plenty of meat, and alcohol in moderation (Da C). 
Warm clothing, bathing and friction of skin, moderate exercise, and a suitable 
climate. Climate, the best by far is that of Egypt, or Algeria ; next coming 
New Mexico, Southern California, South Carolina, and portions of Georgia 
and Florida ; the latter being especially suitable for cases having a co-exist- 
ing bronchitis. For some cases Colorado is very good, and the Adirondack 
region for early cases in which there is no tendency to hemorrhage (Da Costa). 
[Compare Cough, Hemoptysis, Hectic Fever, Perspiration.] 



PITYRIASIS. 



695 



R. Quininae Sulphatis, 

Pulv. Digitalis, . . gr. vj. 
Pulv. Opii, . . gr. iij. 

M. ft. pil. no. xij. Sig. — One pill 
thrice daily, for the irritative fever. 

{Da Costa.) 



Prescriptions. 
gr. xviij. ; R. Codeinse Sulphat., 



R. Pepsini (Jensen), . . gr. xl. 

Ac. Hydrochlor. Dil., . ^ijss. 

Glycerini, . . . £v. 

Succi Limonis, . . j^iv. 

Aq. Aurantii Flor., q. s. ad ^iv. 
M. Sig. — Dessertsp. with meals for 
the dyspeptic symptoms. {Hughes .) 



R. Petrolei Massae, . . gj 4 

Pulv. Cubebae, 

Pulv. Doveri, . . aa ^ss. 

Cinchonidinae Sulph., . gi], 
M. ft. massa, et div. in pil. no. 
cclxx. Sig. — One pill every 3 or \ 
hours. [Griffith.) 



Ac. Hydrocyan. Dil., 
Syr. Tolutani, . 



M. Sig. — A teasp. 
daily, for the cough. 



gr. v-vnj, 
m_xx. 

3* 



several times 



R. Tinct. Belladonnae, . . ?ij. 

Syr. Scillae, . . . ^ij. 

Morphinae Sulph., . . gr. j. 

Syr. Tolutani, . . ad Jiv. 
M. Sig. — Tablesp. at bedtime, for 
cough and restlessness, to be repeated 
if necessary. {H % Gibbons, J-r.) 



R . Olei Morrhuae, 

Mucil. Acaciae, 

Sacchari, 

Tinct. Lavandulae Co., 

Aquae, . 

M. Sig. — Teasp. for children. An 

agreeable mixture. (Farquharson.) 



[For a Cod-liver Oil Emulsion see formula on page 492.] 



Pityriasis. 

Alkaline and Tonic Remedies generally control mild cases, together with 
baths and emollients ; the more severe ones requiring constant envelopment 
in oil, as linseed or cod-liver oil (Bulkley). Mercury, in obstinate cases, 
Donovan's solution of Arsenic and Mercury is highly successful (Wa.) ; the 
green iodide, gr. x to ^j of lard, or a 5 per cent, solution of the oleate of 
mercury in oleic acid with one-eighth part of ether, applied by a camel's-hair 
brush (B.) ; citrine ointment, especially when the hairy parts of the face are 
affected (R.) ; an ointment of ammoniated mercury and calomel is very useful 
in ordinary cases of dandruff or pityriasis simplex (Bronson). Sulphur, g] of 
sulphur lotum to §j of vaseline applied every morning to the scalp, with sweet 
almond oil anointing at night (Jackson). Soap, the tincture of green soap 
as shampoo, every morning for cleanliness, or Borax and water, or the yolks 
of three eggs beaten up in a pint of limewater with Jss of alcohol, all of 
which make good shampooing mixtures (Jackson). Borax, to cleanse the 
scalp, a saturated solution; or the glycerite of borax (R.). Lead, the liquor 
plumbi, with glycerin equal parts, and two parts of water, as lotion for cases 
where there is high inflammation and abundant weeping (R.). Carbolic Acid, 2 
parts to 3 of glycerin and water, twice daily, with the daily use of a carbolized 
soap, is often effectual (Wa.). Sulphides, ^ss of Potassa Sulphurata to Oj of 
Lime-water, as a lotion, or the Bareges Pomade, see formula below (B.). 
Baths, frequently, and hard rubbing after shampooing the scalp ; avoid stim- 



6 9 6 



PLETHORA — PLEURITIS. 



ulating food in bad cases, as well as the use of a fine-toothed comb on chil- 
dren's heads. [Compare Seborrhcea, and for Pityriasis Versicolor, see 
Tinea Versicolor.] 

Prescriptions, 



]£. Sodae Sulphuratae, 

Sodii Carbonatis, . aa Tij. 
Axungise, . . . 3VJSS. 
M. Sig. — Pomade de Bareges, 



R . Hydrarg. Ammoniat. , . gr. xx. 
Hydrarg. Chlor. Mitis, . gr. x. 
Petrolati, . . . gj. 
M. ft. unguent. Sig. — Local use. 



Plethora. 

Aconite, is useful for affections of plethoric subjects. Decidedly the best 
remedy for apoplexy in the plethoric (P.). Arsenic, used with advantage when 
determination of blood to the head(Wa.K Sulphur, as mild purgative for 
plethora, from cessation of the menses (Wa.). [Compare Abdominal Ple- 
thora.] 

Pleuritis. 

Aconite, no remedy more effective prior to stage of effusion (R., P.). [See 
Inflammation.] The tincture in closes of j^-drop every 3 hours to a child 
3 years old, for 2 or 3 days (J. Lewis Smith). Veratrum Viride. Opinions 
differ as to whether it should be used in sthenic or asthenic forms (R.) ; gtt. 
viij of tincture every 3 hours, with a drop added to each dose until pulse 
reduced or nausea (Wa.). Bryonia, exceedingly valuable in second stage; 
should follow aconite (P.)« Tartar Emetic, see Inflammation. In early 
stages and young plethoric subjects, when much febrile action, small doses 
(gr. r ^ to \) may be useful (Wa.). Digitalis, as antipyretic (R.) ; deranges 
intestinal canal (B.) ; aconite preferred (P.); the tincture in doses of one drop 
every 3 hours to a child of 2 years old (J. Lewis Smith). Potassium Iodide, 
to promote absorption of effusions, steadily for a long time (R.) ; also chest 
painted with tincture of iodine, one day on each wall alternately; may be 
washed off with iodide of potassium, alcohol or ether (B.); as a diuretic to 
remove effusion (Clark). Iodine, also as injections, with great benefit and with- 
out risk, in empyema and hydrothorax (B., R.). Quinine, has abortive power, 
increased by combination with morphine (gr. xv -\- gr. ss) ; also as restorative 
tonic in low-type cases (B.). Opium, cannot be too highly extolled (P.) ; is es- 
pecially beneficial ; gr. ss of morphine hypodermically at beginning will often 
cut short an attack. During the disease, its effects are very beneficial. A slight 
physiological effect should be maintained (B.). Morphine for severe pain 
(R.). Burgundy Pitch, plaster externally as a mechanical support (P.). 
Asclepias, the popular, "pleurisy-root," is a favorite remedy in the south (W.). 
Pilocarpus, in subacute cases to remove fluids (Caro) ; or the nitrate of pilocar- 
pine, gr. i bis die, for children (Vigier) ; is too depressing and therefore 
unsafe (Smith). Bloodletting, by cups or leeches, useful by reason of counter- 
irritation produced, and to relieve pain, only in robust sthenic cases (B.). 
Blisters, often greatly abused ; are harmful during inflammatory stage (B.). 
Poultices, large, hot, and frequently renewed (R.). Water, cold wet-pack to 
chest probably better than a hot one, pinned tightly to limit movement of 
chest -walls (B.). Thoracentesis, by aspiration, if the quantity of fluid seriously 
embarrasses respiration. [For Chronic Pleurisy see Empyema, also com- 
pare Hydrothorax, Pleuro-pneumonia.] 



PLEURODYNIA PNEUMONIA. 697 



Prescriptions. 



R . Potassii Acetat, . . . %]. 
Infusi Digitalis, . ad £\\. 

M. Sig. — Teasp. every 3 hours to 
a child of 4 or 5 years, in the second 
stage. 



R . Mist. Ferri et Ammonii Ace- 

tatis, . . . . gvj. 
Sig. — Teasp. to a tablesp. according 
to age, in the second stage, or in sub- 
acute form. 



Pleurodynia. 

Cimicifuga, curative when rheumatic, valuable in sympathetic cases from 
irritability of uterus (P.) ; or uterine derangements (R., Wa. ). Croton Oi/, in 
obstinate pleurodynia especially when biackened feces (R.). Belladonna, 
plaster or liniment; the latter generally best 1 R.). Chloral, made liquid with 
equal weight of camphor, rubbed in gently, often affords instant relief in severe 
pleurisy (R.). Sodium Salicylate, gr. xv-xx, every 2 or 3 hours, useful in 
most cases (Hughes). Ether, as spray, sometimes immediately and perma- 
nently removes the pain (R.). Opium, liniment rubbed in after warm fomen- 
tations (Wa.); or a hypodermic injection of morphine (R.). Iodine, as 
liniment painted on the chest, often relieves where mustard fails (R.). Blis- 
tering, often successful when other means fail; sometimes strong vesication 
necessary (R.). Rest, is important and may be obtained by strapping the 
affected side with strips of adhesive plaster. Poultices, very hot, followed by 
application of lint and oil-skin. Belladonna liniment generally better (R.). 
Mustard, as a poultice, is generally efficient, and can be renewed when pain 
returns (R.). [Compare Neuralgia, Myalgia.] 



Pleuro-Pneumonia. 

Bryonia, often of great service; limits effusion and assists absorption (P.). 
Carbolic Acid, a 2 per cent, solution injected parenchymatously, once or twice 
a day, has had remarkable success (B.i. Sanguinaria, as a contra-stimulant 
(P.). Turpentine, as a fomentation (P ). Arnica, the tincture in doses of 
nix every 3 or 4 hours, very useful in controlling the heart's action (Wa.). 
Pilocarpine, gr. ss, or 5jij of the tincture of Jaborandi, benefits cases of pleuro- 
pneumonia ^Wa.). [Compare Pneumonia.] 



Pneumonia. 

Aconite, gives good results in catarrhal and fibrinous (B.) ; has marked 
effect (R.) ; very valuable in first stages (P.) ; in several cases it apparently cut 
short the attack (Wa.); to reduce circulation either Aconite or Veratrum 
Viride, until pulse is impressed (Da Costa). Veratrum Viride, valuable (P.) ; 
in the very incipiency (B.) ; opinions differ as to whether it should be used in 
sthenic or asthenic cases (R.). Bryonia, when pleural complications (P.). 
Phosphorus, especially when typhoid symptoms; approved by Fleischmann 
(R.). Belladonna is useful in the first stage (P.) ; Harley esteemed it highly 
in pneumonia (Wa.); as an adjuvant to Digitalis in infantile pneumonia, to 
soothe the irritable nervous system and curtail superabundant secretion 
(Brown). Tartar Emetsc, formerly given in large doses; now abandoned; 
small doses may be useful, but should be used with care, lest depression ensue 



6 9 8 



PNEUMONIA, 



(B.) ; at commencement with alcoholic stimulants, if patient be weak (R.) ; 
may benefit young, robust subjects (Wa.). [See Pleuritis.] Sanguinaria, 
as a contra-stimulant, when fever abated, and graver symptoms have amended 
(P.). Iodides, none more efficient; the Iodide of Ammonium with Arsenic, 
to prevent caseation of inflammatory products (R.) ; Ethyl Iodide, gtt. v- 
xx ter die by inhalation, very valuable in catarrhal form (B.). The Iodide of 
Sodium is useful in catarrhal pneumonia (Da C). Ipecacuanha, the wine in 
infantile pneumonia, should never be dispensed with, as it promotes expectora- 
tion, controls hemorrhage and regulates secretion (Brown). Senega, in advanced 
stages as expectorant, when cough is dry, irritating and painful, tightness and 
oppression of chest (P.). Opium, morphine by injection, sometimes needed 
for severe pain (R.) ; opium is very desirable in many cases, relieves the 
symptoms and arrests delirium (Wa.). Copper Acetate, Kissel regards it cura- 
tive ; under it the mortality was only 4 T ^ per cent. Ammonium Carbonate, 
at crisis for depression; give in infusion of senega (B.) : see formula below: 
is useful as expectorant late in disease when lung tissue breaks down (Da C). 
Digitalis, of doubtful value ; may be useful for high temperature, ischaemia, 
and low tension of vessels (B.) ; as case goes on and circulation is to be 
further controlled, digitalis is indicated (Da C.) : the best agent to slow the 
heart in infantile pneumonia, with Belladonna as an adjuvant (Brown). Anti- 
py?'ine, to reduce pyrexia; is decidedly more serviceable in pneumonia than 
quinine (Wa.) ; gr. xv several times a day, or 3 hourly doses each of gr. xxx, 
then stopping until temperature rises again (R.). Stimulants, in asthenic 
cases, those of malignant type, and those occurring in aged people (Wa.). 
Ammonia, the aromatic spirit as substitute for Ammon. Carbonate, in doses of 
^ss in simple elixir (Da C). Turpentine, as stimulant at crisis (B.). Serpen- 
taria, with carbonate of ammonium in low types, as a stimulant about the 
crisis. Quinine or Salicylic Acid, to reduce temperature ( R.) ; Quinine as 
a tonic in cases which are asthenic from the first (P.) ; in conjunction with 
Aconite and Veratrum, gr. viij-xij daily at start, is benficial (Da C). Blisters, 
useful at very beginning only or at crisis of disease ; harmful in inflammatory 
stage (B.) ; to lessen the pain, but should be used in moderation (R.). Wet- 
pack, hot, tightly pinned to limit motion of chest-walls (B.). Poultices, encir- 
cling whole chest in children (R.). Diet, farinaceous, mucilaginous drink, 
and rest in a warm room (R.). 

Prescriptions. 



R . Tinct. Verat. Viridis, . rrtxl. 

Spt. Athens Nitrosi, . £vj. 

Liq. Potassii Citratis, . ^ivss. 

Syr. Zingiberis, q. s. ad ^vj. 
M. Sig. — A tablesp. every 3 hours, 
in the early stage. (Da Costa.) 



R. Sodii Iodidi, . . . £jss. 

Morphinae Sulph., . . gr. ss. 

Elixir. Simplicis, . . gij. 

M. Sig. — Teasp. thrice daily, with 

blisters over the apex, in catarrhal 

pneumonia. (Da Costa.) 



R. Ammonii Carbonat., . gr. xl. 

Infusi Serpentariae, . * . 5iv. 

M. Sig. — A teasp. every 3 hours, 
as a stimulant about the crisis. (B.) 



R. Ammonii Iodidi, . gr, xl. 

Spt. Ammon. Aromat., . £ij. 
Elixir. Simplicis, . . J|j. 
Aquae, . . q. s. ad ^vii). 

M. Sig. — One-eighth thrice daily, 
in syphilitic lobar pneumonia, to- 
gether w r ith the following pill. 

(Da Costa.) 



POLYPUS — POULTI CES. 



699 



R. Potassii Iodidi, . . . gj. 
Ammonii Muriatis, . . £jss. 
Mist. Glycyrr. Comp., . ^vj. 
M. Sig. — Tablesp. 4 times daily, 
to promote absorption, together with 
blisters to the chest. 

{Univ. Penna.) 



R 



thrice daily, with the preceding mix- 
ture. [Da Costa.) 



. Digitalis, 


. gr. vj. 


Quininse Sulph., 


. gr. xij. 


Extr. Opii, . 


• gr. iij- 


Extr. Ipecac,. 


. . gr. nj. 


M. ft. pil. no. xij. 


Sig. — One pill 



Polypus. 

Sanguinaria, has been employed as snuff for nasal polypi (P.) ; with doubt- 
ful benefit (Wa.). Tannin, finely powdered, as snuff blown daily into nostrils 
through a quill, is especially adapted to the soft and gelatinous varieties ; while 
it has apparently no effect on the healthy mucous membrane, it causes the 
complete withering of the polypus (Wa.). Zinc Chloride, has been injected 
interstitially with success in a case of naso-pharyngeal polypus (Barthelemy). 
Iron, a solution of the perchloride is advised as an interstitial application 
(Auger). Acetic Acid, glacial, injected into the body of the tumor, will cause 
it to shrink up and to drop off in a few days.' Alum, in powder, applied to 
point of origin to prevent recurrence (D.). Surgical. A nasal polypus should 
be seized with polypus forceps and twisted off at the neck ; it may be removed 
through the mouth or the nostril. In a few cases the nostril must be dilated 
with a speculum, or the ala slit to give access to root of tumor (D.). 



Poultices, 



Poultices and Fomentations are simply local baths utilizing warmth and 
moisture, relaxing the tissues and relieving pain. If applied early they will 
check inflammation, or assist the evacuation of pus when suppuration has set 
in. Poultices should be applied thick (thin in peritonitis), as hot as possible, 
covered with cotton wool, and frequently changed ; large at onset, very small 
after maturation. Belladonna and Glycerin, partes aequales, smeared over tis- 
sues under a poultice, aid the latter greatly, also Tinctura Opii, especially where 
skin is broken. Linseed -meal or Oatmeal, Starch, Bread, Bran, are best in 
the order mentioned ; add meal to boiling water, stir and spread quickly on 
warm linen. Charcoal under the poultice, when foul sores are being treated. 

An excellent method of preparing poultices is to make a lot of bags of 
various sizes, and of the fabric known as " Swiss," filling each one half- full of 
the linseed-meal or other agent employed before sewing up its open end. 
When wanted for use one of these bags is submerged in boiling water for a 
few minutes, and on taking it out the meal is found to have swelled so as to 
fill the bag, which should then be squeezed enough to rid it of the superfluous 
water, laid on the part and covered with oiled silk and a bandage. 

Fomentations. Flannel should be wrung very dry out of boiling water, and 
covered with oiled silk. Spongio-piline, a fabric composed of sponge and wool, 
coated with india-rubber, is an excellent vehicle for the application of warmth 
and moisture. The inner surface is moistened with hot water ; and its utility 
may be increased by sprinkling the moistened surface with charcoal, yeast ; or 
saturating it with any desired lotion or liniment. 



700 PREGNANCY — PROLAPSUS UTERI. 

Pregnancy, Disorders of. 

Mercury \ a few grains of blue pill to correct clay-colored stools (L.). Iodine, 
the tincture internally for cardialgia (Wa.). Aloes, have cured piles in preg- 
nancy, by removing constipation ; cautiously (P.). Alum, Tannin, or Catechu, 
in medicated pessaries for vaginal leucorrhcea (L.). Castor Oil, an excellent 
laxative (P.); to clear out the bowels in diarrhcea (L.). Cocculus Indicus, 
when intestines much distended with flatus, and frequent desire to urinate from 
flatulent pressure on bladder (P.). Bismuth, Calumba and Antispasmodics, 
with minute doses of Opium, for gastrodynia and pyrosis (L.). Potassium 
Bromide, with chloroform, as an antispasmodic in dyspnoea (L.). Sumbul, is 
invaluable in restlessness ; — ttl xxx-xl of tincture with a little chloric ether, 
giving quiet nights for a longtime (P.). Galla, unguentum gallae cum opio, 
the best local application to hemorrhoids, also fomentations with sponges wrung 
out in very hot water, to relieve pain (L.). Digitalis, in infusion, very bene- 
ficial in albuminuria (L.). Potassium Acetate, with Basham's mixture (Liq. 
Ammonii Acetatis), when albuminuria with anaemia. Calcium Phosphate, 
believed to exert an influence on the foetus if administered during pregnancy, 
so that mothers who have borne only rachitic or scrofulous children will bear 
healthy ones (W.). Berberine, found very useful in the periodical neuralgiae of 
pregnancy, even in cases in which quinine had previously failed (Maclagan). 
Camphor, liniment for lumbar pains (Wa.). Senna, the confection proves a 
mild and efficient purgative in the constipation of pregnancy (Wa.). Milk- 
diet, for albuminuria of pregnancy the best remedy, if strictly carried out 
(Parvin). Injections must be used carefully, even tepid water often induces 
uterine contractions (L). [Compare Vomiting of Pregnancy, Ptyalism, 
Albuminura, Nephritis, Nervousness.] 

Prolapsus Ani. 

Nux Vomica. Strychnine, especially when in children, with constipation ; 
in the latter event add nux vomica to a purgative, as tincture of rhubarb (R., 
P.), or strychnine hypodermically, gr. y 1 ^ for an adult every 48 hours, ^ inch 
from anus and parallel to rectum, into the cellular tissue ; generally requires 
4 to 8 injections (Weber). Piper, the confectio piperis in doses of gr. lx-gr. 
cxx, persevered in for 3 or 4 months, in chronic, weak subjects (Wa.). Sul- 
phur, has a beneficial effect in addition to its laxative value (R.)- Alum, in 
solution, gr. vj to the £ (R-)- ^ ce 9 locally, when parts inflamed (R.). Ergot, 
the fluid extract injected into the perineum, is followed by immediate relief 
(Vidal). Ferrum Sulphate, £j to ^viij aquae, of which one-third by enema 
twice daily. Podophyllin, in small doses for rectal prolapse in children (P.). 
Tannin, injection to restrain the prolapsus (R.). Hydrastis, by enema, or as 
a lotion (P.). 

Prolapsus Uteri. 

Cimicifuga, to prevent miscarriage in prolapsus uteri (R.) ; has a remarkable 
effect upon the uterus (P.). Astringents, decoctum quercus, decoctum gallae, 
(Wa.). Pomegranate bark (P.). Tannin, as catechu, kino, red gum, rha- 
tany. Alum, a solution gr. vj ad gj (R.J ; lb. j ad Cj aquae, as hip-bath, also 
should be passed well up vagina (Wa.). Ice, locally when parts inflamed 
(R.) ; applied to the spine (Wa.). Pessaries, in any form, are of but tem- 
porary benefit, and in the end positively detrimental (E.) ; but many cases 
cannot be treated without mechanical support of some kind. 



PROSTATE, HYPERTROPHIED — PRURIGO. 7OI 

Prostate, Hypertrophied. 

Alkalies, for the cystic irritation with acid urine. Great benefit from liquor 
potassge, citrates and acetates of potassium (B.). Triticum Repens, benefit 
follows its use in the prostatic enlargement of old men (Sir H. Thompson). 
Ammonium Benzoate, for the cystitis, urine alkaline (B.). Ammoniuin 
Chloride, is occasionally useful, gr. xv-xxx, 3 or 4 times daily (Wa.). Iodine 
Injections, through rectal walls (B.); a weak ointment applied by rectum 
(Wa.). Iodine, has been tried in all forms, but is of no value (Thompson). 
Iodoform, as suppository in rectum, has proven of great value (B.). Colchi- 
cum, in persons of a gouty diathesis (Wa.). Medicine is not likely to have 
any control over this condition, which is a simple hypertrophy. 

Prostatitis. 

Cantharides, gtt. j of tincture (5 may be required) 3 or 4 times a day (R.). 
Triticum Repens, is found to be of benefit (Sir H. Thompson). Urino- Gen- 
itals, especially turpentine, cubeb, juniper, cantharis (B.); cubeb, in doses of 
gr. xx daily, is found of much beneht (Wa. ); buchu relieves (P.). Silver 
Nitrate, a solution (gr. v-x ad gj), applied to the prostatic urethra in chronic 
prostatitis, may be useful (Wa.). Blisters, in chronic prostatitis, a small blister 
on each side of the raphe of the perineum, kept open 4 to 6 weeks, has given 
the best results (Wa.). Tonic medicines and regimen should be prescribed 
(Wa.). Hot Injections, to relieve pain (R.). [Compare Prostatorrhcea.] 

Prostatorrhcea. 

Iron, the tincture of the chloride, when there is much debility (B.) ; chaly- 
beate tonics, with quinine and strychnine (Gross). Atropine, indicated in 
all cases, with potassium bromide (Gross). Potassium Bro??iide, when irrita- 
bility and excitement (B.); indicated in all cases (Gross). Lead, injections 
of Goulard's extract, 3] to sjx of water, night and morning, for 10 minutes at a 
time (Gross). Ergot, when relaxation exists (B.). Bougie, methodically 
introduced, is one of the best local measures (Gross). Hydrastis, locally 
applied, a useful medicine (B.). [Compare Prostatitis.] 

Prurigo. 

Alkaline Baths, followed by a carbolized ointment, and carbolic acid in- 
ternally, are of value in the papular eruption known as prurigo (Bulkley). 
Sulphides, Potassa Sulphurata, with tar and benzoated lard, as ointment in 
genuine prurigo (R.). Arsenic, in doses of rri.v of liquor arsenicalis thrice 
daily and gradually increased, has exercised a more or less powerful influ- 
ence (Wa.) ; has only a moderate effect (Bulkley). Belladonna, controls 
cases which have resisted ordinary treatment (B.). Carbolic Acid, locally 
and internally, is especially serviceable in prurigo senilis (B.). Borax t a sat- 
urated solution in rose-water locally (R.) ; gr. v-x to Jj of hot water for 
pruriginous eruptions on mucous membrane of vulva and vagina (R.)* Gal- 
vanism, when prurigo is referable to alterations in the cutaneous nerves (B.). 
Tonics, are required, nerve-tonics as well as general ones, Cod-liver Oil, 
Quinine, Strychnine and Phosphorus (E: Wilson). Quinine, in large doses, 
gr. v-x, will control violent exacerbations (Wilson). Baths, the Turkish, fre- 
quently repeated, with inunction of the skin, may be regarded as curative in 
most cases (Wilson). [Compare Pruritus.] 



702 PRURITUS. 

Pruritus. 

Alkaline Baths, locally, followed by the application of Carbolic Acid Oint- 
ment, gives great comfort in all forms of pruritus (Bulkley). Sodium or 
Potassium Carbonate preferred (Tr.) ; in solution locally, ijiij ad giv (B.). 
Carbolic Acid, as lotion with glycerin, to the itching surface, gives great relief 
(Bulkley) ; internally and locally in pruritus senilis (B.) ; a one per cent, 
solution as lotion in pruritus ani (R.). Mercury, strong solutions of the Bi- 
chloride, black wash, yellow wash or mercurial ointment, in itching of skin 
affections (R.) ; solutions of the Bichloride are very useful ^ap plications in 
pruritus vulvae et ani (Tr.) ; for pruritus vulvae a lotion of the Bichloride I to 
2500 parts of water, with alum and starch, is recommended (B.). Calomel 
£j to ^j of lard, as ointment, is the best application, except in the pruritus of 
urticaria; very useful in pruritus ani, less so in pruritus pudendi (R.). The 
Oleate, a 5 per cent, solution in oleic acid with one-eighth part of ether, ap- 
plied by a camel's hair brush, in pruritus ani et pudendi (Marshall). Alum, 
a strong solution is very useful for pruritus vulvas (Tr.). Hydrocyanic Acid, 
diluted as lotion, often very serviceable ; may be prescribed in solution with 
borax (B.) ; or laurel-water as lotion, especially in pruritus senilis (P.). Po- 
tassium Cyanide, ^j to Oj of water, as lotion for pruritus of various kinds when 
the skin is unbroken (R.) ; as ointment or solution, if strong enough, relieves 
greatly, but must be used with caution (B.); or nixxx of the dilute acid of 
the Br. Pharmacopoeia in gj of water or glycerin, may be used instead (R.). 
Silver Nitrate, a solution, gr. xx ad gj, painted over the affected parts in 
pruritus vulvae, is very effective (B.). Tobacco, is an effective but dangerous 
application (B.). Iodoform, as ointment, £j ad gj adipis (R.). Iodine, for 
itching of the nose or inner canthus, sneezing, etc., iodine inhalations have 
a marked effect (R.). Arsenic, for itching of the nose, accompanying asth- 
matic symptoms (R. ). Benzoin, the compound tincture painted on the skin, 
for the itching of eczema, urticaria, etc. (R.). Boracic Acid makes an excel- 
lent lotion in pruritus pudendi, a teasp. to the pint of hot water (R.). Borax, 
gr. v-x ad gj hot water (R.). See Prurigo. Balsam of Peru, is a very good 
application in pruritus ani, scabies, and many other forms of itching (Auer- 
t>ach). Camphor, with Chloral, rubbed together, makes a liquid which, added 
to vaseline, makes an ointment which is powerfully antipruritic (Bulkley); 
added to dusting powders, allays heat and itching of eczema and intertrigo 
(R.), Chlorofor?n, as ointment to allay itching of skin diseases (R.). Gel- 
semium, Tn_xv of the tincture every half-hour, up to 3J, for itching which is 
out of proportion to the cutaneous lesion (Pelcher). Lead Lotions, to ease 
the itching of urticaria, pruritus pudendi, etc., especially when the mucous 
membrane is red and excoriated (R .). Salicylic Acid, as ointment, in pru- 
ritus ani et vulvae (R.). Sodium Salicylate, in 15-grain doses by mouth 
every four hours, will greatly relieve pruritus vulvae, when due to diabetes 
(Goodell). Tar, as ointment, is strongly recommended (Tr.) ; for general 
pruritus, if no cause can be found, the two best remedies are Tar and Sul- 
phur, as lotion or bath (Sparks) ; ointments containing Tar give relief in many 
instances (Bulkley). Sulphur, may be employed as a bath, Potassa Sulphu- 
rata, ^ij ad Cxv of hot water (Sparks) ; or the alkaline sulphites locally (Wa.) ; 
the iodide of sulphur externally and internally, in pruritus senilis (Wa.). 
Chlorine, the liquor Sodae Chloratae, diluted, a useful application in pruritus 
ani (Wa.). Cocaine, in 5 per cent, solution or oleate, is by far the most effi- 
cient of all antipruritics ; relieves the itching of scrotal eczema, pruritus ani 
et pudendi, and especially in lesions of the epidermis where the oleate or so- 



PSORIASIS. 



703 



lution can penetrate at once to the true skin. [Compare Eczema, Ery- 
thema, Lice, Pediculi, Prurigo, Scabies, Urticaria.] 



Prescriptions. 



R. Ac. Carbolici, . . . K}}- 
Glycerini, . . • 5J- 
Aquae Rosae, . q. s. ad £vii}, 
M. Sig. — Lotion for pruritus. 



R 



. Ac. Hydrocyanici Dil., £ss-j. 

Infusi Altheae, . gv-viij. 

M. Sig. — Lotion. {Fox.) 



K. 



Potassii Cyanidi, . 
Aquae Laurocerasi, 
M. Sig. — Lotion. 



. gr. xv. 
. gviij. 

{Anderson.) 



r. 



ss. 



Liq. Carbonis Detergentis, 
Glycerini, . . . . §j. 
Aquae, . . . ad£x. 
M. Sig. — Lotion. {Sparks. 



R. Acidi Benzoici, . . gr. ex. 
01. Caryophylli, . . gtt. xl. 
Alcoholis, . . , gijss. 
Solve et adde — 

Cerati Simplicis, . . §viij. 
Balsami Peruviani, . 3J. 

M. ft. unguentum. Especially good 
for scabies, but may be used for any 
pruritus. 



B 



, Ac. Hydrocyan. 
Sodii Boratis, 
Aquae Rosae, . 

M. Sig. — Lotion. 



Dil., 



gj- . 

gviij. 
(Fox.) 



R. Potassii Cyanidi, 
Pulv. Cocci, . 
Ung. Aquae Rosae, 
M. Sig. — Ointment. 



. gr. vj. 
. gr.j. 

• £• 

{Anderson.) 



r. 



Cretae Praeparatae, 
Coal Tar, 
Ol. Lini, 
M. ft. unguent. 



Jijss. 



R. Gummi Camphorae, 

Chloralis Hydratis, . aa gj-ij. 
Rub together until liquefied, 
then add, slowly with friction, — 
Unguenti Aquae Rosae, . |jj. 
Sig. — Ointment for itching. 

(Bulkley.) 



R. 



Hydrarg. Chlor. Corr., . gr.j. 
Pulv. Aluminis, . . gr. xx. 
Amyli, . . . . £jss. 
Aquae, .... gyj. 
M. Sig. — Apply locally. ( Goodell.) 



Psoriasis. 

. Arsenic, at first apparently aggravates, but soon heals the disease (R., B.) ; 
in lepra must be persistently used for a long time (B.) ; exercises a powerful 
influence (Wa.) ; maximum dose ttiv liquor arsenicalis ter die, never on empty 
stomach (R.). Mercury ; in patches of obstinate psoriasis, especially of hands 
even when not syphilitic. Calomel and mercuric nitrate ointment may be 
mixed, and tar ointment added (R.). Lappa Major, a tincture of the seeds 
in whiskey, used by tablespoonful doses, curative of psoriasis of long stand- 
ing (Reiter). Carbolic Acid, I to 4 of lard, as ointment (Wa.). Mezereon, a 
useful adjunct (Wa.).. Sulphur, internally (R.) ; a solution of potassa sulphu- 
rata in water, is excellent in chronic psoriasis (B.) ; not in acute (R.). Sul- 



704 PTERYGIUM — PTYALISM. 

phur Iodide, externally and internally, in doses of gr. j-vj used with great ad- 
vantage (Wa.). Silver Nitrate, in psoriasis of tongue and buccal mucous 
membrane occasionally ; if syphilitic, mercurials best (R.). Chrysarobin, has 
the most decided effect on psoriasis, ^ss-ij ad ^j of ung. aquae rosae ; often irri- 
tates, and should be employed at first with caution i Bulkley). Nitric and 
Nitro-Hydrochloric Acids, when symptomatic of imperfect digestion and as- 
similation (B.). Phosphorus, as substitute for arsenic (B.). Coptis, has repu- 
tation in New England (B.). Copper Sulphate, applied solid to spots (R.). 
Lead, the ointment of the iodide (B.). Tar, painted on, in obstinate cases 
(R.). Oils, Cod-liver Oil internally and locally, is the sheet-anchor, especially 
when of strumous origin (B.) ; oils and fats to lubricate skin, with warm baths 
(R.). Diet and Hygiene, nourishing diet, frequent small quantities of raw 
vegetables. Cod-liver oil for growing persons, especially when stale fish the 
cause. Rest and change for overworked subjects. Daily baths and cold 
sponging. Free, open-air exercise is also most useful. Warm or tepid soft- 
water baths at night, with use of pure soap. 

Pterygium. 

Silver Nitrate, locally, especially when pterygium with catarrhal conjunc- 
tivitis (Wa.). Treatment unavailing. Benefit seldom derived from any opera- 
tion (C.). ArWs Operation, the most satisfactory; cut away as little tissue as 
possible, dissect cleanly, close with suture (Green). 

Ptosis. 

Veratrine, gr. x in £ij of sulphuric ether and j|j of alcohol, brushed over 
the eyelids, brows and temples every morning, till a slight burning sensation 
is produced; conjoined with the use of electricity (Wa.). Ergot, aqueous 
infusion as collyrium (Wa.). Electricity, the constant current may often re- 
lieve recent cases (C). Operation for shortening the lid, by removing an 
elliptical piece of skin and subjacent muscle (C.) ; is not advisable unless the 
ptosis is nearly or quite complete, and of great inconvenience. 

Ptyalism. 

Iodine, as gargle, ^ij of tinct. ad gviij aquas (R.) ; is worthy of trial (Wa.). 
Acids, as astringents, small medicinal doses (R.). Sulphuric, int. and as a 
gargle with decoctum cinchonae, of great benefit in mercurial ptyalism (Wa.). 
Potassium Chlorate, in simple or mercurial ptyalism (R.); in the latter form 
gj ad j|vj aquae as mouthwash, and internally in teasp. doses, 4 or 5 times 
daily (St.). Belladonna, very effective in mercurial ptyalism, and that of 
pregnancy. Gtt. v-x, or Atropine gr. T \^ to j^ every 4 to 6 hours (B.). Atro- 
pine hypodermically (R.) ; should be useful (W.). Tannic Acid, in mercurial 
ptyalism is an excellent gargle, ^j of tannin to ]|ij of mel rosae, and gvj of 
water (B.). Alcohol, diluted, as a gargle (R.). Potassium Iodide, sometimes 
beneficial in mercurial ptyalism, but often aggravates it (R.)» 

Prescriptions. 

R . Sodii Boratis, . . . gij. 
R. Tinct. Myrrhae, . . -Eh Fu\w. Myrrhae, . . gj. 

Aquae, .... gvj. Aquae, .... 3VJ. 

M. Sig. — Mouth-wash. M. Sig. — Mouth-wash or gargle. 



PUERPERAL CONVULSIONS PUERPERAL FEVER. 705 

Puerperal Convulsions. 

Aconite, one of the best agents (P.) ; gtt. j-ij of tinct. every 10 or 15 minutes 
for the first hour, then at longer intervals (P.). Belladonna, the tincture in- 
ternally with atropine hypoder., of verified utility (P.). Veratru??i Viride, in 
zss doses of fluid extract every 15 minutes, to nausea, invaluable (R.) ; the 
n. extract, in doses of trtviij-x hypodermically, may be repeated in half hour 
with Morphine, or TTVx by enema, promptly efficient in the worst cases (El- 
mer). Opium, as morphine hypodermically ; the most important agent for 
cure of uraemic convulsions (B.); with the lancet, sometimes required (P.). 
Ancesthetics, especially chloroform (R.) ; utility unquestionable, when not due 
to cerebral hemorrhage (B.). Chloral, full doses (gr. xx-xxx) every 2 hours, 
may arrest (B.) ; a remedy of the greatest value, a full dose, gr. xx-xxx, be- 
fore proceeding to one of the bromides (Playfair, Barnes, etc.). Amy I Nitrite, 
by inhalation (B.) ; may cause alarming hemorrhage (W.). Ice, to the head 
(R.) ; and mustard poultices at same time to the feet (Wa.). Venesection, by 
far the most efficient measure (Wallace) ; when great cerebral congestion and 
vascular tension, shown by a livid face, a full and bounding pulse, and strong 
pulsation in the carotids (PlayfairJ. 

Puerperal Disorders. 

Cimicifuga, in puerperal hypochondriasis, and depression (Wa., P.). Opium, 
either alone or with alteratives, highly serviceable in puerperal intestinal irri- 
tation ; a few drops of tincture effectually arrests the diarrhoea (Wa.) ; when 
shock and marked exhaustion, a moderate dose is of benefit (L.). Castor 
Oil, undoubtedly the best laxative (L.) ; purgatives generally are not required. 
Castor oil the very worst (Fordyce Barker) ; action uncertain (Parry). Rhu- 
barb, or enemas, best means of stimulating bowels after fourth day (L.) ; gr. 
xx-xxx in some aromatic water a good aperient (Wa.). Aliment, in puerperal 
state should be easy of digestion and sustaining (L.). Catheter necessary often 
for several days when bladder paralyzed, if warm water lavements fail to 
excite (L.). Water, tepid sponging of external parts, vaginal washings daily 
with warm water, with T i^ part carbolic acid (L.). [See After-pains, Hem- 
orrhage, Labor, Lactation, Mastitis, Nipples, Phlegmasia Alba Do- 
lens, etc.] 

Puerperal Fever. 

Aconite, drop doses every one or two hours steadily, with an occasional dose 
of castor oil, and repeated hot poultices or laudanum fomentations, the most 
successful treatment, even in the worst cases, but is useless if not promptly 
efficient (P.). Veratrum Viride, is used with great benefit in most cases (F. 
Barker). Opium, for wakefulness and delirium (B.). ; a very valuable rem- 
edy, tending to allay pain, and reduce excitement of the nervous and vascular 
systems (Wa.). Alkaline Sulphites, especially valuable in early stages, internally 
and locally ; gr. xx-xxx of magnesium or calcium sulphite every 2 or 3 hours, 
with injections every day (Wa.). Stra??ionium, when cerebral excitement 
(P.). Potass. Permang., gr. %-) ter die, has been given with benefit (B.). 
Calumba, preferable to cinchona (P.). Quinine, only large doses are useful; 
gr. v-xx every 4 hours (B.); reduces temperature (P.). Turpentine, when 
depression of vaso-motor nervous system, cardiac Weakness, and tympanitic 
distension of abdomen (P., R.). Resorcia, is much used in Vienna by Braun ; 

59 



706 



PUERPERAL MANIA PULSE. 



gr. xl repeated p. r. n. Antiseptic Injections, into uterus opposed very strenu- 
ously by many of our best men. See N. Y. Med. Rec., 1884, p. 14. For an- 
tiseptic treatment by Hydrarg. Bichlor., see Dr. Garrigues in N. Y. Med. Rec. 
of December 29, 1883, and N. Y. Med. Jour, of March 1, 1884, and the dis- 
cussion in the N. Y. Academy of Medicine, reported in the N. Y. Med. Record 
of January 5 and Feb. 16, 1884, et seq. Water, hot fomentations frequently 
to parts, a valuable preventive. Rest, and quiet but attentive nursing ; frequent 
liquid nourishment. Warburg's Tincture, is more efficient than the largest 
doses of quinine in cases of puerperal malarial fever, gss every four hours 
until fever abates, then in diminishing doses to gj-ij, until convalescence is es- 
tablished (Fordyce Barker). [Compare Puerperal Peritonitis.] 

Puerperal Mania and Melancholia. 

Stramonium, will allay cerebral excitement, and soothe nervous system ; 
when delirium wild and furious, but intermittent ; tendency to suicide or to 
destroy the child. lUx-xx of tinct. every 3-4 hours (P.). Hyoscyamus, in 
milder cases; nervous system greatly excited (P.). Aconite, in puerperal 
mania, with high fever, restlessness ; speedy and marked success if given soon 
after chill (P.). Cimicifuga, has cured (B.) ; its effects are truly remarkable 
in mania, and hypochondriasis of puerperal state (P.). Chloral, often alle- 
viates symptoms (B.) ; to produce sleep (Wa.). Potassium Bromide, in sthenic 
cases (R.) ; its effects are very variable (Wa.). Ancesthetics, ether inhaled in 
violent paroxysms of mania (B.). Tartar Emetic, in frequently repeated 
doses (Wa.). Quinine, when much weakness; skin cold and sweating (B.). 
Chalybeates, tinct. ferri chlor. (rri v-xx) in anaemic form (B.). Opium, cau- 
tiously (B.) ; gives the best results in such doses as may be necessary to allay 
irritation and procure sleep (Wa.). Poultices, hot fomentations, enemas, or 
gentle laxatives ; nutritious and stimulating diet. Lochia should be watched 
(P.). Weaning, imperative in melancholia; not so in acute mania. 

Puerperal Peritonitis. 

Aconite, has cured cases of the usual type (P.). [See Puerperal Fever.] 
Cimicifuga, in rheumatic form especially, has remarkable effects (P.). Opium, 
its curative power in this, one of the best established facts in therapeutics 
(B.); is good, but aconite often better (P.) ; especially valuable in adynamic 
cases (Wa.) ; the drug of all others to be relied on (Godson). Turpentine, as 
stimulant, nix frequently repeated ; better than alcohol (B.) ; enemas, also hot 
turpentine epithems, may be used with advantage (Wa.). Quinine, in con- 
siderable doses, with or without opium (B.) ; gr. x-xx twice daily as an anti- 
pyretic (Wa.). Antimony, as Tartar Emetic, gr. ^ to J every hour to shorten 
attack and render it more mild (R.). Cathartics, advised by many, prohibited 
by as many ; evidence is in favor of mild aperients combined with Dover's 
powder or Hyoscyamus (Wa.). Poultices, hot, of very great value (B.). 
Water, ice in mouth or swallowed, hot fomentations to abdomen. In some 
cases cold compresses best. [Compare Puerperal Fever.] 

Pulse. 

Aconite, for a quick, resisting pulse (P.) ; a moderate dose, while it makes 
the pulse less frequent, renders it fuller, stronger and less compressible (R.)« 



PURPURA — PYAEMIA AND SEPTICEMIA. JOJ 

Veratrum Viride, reduces febrile heat with abnormal rapidity of pulse (P.). 
Veratrine, pulse at first quick and strong, then slowed; afterwards quick, 
weak and irregular (R.). 

Purpura. 

Sulphuric Acid, often acts happily (B.). Ergot, has been strongly urged (R.) ; 
is most useful in removing purpura (P.) ; many cases are recorded as cured 
by hypodermic injections of Ergotin (Wa.). Turpentine, has been used (R.) ; 
with invariable benefit (Wa.). [See Hematemesis.] Nux Vomica, no pre- 
scription more generally useful than the Syrup of Iron, Quinine, and Strych- 
nine (B.). Iron, when due to anaemia; the tincture of the chloride (B.) ; 
is preeminently the curative remedy for purpura hemorrhagica, arresting the 
hemorrhagic tendency in 24 to 48 hours (Pize). Vinegar, and water, is an 
excellent application by sponging over the body (E. Wilson). Quinine, 
or Huxham's tincture of bark, are much used (H.). Potassium Nitrate, gr. 
x thrice daily in purpura simplex, used successfully (Wa.). Styptics, as the 
ammonio-ferric alum, tinct. of ferric chloride (Tr.) ; tannic and gallic acids, 
used in some cases (H.). Alum, and brandy, or whiskey and water at such 
temperature as is not chilling, applied by sponging the body, is the best local 
measure (H.). Wines are generally indicated (B.). [Compare Hemorrhage, 
Scurvy.] 

Pustule, Malignant. 

Nitric Acid, strong, applied steadily (after thorough cleansing and drying) 
to destroy the diseased mass (D.). Bromine, to saturate the surface (D.). 
Carbolic Acid, undiluted, as caustic, or with oil, the favorite (D.) ; the most 
preferable caustic (Greenfield). Quinine and Carbolic Acid, internally, are 
indicated in all forms, also stimulants, as Ammonia, Ether, and Alcohol 
(Greenfield). Eschar should be promptly destroyed, to avoid contagion (R.). 
Excision and cauterization demanded, when from direct inoculation; the two 
most successful remedies (Greenfield). 

Pyaemia and Septicaemia. 

Quin ine, large doses only (gr. xv-xx) are useful (B.) : supposed to diminish 
the temperature (R.) ; to cinchonism, in childhood the best remedy (Wa.) ; is 
probably the most useful medicine, given in full and frequently repeated 
doses (Havvard). Salicin, to reduce temperature in septicaemia and to relieve 
the cerebral symptoms (R.). Salicylic Acid, has decided value (B.). Potas- 
sium Permanganate, given with advantage, gr. J-gr. j thrice daily in distilled 
water (B.). Boracic Acid, a saturated solution to wounds, ulcers, etc. Also 
Chlorine, as disinfectant ( B.). Oleum Carophylli, locally. Also olei gaul- 
theriae, thymi, etc. (B.i ; as antiseptics. Water , cold, as dressing. Hot better, 
95°-ioo° F. Hamilton's immersion plan for wounds (B.). Stumps to be im- 
mersed in a warm bath, to avert pyaemia (R.). Sulphites, may do some good 
in chronic cases, but the use of sulphurous acid has not given the results in 
man which Polli obtained from its use on animals (Haward). Turpentine, is 
a better stimulant than alcohol (B.). Ice, dissolved in the mouth (Wa.). Ali- 
ment. Plentiful nourishment, with wine and good ventilation, are not to be 
neglected (Wa.). Malt liquors are justly esteemed (B.). Stimulants neces- 
sary; brandy the best (Wa.). Abscesses, must be opened early, especially 
when in joints. 



708 PYROSIS — RECTUM, ULCERATION. 

Pyrosis and Cardialgia. 

Capsicum, in atonic dyspepsia, with heartburn and diarrhoea (P.). Nux 
Vomica, of the highest possible value in atonic dyspepsia with heartburn, hic- 
cough, regurgitation, etc. An excellent combination is Tit v-x of the tinc- 
ture with ttlxv of dilute nitric acid for one dose (P.). Pulsatilla, a good 
medicine in heartburn of dyspepsia in phlegmatic subjects (P.). Podophyllin, 
g r< fa night and morning in obstinate heartburn, with liver derangement (P.). 
Abnonds, six or eight blanched, said to relieve heartburn (P.). Diet, lemon- 
juice, aerated bread, plain biscuit, etc. ; but avoid new bread, much vegetable 
food, and pastry. [Compare Acidity, Dyspepsia.] 

Rachitis. 

Lime, as lime-water, or the carbonate, or the syrupus calcii lacto-phosphatis 
(B.); in small doses (R.); the phosphate maybe advantageously combined 
with cod-liver oil (Wa.). Iron, the syrup of the iodide preferred; calcium and 
ferric phosphates excellent in combination (B.); must be continued a long 
time (R.). Nitro-hydrochloric Acid, as baths, gives excellent results (Wa.). 
Quinine, often very valuable (P.). Aliment, food rich in phosphate of lime 
and other phosphatic salts; oatmeal, Graham bread, etc. (B.). Cod-liver oil, 
the best constructive agent (B.). A full animal diet (Wa.). Cold sponging 
(R.). 

Rectum, Diseases of. 

Podophyllum, in doses of gr. fa to y 1 ^ night and morning, for a child, may re- 
move prolapsus of the rectum (P.). Belladonna, the extract locally in fissure 
(R.) ; and irritable ulcers (P.) ; internally and locally to remove ulcers, also 
excellent in burning pain following defecation, or with mercurial ointment in 
equal parts, for fissures and ulcers (P.). Phosphorus, in chronic inflammation 
of the rectum, has been highly recommended (R.). Potassium Bromide, in 5 
parts of glycerin, locally, fissures and painful growths (R.). Iodoform, as sup- 
pository in painful diseases, relieves greatly (R.). Pepper, the confection, as 
gentle stimulant in fistula, ulcers, hemorrhoids (P.). Castor Oil, in fissure and 
hemorrhoids, is commonly used as purgative (R., P.). Sulphur, with confec- 
tio sennae, in irritable rectum, is very soothing (Wa.). Stramonium, ointment 
from fresh leaves to alleviate pain (P.). Conium, the extract in doses of gr. 
x to allay pain and irritability in cancer (Wa.). Purgatives, best for proctalgia 
(D.). Surgical, in ulcer or fissure, an incision through mucous membrane, 
and in severe cases to divide part of the sphincter. A flake of cotton should 
be laid in the wound, so that it may heal by granulation (D.). [See Anus, 
Diarrhcea, Dysentery, Rectum Ulceration of, Hemorrhage Intesti- 
nal, Hemorrhoids, Prolapsus.] 

Rectum, Ulceration of. 

Mercury, the red oxide, 3} to the g of unguentum, as ointment in flat ulcers 
of rectum existing just within the anus (Coulson). Belladonna, locally the ex- 
tract for rectal ulcers, is very efficient (P.). Carbonic Acid, the gas, per anum, 
is strongly advised (Wa.). Chloroform, as ointment, in irritable ulcer of rectum 
(Curling). Iodofor?7i, in suppository, extremely useful in painful ulceration 
(R.) ; used in many cases with very satisfactory results, but in some instances 
poisoning occurs; hence it should be used with caution (Wa.). Phosphorus, 



RELAPSING FEVER RETINA. 7O9 

as an internal remedy, is highly recommended in chronic inflammation of the 
rectum (R.). Copper Sulphate, with opium, may often be used internally with 
advantage, and a weak solution of the same, or of Silver Nitrate, locally 
(Curling) ; the writer had a case which resisted treatment for 3 years, and in 
which a cure was effected by a persevering use of a pill of Cuprum Sulphate, 
Extract of Opium, and Quinine Sulphate. Silver Nitrate, gr. ^-j combined 
in pill with Opium, gr. ss ; and a solution, gr. x-xx to the pint, by enema (B.). 

Prescriptions. 



R. Cupri Sulphat., 

Morphinae Sulphat., aa gr. ij. 

Quininae Sulphat., . . gr. xxiv. 

M. ft. pil. no. xxiv. Sig. — One pill 

thrice daily. {Potter.) 



rj. Chloroformi, . . . gj-ij. 

Zinci Oxidi, . . . £ss. 

01 ei Olivae, . . . ." gj. 

Cerati Cetacei, . . £iv. 

M. ft. unguentum. {Curling.) 



Relapsing Fever. 

Cathartic, mild at beginning (H.) '; if jaundice or other hepatic derange- 
ment, a calomel purgative, cautiously, lest irritation (Wa.). Potassium Citrate, 
as cooling diaphoretic. Quinine, in moderate doses after the crisis, at least 
until the relapse, which will not be prevented by any amount of quinine (Wa.). 
Leeches or Cupping, best for headache (A.). Alcohol, required by some pa- 
tients. Diet, supporting, especially in third week, beef-tea, etc. Urine, should 
be watched carefully (A.). [Compare Typhus Fever.] 

Remittent Fever. 

Aconite, in hot stage, if any febrifuge is required, frequently repeated doses 
(B.) ; is next in value to quinine for high fever and headache, gtt. j of a good 
tincture every hour (Da Costa). Quinine, 20 to 30 grs. in single dose once 
or twice daily till temperature is reduced, with other appropriate remedies 
(B.) ; 15 to 20 grs. at most (Maclean) ; 30 to 50 or 60 grs. in severe cases of 
pernicious remittents several times a day without regard to exacerbation (P., 
B.). Warburg 's Tincture, has achieved a very high reputation, but must be 
used in less dosage than directed, and supporting treatment given when its 
sudorific action commences (Wa.). Gelse?nium, exercises a really beneficial 
influence; depresses temperature (B.) ; valuable in bilious remittents of the 
South (Pf.). Morphine, gr. ^ hypodermically to abort pernicious remittent 
fever (B.). Purgation, by calomel with jalap or salines afterwards, is very 
necessary during course of the disease (Da Costa). Quassia, an excellent tonic 
in convalescence, combined with mineral acids (Wa.). Packing, by wet sheet, 
is resorted to with advantage, except when hepatic or splenic congestion 
(Wa.). 

Retina, Affections of. 

Mercury, in syphilitic retinitis is of great value ; calomel gr. j-ij with opium 
gT- X~/4 every 4 or 6 hours ; also mercurial inunction till the gums are affected 
or the disease yields (Wa.). Potassium Iodide and Bro?nide, in combination, 
in retinal hemorrhage, to promote absorption of the effused blood, and benefit 
congestion (C). Eserine, locally to contract pupil, and diminish the amount of 
light admitted to the eye (Wa.). Iron, in full doses, generally the tinct. of 
the perchloride, in pigmentary retinitis; seems to have a tendency to arrest the 
malady (C). Leeches, to the temple better than general bloodletting (Wa.). 



7IO RHEUMATIC ARTHRITIS RHEUMATISM. 

When much local congestion present, depletion by artificial leech is almost 
always indicated (C). Pilocarpus, in detached retina and optic neuritis ; has 
been found a very useful remedy in retinal affections generally. [Compare 
Amaurosis.] 

Rheumatic Arthritis. 

Aconite, highly spoken of; as liniment, conjoined with internal use ( Wa.). 
Cimicifuga, when joints enlarged and much stiffened, and when traceable to 
uterine derangement, is very useful (R.) ; when pains worse at night (Wa.). 
Iodine, tinct. internally, said to be better than potassium iodide (R.)- Iodoform, 
io parts to 20 of Ether and 20 of Alcohol, as liniment to the joint, applied by 
a pencil, and covered with oiled silk (Gubler). Iodides, often signally benefit, 
especially when due to syphilitic, mercurial, or mineral poisoning (B.). 
Large doses of potassium iodide sometimes required (R.) ; combined with 
guaiacum, or corrosive sublimate, often curative in cases resisting these rem- 
edies given separately (Wa.) ; Potassium Iodide should always be fairly tried 
(Da Costa). Guaiac, the ammoniated tincture, in doses of £j-ij in milk, 
often gives excellent results (Da C). Colchicum, with alkalies, extremely useful 
(B.). [See Gout, for formulae.] Arsenic, when referable to nervous affec- 
tions (B.) ; as a bath containing giv washing soda and gr. xx arseniate of so- 
dium ; in large doses, continued for some time, sometimes of great benefit, 
but action is capricious (R.) ; in small doses is of great benefit (Da Costa). 
Lithium Bromide, of great value in acute and chronic (B.). Potassium Bro- 
mide, sometimes allays the severe pain (R-). Arnica, the tincture and infu- 
sion are said to be of great value (P.). Cod-liver Oil, internally and locally, 
of much value (R.). Baths, Turkish or sulphur. The cold douche, which 
may be slightly warmed in winter ; use for one or two minutes and rub dry 
(R.). Adhesions may be broken up under anaesthetics (Da C). Massage may 
be used with benefit to ameliorate the condition in chronic cases, where a cure 
cannot be obtained (Da C). 

Prescriptions. 

R. Lithii Bromidi, . . ziij. 
Syr. Zingiberis, . . ?ss. 



R. Vini Colchici Sem., . giij. 

Spt. Ammon. Aromat., . gxiij. 
M. Sig. — A teasp. every 3 hours, 
until some physiological effect is pro- 
duced. (B.) 



Aquae, .... 3JSS. 
M. Sig. — A teasp. thrice daily, 
conjointly with a lotion of the same. 

(B.) 



Rheumatism, Acute. 

Aconite, very serviceable when much heat and dry skin (B.) ; subdues pain 
in inflamed joints and perhaps shortens the fever (R.) ; small doses frequently 
repeated of the greatest value, and if used from the start prevent permanent 
organic disease (P.) ; is not reliable as a cure, but a valuable adjunct to other 
remedies (Wa.). Veratrum Viride, tinct. said to be useful (R.) ; as antipy- 
retic, small doses; may be combined with opium (P.). Bryonia, has proved 
useful, especially for painful and stiff rheumatic joints (P.). Salicin, gr. x- 
xxx every 2, 3, or 4 hours. Gr. xv every 3 hours in powder mixed with water 
(Maclagan), or same dose of Salicylic Acid, is of great benefit; good effects 
generally experienced within 48 hours (R.) ; the acid is better than the sali- 
cylates, but must be abandoned if not effective after 3 or 4 days (Da Costa). 
Sodium Salicylate, behaves as Salicin ( R.). Oil of Gaultheria, as a substitute 
for salicylic acid, used very successfully in form of emulsion (B.). Rhus Toxi- 



RHEUMATISM, ACUTE. 7II 

codendron, positively invaluable in after-stage, also in subacute forms, mus- 
cular or tendinous, worse at night (P., Pf.). Hydriodic Acid, the syrup, in 
dessertsp. doses every 2 or 3 hours, the best remedy for acute and subacute 
rheumatism, relieving pain and swelling in 18 to 24 hours (Craig). Cimici- 
fuga, excellent reports from (B.); has been much used, said to quell the 
pain speedily (R.) ; found very serviceable (P.). Dulcamara, recommended 
especially in persons who are subject to catarrhal affections in cold and 
damp weather (P.). Ammonium Bromide, a very excellent treatment, 
followed by quinine ; gives a very low proportion of cardiac complications, 
gr. xv-xx every 4 hours (Da C.) ; disagreeable but strongly recommended 
(B.). Arnica, lowers pulse and temperature, relieves articular pain and 
swelling, diminishes urea (P.). Trim ethyl amine, "Hliv-viij in peppermint 
water, often has remarkable power in acute rheumatism and gout (B.). 
Spigelia Anthelmia, rheumatic pericarditis and endocarditis ; rheumatic fever 
with pain shifting from joint to joint (P.). Sulphurous Acid, fumigation, and 
patient covered with blankets exposed to strong fumes, produces perspiration, 
sleep and relief (R.). Colchicum, alleviates the symptoms, and shortens their 
duration (Wa.). Laville's Mixture, is said to be a tincture of quinine and 
colocynthine, but it is more than probable that colchicine is the active agent 
therein. (See N. Y. Med. Record, Dec. 5, 1885, page 642.) Quinine, as 
antipyretic ; not so useful as wet pack or cold bath ; gr. ij-v after the more 
acute symptoms have subsided (B.) ; is best for the head symptoms (Da C). 
Opium, strongly recommended as anti-rheumatic ; gr. j every 2 or 3 hours, in- 
creased to gr. xij in 24 hours ; tolerance remarkable in this disease. Also, in 
rheumatic carditis it is indispensable (Wa.) ; a very good remedy in moderate 
doses (Da C). Lithium Bromide, equally good in all forms, especially for 
insomnia, delirium, etc. (B.). Digitalis, in powder, gr. ij every 4 hours, usu- 
ally effective after 2 to 7 days ; especially useful in cardiac complications with 
cyanosis and oedema. Iron, tincture of chloride very serviceable in pale, 
delicate subjects, TT1.XX-XXX every 4 hours; also as prophylactic where ten- 
dency (Anstie) ; harmful to the plethoric and overfed (B.). Alkalies. The 
alkaline treatment is now seriously questioned ; an injurious dyscrasia results 
from their use (B.). Potassium Bicarbonate, gr. xxx every 4 hours, in a dilute 
solution, until joint-symptoms and fever* disappear (Wa.). Lime-juice, ^viij 
daily, lemon-juice inferior (R.). Blisters, are a very effective method ; a num- 
ber of small blisters applied to vesication around a joint (B.); large flving 
blisters around a joint (R.). Water, cold baths for the hyperpyrexia (Da C.) ; 
the wet pack very efficacious in rheumatism, also a vinegar vapor bath (B.) ; 
the wet pack, 20 or 30 minutes, and tepid (70 ) shallow bath 1 or 2 minutes. 
Cold applications only when skin hot and dry, and temperature high. Warm 
baths, or hot compresses very useful. Spongio-piline an excellent substance 
for applications. Diet, low during the fever, water, barley-water, milk-and- 
water, gruel, etc. All through use liquid food. Avoid malt liquors, port 
wine, and sugar. Lemon-juice maybe used freely. Blankets, instead of sheets 
to sleep in, and flannel underclothing are useful adjuncts. Pack the joints 
with cotton covered with rubber cloth or oiled silk. 

Plans of Treat?nent, may be resolved into three, viz., — (1) that by Salicin, 
(2) that by Alkalies, (3) that by Iron. Salicylic Acid and the Salicylates, in 
20-grain doses, to not less than £ij in 24 hours, in solution with excess of 
alkali, is especially suited to vigorous, sthenic subjects, whose stomachs will 
bear it, in whom it often effects a cure in 3 or 4 days. Alkalies, for flabby, 
fat subjects ; alkaline carbonates, as the Potas. Carb., gjss, every 24 hours, 
alone or with a vegetable acid, until the urine becomes neutral or alkaline, 



712 



RHEUMATISM, CHRONIC. 



when it may be reduced one-half, and so maintained for some days, when 
quinine or iron may be used. If successful, this treatment brings about a cure 
in two weeks. Tincture of the Chloride of Iron , for the feeble, anaemic, and 
nervous subjects, Tn.xxx every 4 hours, with an occasional saline laxative, 
blisters around joints, and Atropine as an anodyne rather than Opium, used 
hypodermically in the vicinity of the affected joints (B.). 

Cardiac Complications require Ammonium Carbonate, in 5 -grain doses fre- 
quently, also Infusion of Digitalis with hypodermics of Morphine, and a 
blister over the praecordium, followed by Iron and Quinine after the acute 
symptoms have subsided (B.). 

Prescriptions. 

R. Potassii Iodidi, . . spj. 

Vini Colchici Sem., 
Syr. Simplicis, . aa £iv. 

Aquae Menthae Pip., . gv. 
M. Sig. — Tablesp. every 4 hours. 
[New Orleans Charity Hosp.) 



R . Olei Gaultheriae, 
Acidi Salicylici, . 
Sodii Boratis, 
Syr. Picis Liquidae, 
Aquae Anisi, 
M. Sig. — A dessertsp. 

hours. 


• 3j. 

. gr. Ixxx. 
every two 



R . Propylaminae Chlorid., gr. xxiv. 
Aquae Menthae Pip , . Jvj. 
M. Sig. — A tablesp. every two or 
three hours. ( Tyson.) 



R . Sodii Salicylatis, . . gss. 

Tinct. Lavand. Co., . ^iij. 

Glycerini, . . . gvj. 

Aquae, . . q. s. ad £v]. 

M. Sig. — A tablesp. every three 
hours, well diluted. 



R . Ammonii Phosphatis, . gjss. 

Tinct. Colchici Seminis, . 3J. 

Tinct. Aconiti, . . zij. 

Syr. Simplicis, . . ^iij. 

M. Sig. — A teasp. every three or 
four hours. ( Corson.) 



R. Acidi Salicylici, . . £ij. 

Sodii Bicarbonat., . . zj. 

Aquae, .... ^ij. 

M. Sig. — A teasp. or two every two 

hours. (B.) 



Rheumatism, Chronic. 

Arsenic, is very good in most cases, given in small doses steadily (Da C). 
Bryonia, is useful, especially for painful and stiff joints (P.). Rhus Toxico- 
dendron, a very powerful agent in subacute muscular or tendinous rheumatism, 
worse at night (Pf.) ; the tendons, ligaments, and fasciae are most benefited ; 
externally, as lotion on compresses ; also, internally, small doses every two 
hours (P.). Potassium Iodide, especially when pains are worse at night, or 
of syphilitic origin (R.) ; should always be fairly tried in chronic rheumatism 
(Da C.). Cit?iicifuga, sometimes has wonderful success, yet often fails ; no 
indications (B.) ; in rheumatic neuralgias and headaches, and rheumatism of 
uterus (P.) ; signally beneficial in many forms (R.). Mercury, and Morphine, 
the oleate locally, for joint affections (R.). Colchicum, is of decided advan- 
tage in neuralgia of chronic rheumatism (B.). Mezereon, strongly recom- 
mended (P., R.). Phytolacca, has been useful (B.). Iodides, often prove very 
satisfactory, especially in strumous or syphilitic subjects (B.). Aconite, the 
extract as plaster to joints is unquestionably very useful (P.) ; is more useful 
in chronic than acute rheumatism (Wa.) ; the liniment of the B. P. locally 



RHEUMATISM. GONORRHCEAL. 



713 



over the sciatic nerve when affected (Fothergill). Dulcamara, has been em- 
ployed with advantage (P.). Sulphur, locally, also sulphides as baths (R.); 
is certainly of benefit (B.); sulphur waters are undoubtedly efficient (Da C). 
Iodine, for pain around joints (R.). Lithium Bromide, gives excellent re- 
sults, when smaller joints swollen, tender (B.). Lithium Salicylate, in 15 to 
20 grain doses every four hours, gives good results in lingering, subacute cases 
after acute attacks (Da C). Quinine, in rheumatism with debility, shown by 
night sweats, or sweats during sleep, and only then (Wa.). Arnica, the tinct- 
ure and infusion are useful (P.). Cajeput Oil, internally and externally in 
muscular rheumatism (P.). Turpentine, benefits and relieves the pains; in- 
ternally and externally as liniment (P.)- Guaiac, used with varying success 
(B.); often gives excellent results; the ammoniated tincture, ^j-ij in milk 
(Da C.) ; is vile to the taste. Eucalyptus, the leaves wrapped around the 
affected part, renewing them daily for a week or more, often very efficient as 
a local stimulant, and will produce vesication if too long continued (Gibbons). 
Xanthoxylum, has long had deserved reputation, rrixv-^ij fluid extract (B.). 
Thuja Occidentalis, is useful for rheumatic pains (P.). Manganese Sulphate, 
is one of the remedies (B.). Belladonna, the extract locally very valuable for 
pains (P.). Cod-liver Oil, internally and externally, exercises some influence 
(B.). Chimaphila, may prove useful, especially when lithiasis (P.). Lupulin, 
as an anodyne (P.)- Burgundy Pitch, as plaster locally (P.)- Aliment, avoid 
animal and saccharine food. The farinaceous vegetables and acid fruits suit- 
able (B.). Alkaline mineral waters have deserved reputation (B.). Turkish 
Baths, in chronic muscular rheumatism (B.) ; steam bath daily of great benefit, 
may be obtained at home by pouring water on hot bricks in a tub, the patient 
sitting on a board or chair above, enveloped in a blanket (Brick). Red Flan- 
nel, next skin, very popular, but white better, as the red gives rise often to 
eruptions (Da C). [Compare Lumbago, Myalgia, Pleurodynia, Rheu- 
matic Arthritis, Sciatica.] 



Prescriptions. 



K. 



aa ^j . 
. giij, 



Pulv. Resin. Guaiaci, 
Potassii Iodidi, 
Tinct. Colchici Seminis, 
Aquae Cinnamomi, 
Syrupi, . . aa q. s. tfdfgvj. 
M. Sig. — A dessertsp. to a tablesp. 
thrice daily. {Pepper \ 



R. Tinct. Guaiaci ^Ether., . ^j. 

Tinct. Colchici ^Ether., . £vj. 

Tinct. Cann. Ind. ^Ether., 31J. 
M. Sig. — 25 to 30 drops on sugar, 
every 4 hours, for rheumatic and neu- 
ralgic symptoms. (Atlee.) 



R. Linim. Aconiti (B. P.), 

^ Linim. Belladon., . . aa gij. 

Glycerini, . . q. s. ad £\], 

M. Sig. — Apply locally over the 

seat of pain. (Fothergill.) 



R. Olei Sinapis, 

Olei Terebinth., 

Camphorae, 

Liq. Ammon. Fort., . 

Tinct. Capsici, . 

Alcoholis, . q. s. 

M. Sig. — Russian Spirit, 
ment for rheumatism. 



. gss. 

. giij. 

• 3 1V - 

. 311J. 

. giv. 
adgv]. 

a lini- 



Rheumatism, Gonorrhoeal. 

Opium, as Dover's powder, in the acute stage, full doses (Wa.). Potassium 
Iodide, with tonics and stimulants, after the acute stage has passed, followed 
by friction, shampooing, and passive movements of the joints (Wa.). Ammo- 

60 



714 RHEUMATISM, MUSCULAR — SCABIES. 

nium Chloride, in free doses, especially when the muscles are affected (Fuller). 
Potassium Chlorate, internally, and as urethral injection, until urethral dis- 
charge is entirely stopped, then rn.xx of tinct. ferri chlor. 4 times daily, with 
gr. x of quinine daily, and good food (Da Costa). Aspirate, when pus is dis- 
covered around the joints, as the case will be one of pyaemic rheumatism, and 
may involve more joints than one (Da C). 

Rheumatism, Muscular. 

Diaphoretics, as Dover's powder, with Potassium Nitrate, or Salts of Ammo- 
nium, with dry heat to the part involved and rest in bed (Da C.). Morphine 
and Atropine, gr. \ and gr. J^, together hypodermically, are of great service 
in most forms (R.). Jaborandi, or Pilocarpine hypodermically, to get the 
skin acting freely, a great desideratum (Da C.). Potassium Iodide and Col- 
chicum, or Quinine, gr. xij-xvj in 24 hours, if case lingers over a week (Da 
C). Liniments are of little use except to amuse the patient, but Chloral gj 
in ^vj of Linim. Saponis, makes a good one (Da C). Capsicum, powdered, 
with lard, ^ij ad 5j, rubbed over the part, night and morning, with a gloved 
hand, is very efficient (Macdonald). Cimicifuga, is often very efficient in lum- 
bago, myalgia, pleurodynia, and similar conditions (Wa.). Xanthoxylum, gives 
relief in some cases of muscular rheumatism (B.). Lithium and its salts, 
where there is a uric-acid diathesis (B.). Colchicine, 5-minim doses of a 
Y 1 ^- solution of Merck's, hypodermically into affected muscles, thrice daily, 
eery effective in cases resisting other treatment. [Compare Lumbago, 
Myalgia, Pleurodynia, Torticollis.] 

Roseola. 

Scarcely any treatment called for; no local application needed, as the rash 
is but slightly irritating. Aconite or Belladonna, according to the symptoms, 
or the Carbonate of Ammonium, answers all the indications. 

Sarcinse. 

Sulphites and Hyposulphites, have been employed to destroy sarcinae and 
torulae in the stomach (R.) ; or Sulphurous Acid, diluted, before each meal 
(Wa.). 

Scabies. 

Sulphur, a solution of potassa sulphurata ^ss-^j, as local application. An 
extemporaneous sulphide may be made by boiling one part of quick-lime and 
two of sulphur in ten of water (B.). Sulphurous acid, as gaseous bath, the 
quickest method. Hebra's mixture of sulphur, chalk, tar, soap, and lard, less 
irritating, and equally sure (R.). Calcium Sulphide, as a bath (Wa.). Sul- 
phuric Acid, internally, has cured when other remedies failed (Wa.). Storax, 
equally serviceable and not irritating as is sulphur, one part to two of olive oil, 
with a warm bath (R.). Mercury, the bichloride is very efficient, if used 
strong enough, but caution is required in its employment (B.). See formula 
below. Staphisagria, a certain remedy; 3 parts to 5 of lard, boiled at 212° 
F. for 24 hours, when cooled after straining add a little essence ; friction with 
this 4 times daily (Wa.). Balsam of Peru, the best of all applications, killing the 
acarus, relieving the itching and dermatitis, and disinfecting the parts ; rub in 
^j over the body after a warm bath (Bruce) ; is fatal to the itch-mite (Oldberg). 



SCARLATINA. 



715 



Manganese, the oxide, spj-^j adipis suilli as ointment (B.). Copper Sulphate, 
as lotion (Jfj-Oj) has been used with great success, after crusts are thoroughly 
removed with soap-and-water (B.). Alkalies, as soaps or ointments to remove 
cuticle and break up burrows (R.)« Carbolic Acid, locally (B.). [See Tinea 
for formula.] Cocculus Indicus, as ointment, useful (P.). Tar Ointment, 
relieves itching quickly and cures disease in lo or 1 2 days (P.). Anise, Ka- 
mala, as ointments, efficient (P.). Benzoic Acid, gr. x-xx ad 0]/ 2 aquae, as 
lotion, effectual for the pruritus (R.). [See last formula on left-hand column, 
under Pruritus.] Linen should be immersed in boiling water ; other gar- 
ments well fumigated with sulphur vapor to destroy insects or their ova, or 
baked in oven (R.). 

Prescriptions. 



rj. Styracis Liquidis, . . £ij. 
Ung. Sulphuris, . . ^iv. 
Ung. Petrolei, . . ad jj. 

M. Sig. — Apply after washing. 

(Bulkley.) 



R. Hydrarg. Chlor. Corr., . gr. iv. 

Alcoholis, . . . ^vj. 

Ammonii Chloridi, . . ^ss. 

Aquae Rosae, . q. s. ad%v]. 

M. Sig. — Lotion for scabies, phthei- 
riasis, and tinea versicolor. (Fox.) 



R 



. Sulph. Sublimat., . . £j. 

Balsam. Peruv., . . Zss. 

Adipis, . . . . 3J. 
M. Sig. — For children. 

(Duhring.) 



R. Sulph. Sublimat., 
Olei Cadini, 
Cretae Preparatae, 
Saponis Viridis, 
Adipis, . 
M. ft. unguentum. 



aagij. 
. gijss, 

aa gj. 

(Bulkley.) 



Scarlatina, 

Aconite, of the highest value for all marked increase of temperature (B., R.) ; 
helps the development of eruption when due (P.) ; in the early stage, when 
not decidedly adynamic, is very useful (W.). Belladonna, during the erup- 
tive stage, when depression exists, and rash is imperfectly evolved (B.). As 
prophylactic has been recommended (iT.) ; is often efficacious as prophylactic 
(P.) ; the preponderance of evidence is certainly in favor of such use of the 
drug (Pf.) ; this virtue is claimed by imposing authorities ; when so given its 
dose is gr. | several times a day (Tr.). Mercury, gr. \ of gray powder every 
hour has marked effect on inflamed tonsils (R.). Ammonium Carbonate, 
feeble circulation, cyanosis, delirium (B.) ; in all forms, especially if given 
early (R.) ; one of the most reliable remedies ; gr. iij-vij, according to age, 
in milk or cinnamon water, every hour or two (Wa.). Potassium Iodide, in 
full doses, a very satisfactory remedy (Mitchell). Mineral Acids. Muriatic, 
internally and as gargle; Nitric, to sloughs in throat (R.). Carbolic Acid, 
internally and as gargle, successfully used. [See Measles, for formula.] 
Seems to exercises some influence as prophylactic (Wa.); is good for the 
vomiting and for its general effect on the disease ; ttiss, every 2 or 3 hours 
(Da Costa.). Veratrum Viride, in convulsions (R.). Rhus Toxicodendron, of 
great service, if typhoid or rheumatic symptoms (P.). Digitalis, very useful; 
lowers temperature and maintains kidney action (B.) ; the best antipyretic and 
diuretic, the infusion with dry cups for the renal dropsy in its inception. Later 
on, milk diet and Basham's Mixture (Da C). Potassium Permanganate, 
locally to throat, and internally (gr. J^-j ter die) has undoubted benefit 
(B.). Sulphurous Acid, by inhalation, spray, or fumigation, in malignant 



716 



SCIATICA, 



sore throat (R.). Chlorine Water, in sloughing of throat (R); seemingly 
prophylactic (Wa.). Quinine, small doses, in adynamic states, large in hyper- 
pyrexia (B.); very successful when used systematically from the start (Wa.). 
Ferrum Perchloride, the tincture in doses of ntx-xv, according to age, in 
advanced stage, when with albuminuria and hematuria, is very valuable (Wa.). 
Potassium Chlorate, in grain-doses every y^ hour, will not injure the kidneys, 
and will give equal results as larger doses on the throat inflammation (A. A. 
Smith). Asclepias, to promote the eruption (W.). Zinc Sulphate, gr. y 1 ^ every 
3 hours, believed to have specific influence on the disease (Hoyt). So- 
dium Benzoate, is highly efficient, having slower but more permanent effects 
on the fever than quinine or the salicylates (Klebs). Boric Acid, makes an 
excellent gargle (Da C). yuniper, as diuretic when dropsy ( R. i. Magnesium 
Sulphate, as purgative, to prevent sore throat and other sequelae (R.). Sodium 
Sulpho-carbolate, as a menns of introducing carbolic acid into the system. 
Has been successfully employed (Wa.). Mustara I Bath, on recession of rash, 
to bring it back (R.). Oil Inunctions, very grateful, especially useful in des- 
quamative stage. Cocoa butter the mo-t elegant (B.). /^ sucked, in the sore 
throat (R.). Water, cold baths with oil are all that are needed in mild cases. 
When temperature above 104 , urine scanty and rash retroceding, the cold 
wet-pack renders signal service (B., R.). A cold wet compress to neck, through 
the whole course, renewed every 3 hours (R.). Diet, fruit, if ripe, in season, 
toast, gruel, etc., in simple cases. In malignant, extract of beef, stimulants as 
per pulse. Milk the most suitable aliment, both as nutrient and as diuretic. 



Prescriptions, 



R. Ac. Borici, 

Potass ii Chloratis, 

Tinct. Ferri Chloridi, 

Glycerini, Syrupi, 

Aquae, .... 
M. Sig. — Tablesp. every 2 hours, 
to a child of five years. (Smith.) 



• 3«- 
- 3* 

aa |j. 



R. Acidi Carbol., . . ^ss-j, 

Vaselini, . . . giv. 

M. Sig. — By inunction to the en- 
tire surface. 



R. Acidi Salicylici, . 
Tinct. Aconiii, 
Infusi Digitalis, . 
Spt. Amnion. Aromat., 
Syr. Aurantii Cort., 
Aquae, . 
M. Sig. — Teasp. every 

for a child of five years. 



3*h 

gtt. Xlj. 

5jss. 

3 hours, 
(Brown.) 



r. 



Acidi Borici, . . giij. 

Glycerini, . . . Jiv. 
M. Sig. — For a pint of water as a 
gargle. (Da Costa.) 



Sciatica. 

Aconite, locally (P.) ; as ointment controls in some instances (R.) ; valuable 
and efficient in many obstinate forms ( Wa.). Rhus Toxicodendron, a very pow- 
erful therapeutic agent in various rheumatic affections of the fibrous tissues (P.). 
Cimicifuga, is highly extolled (R.). Turpentine, causes an exquisite sensibility 
along the track of the great nerves (Tr.); occasionally of great value in sciat- 
ica, yet not a specific, nor have we scientific indications for its use (P.) ; gss 
doses for 4 or 8 successive nights (R.). Sulphur, locally, believed to relieve 
the pain; effect probably due to the flannel surrounding it (R.) ; is worthy of 
trial after active symptoms are subdued (Wa.). Phosphorus, in neuralgic form ; 
less satisfactory in sciatica than in other neuralgias (R.). Nux Vomica , often 



SCLERODERMA — SCROFULOSIS. 7 I J 

successful in chronic (Wa.). Belladonna, has afforded relief (R.). Atropine, 
hypodermically, is curative ; large doses, gr. ^ to -^ in vicinity of nerve (B.). 
Cocaine, hypodermically along the nerve, has afforded instant relief i Wa.). 
Veratrine, as strong ointment ; Veratrum Viride, as tincture, is also recom- 
mended (R.). Ammonium Chloride, in mild forms (R.); occurring in the 
young (Anstie). Ether Spray, generally of temporary value (R.); Chloro- 
form on flannel along course of nerve, covered with oiled silk ( Wa.) ; injected 
deeply into vicinity of nerve, gives the best results in old cases, ttlxv of the 
spirit hypodermically (B. i. Stramonium, gr. X~H every 3 or 4 hours for 4 or 
5 doses, often affords decided relief. Stop when slightest symptoms of nar- 
cotism appear (P.). Opium, internally and externally (Wa.) ; Morphine, hy- 
podermically is especially curative in sciatica (B.) ; 3 or 4 injections of gr. yfc 
each ; it may almost be regarded as a specific (Wa. ) ; a single application 
sometimes cures long-standing cases permanently ; if not it may be repeated 
every second day or so (R.) ; should be injected deeply into the adjacent 
muscular structure (Pepper). Iodides, in syphilitic or metal-poisoned subjects 
(B.) ; often fails (R.). Potassium Iodide in doses of £j daily, dissolved in 
decoction of sarsaparilla, most efficacious in subacute or chronic (Wa.). 
Cantharides, as counter-irritant, to free vesication 1 R.). Aguapuncture, ha.s 
had extraordinary success (B.). [See under Neuralgia.] Acupuncture, 
occasionally affords instant relief (B.) ; often cures cases of long standing (R.). 
Nerve-stretching, by forcibly flexing the thigh on the abdomen (Lange). 
Poultices, applied very hot (R.). Turkish Baths, are often very useful (R.). 
Electricity, produces excellent results (B.) ; does great good, but often aggra- 
vates ; the continuous current best, when stage of acute inflammation past (W. \\ 
galvanism often quickly relieves the pain (Pepper). Cod-liver Oil, should 
always be tried in obstinate cases (W 7 .). [Compare Neuralgia, Rheu- 
matism Chronic.] 

Scleroderma. 

Cod-liver Oil, our sheet-anchor, used internally and locally (B.). Elec- 
tricity, is used successfully (B.) ; with stimulating inunctions offers the best 
prospect of improvement (Bulkley). ** 

Scrofulosis. 

Iodides, the Iodide of Ammonium when glandular enlargement ; that of 
Iron when debility and emaciation, a powerful and efficacious remedy ; also in 
amemia of scrofula, the syrup rri xx-gj, ter die (Wa.) ; disappointing, useful 
in simple glandular hypertrophy (B.). Iodine, tinct. or oint. applied over 
scrofulous glands — take care not to increase inflammation (R.). Iodine and 
Iron the best remedies, but all medicines utterly useless without strict hygiene 
(A.). Calcium, the chloride, in doses of gr. x-xx in milk after food, when 
glandular enlargement of neck and chronic diarrhoea. The phosphate of 
great use for sores (R.) ; is of eminent service as a palliative (Wa.) ; see Sul- 
phides below. Spongia Usta, formerly held in high repute ; has fallen into 
perhaps unmerited neglect. Contains sodium iodide, magnesium bromide, 
calcium phosphate, and ferric protoxide, in small quantities (Wa.). Iron, 
ferrum and calcium phosphates combined give good results, also chalybeate 
waters (B.) ; must be long continued (R.). Sulphides, for sores, abscesses, 
suppurating glands ; gr. ^ or ^ of calcium sulphide every hour or two (R.). 
Conine, grain y 2 to £j almond oil, locally, two or three times a day to con- 
junctivae in " scrofulous " photophobia ; has proved very successful (P.). Cod- 



7 1 8 SCURVY — SEBORRHCEA. 

liver Oil, the best remedy to promote assimilation (B.) ;, of great service in 
the various manifestations of this disease (R.). Stillingia, a domestic remedy, 
used with much success (B.). Capsicum, in scrofulous and fistulous ulcera- 
tions, a weak infusion becomes a useful stimulant (P.). Mezereum, strongly 
recommended (P.). Sarsaparilla, useful by reason of its tonic and alterative 
properties (P.). LLyoscyamus, the bruised leaves as cataplasm for scrofulous 
ulcers (P.). Phosphates, for mal-nutrition (B.). Prunus Virginiana, is found 
very useful in the hectic (P.). Chimaphila, holds a certain amount of repu- 
tation as a useful remedy (P.). Tussilago, was employed by Cullen (P.). Gen- 
tian, is valued. As infusion a useful vehicle for chalybeates, etc. (P.). Blis- 
ters, for scrofulous glands (R.). Grape-cure, renders much service (B.). Al- 
cohol, no doubt as to its great value; with cod-liver oil, or in small amounts 
at meals (Wa.). Phosphorus, eminently serviceable in scrofuloderma, gr. x 
in 01. Olivse gj, doses of Titv-x, thrice daily after meals (Broadbent). Aliment, 
raw or broiled meat, the latter for children. Abundance of fresh air and sun- 
shine. Sea-air, sunlight, moderate exercise, and light, digestible food are 
necessary, [Compare Cachexias, Glands, Coxalgia, Ophthalmia.] 

Scurvy. 

Citric Acid, used with great advantage, though inferior to lemon-juice (Wa.). 
Lemon- or Lime-juice, of the utmost value, both as preventive and a curative 
agent. Efficacy believed to be due to its potassium salts. Oranges highly 
useful (Wa.). Acids, especially vinegar, to prevent scurvy, in the absence of 
lime-juice or fresh vegetables (R.) ; dilute Muriatic Acid, gtt. v, thrice daily, 
with juice of three lemons daily, vegetables and fresh meat (Da Costa). Po- 
tassium Chlorate, is probably a remedy of some value (Wa.) ; is not (W.). 
Cinchona, a decoction, or the dilute tincture with myrrh or the chlorates, a 
very useful gargle. Quinine, internally when much prostration, combined 
with mineral acids (Wa.). Alcohol, diluted, as gargle (R.). Atropine, hypo- 
derm, for salivation (R.). Alum, a solution in water with tinct. myrrhae ^ss, 
several times daily as lotion for ulceration of the gums (W.). Liquor Sodce 
Chlorates, £vj ad ^xij aquae, as a mild application to gums (Wa.). Dietetic 
Treatment alone required. Lemon-juice plays no essential part in the treat- 
ment. The full diet of an hospital, comprising fresh meat, vegetables, and 
milk, is generally sufficient. [Compare Cancrum Oris, Purpura.] 

Seasickness. 

Chloral, the most effective remedy; gr. xv-xxx every four hours (R.). Sta- 
phisagria, has given relief (P.). Creasote, checks the vomiting (R.). Chloro- 
form, drop doses pure (R.) ; triij-v on sugar (B.). Atropine, hypodermically, 
gr. T 2^ in epigastrium, will relieve (B.). Morphine, gr. y 1 ^— J- hypoder. will 
often relieve severe cases (B.) ; often fails (Wa.). Amyl Nitrite, by inhala- 
tion (B,) ; is strongly recommended, but must be cautiously used. Cham- 
pagne, iced; tablesp. doses every quarter-hour (B.). Calumba, a few drops 
of the tincture will sometimes relieve (B.)« Spinal Lee- bag, often successful 
(R.). Cocaine is reported quite successful. Bromides, in full doses (Beard). 
[Compare Nausea, Vomiting.] 

Seborrhcea. 

Glycerin, especially useful ; with lead acetate, borax, zinc, diminishing se- 
cretion ; also acts efficiently when there is a want of sebaceous secretion ( W.). 



SNEEZING SPERM ATORRHCEA. 719 

Zinc Oxide, 3}, plumbi carbonat. 3J, cetacei gj, ol. olivse q. s. Ft. unguent. 
(B.), Oleate of Arse?iic, is of benefit (Wa.). Mercury, an ointment of the 
white precipitate is serviceable on the scalp, with an occasional shampoo with 
tar soap or green soap in solution, followed later by mildly stimulating lotions 
(Bulkley). [Compare Acne, Pityriasis.] 

Sneezing. 

Arsenic, a drop of liquor arsenicalis three times a day in paroxysmal sneez- 
ing, allied to asthma (R.). Potassium Iodide, gr. x, several times a day (R.). 
Iodine, inhalations in paroxysmal sneezing, with itching of nose (R.). Cam- 
phor, in incessant sneezing, with profuse running from eyes and nose. The 
powder should be snuffed, or the alcoholic solution inhaled (R.). [Compare 
Catarrh, Hay-fever, Influenza.] 

Somnambulism. 

Potassium Bromide, will give decided relief in the somnambulism of chil- 
dren allied to epilepsy, often with squinting, which may become permanent ; 
generally the result of deranged digestion. The night-mare of adults will 
usually yield to the same drug (R.). [Compare Night-mare.] 

Spasmodic Affections. 

Aconite, ext. and int. for spasms not of a severe type ; Aconitine, as oint- 
ment in the most severe, as well as in the milder local spasmodic affections; 
in angina pectoris, spasmodic asthma, cough, etc. (P.); in spasmodic laryn- 
gitis of good effect (R.). Camphor, in many forms said to relieve, as stran- 
gury, etc. (R.). Belladonna, of value for spasms of sphincter muscles, es- 
pecially of pelvic organs (P.) ; atropine hypoderm. in local spasm (R.). 
Strychnine, of great value in spasmodic asthma (P.) ; also in tetanus, chorea, 
and epilepsy (Pf, S.). Veratrine, as solution, brushed over lids once a day 
in painful spasmodic contraction of the orbicularis (Wa.). Ophim, very useful 
as an antispasmodic, especially if given with a stimulant, as alcohol, ether, or 
chloroform (R.). Ipecacuanha, in spasms of respiratory organs, of great value 
(P.). Chamomile Oil, in spasms of hysterical persons, in 4 to 6 tit. doses, a 
very excellent remedy ; also useful in pseudo angina pectoris (P.). Lobelia, 
a valuable antispasmodic in cautious hands (P.). Lupulin, in gouty spasms 
(P.). Tobacco, in spasmodic asthma, and for relaxation of muscular spasms 
(P.). Sumbul, in gastric spasms is of use (P.). Cardamoms, are usefully em- 
ployed in gastric spasms (P.). Ammonia, useful in children's colic (R.). 
Chloroform, inhaled for intestinal spasm (R.). Sulpho-carbolates, in flatulent 
" spasm," sometimes phosphorus better (R.). Mustard Poultice, an excellent 
counter-irritant in spasmodic affections (P.). [Compare list of Antispasmodics 
on page 405, and in this section the titles, Angina Pectoris, Asthma, Cho- 
rea, Colic, Cough, Convulsions, Croup, Dysuria, Epilepsy, Gastro- 
dynia, Hydrophobia, Hysteria, Laryngismus, Pertussis, Tetanus, 
Torticollis, Trismus.] 

Spermatorrhoea. 

Potassium Bromide, when plethora-erections normal, but persistent and 
teasing; is harmful in debilitated states, or daily losses (B.) ; with cold spong- 
ing and use of a hard bed (R.). Digitalis, 3J or ij of the infusion twice or 



720 SPERMATORRHCEA SPINAL CONGESTION. 

thrice daily; few remedies are more successful in arresting spermatorrhoea 
(R., P.) ; feeble erections, frequent emissions, cold hands and feet (B.). Can- 
tharis, deficient tone of seminal vesicles, erections feeble, sexual feeling tor- 
pid ; tinct. gtt. ij-iij ter die(R.); with Iron internally in emissions (R.). 
Phosphorus, for the induced physical and mental debility ; also, hypophos- 
phites of lime and soda (R.). Gelsemium, as anaphrodisiac, may be combined 
with Belladonna or Cimicifuga (B.). JVux Vomica, relaxation and atony (B.). 
Strychnine, in large doses, especially when impotence (R.). Quinine has been 
recommended (R.). Belladonna, gr. }£ of extract with gr. jss zinci sulphat., 
three or four times a day, often successful in nocturnal emissions (R .). Atro- 
pine, relaxed genitalia, no dream or orgasm (B.). Camphor Bromide, has 
been useful (W.). Lupulin, is a good anaphrodisiac; with Camphor, when 
a genital sedative is required (B.). Iron, the iodide, useful in anaemic cases (B.). 
Ergot, beneficial in relaxed state (B.). Hydrastis, is a useful injection, gtt. x of 
the fluid ext. through a urethral tube to the prostatic portion of the urethra 
(B.). Cimicifuga, useful in weak, relaxed conditions (B.) ; with hypochon- 
driasis, very beneficial (P.). Silver Nitrate, a vesicating solution applied to 
perineum generally useful, and without danger (B.). Arsenic, when from weak 
and relaxed seminal vesicles. Kind Advice, frequently the best treatment, as this 
is often the phantasm of- a morbid imagination. Bladder should be emptied 
after the first sleep. [Compare Emissions, also List of Anaphrodisiacs on 
page 427.] 

Prescriptions. 



R. Potassii Bromidi, . . gj. 

Sodii Bicarbonat., . gr. xv. 

Infusi Digitalis, .. . ^ss. 



Atropinae Sulphat., . gr. 



-h- 



M. Sig. — One dose, to be taken at 
bed-time. ( Gross.) 



R. Tinct. Gelsemii, . . ^j. 

Tinct. Belladonnas, . * gij. 
M. Sig. — 15 drops thrice daily. 

(B.) 



R . Lupulini, . . . gr. x. 

Pulv. Camphorae, . . gr. vj. 

Ext. Belladonnas, . . gr. ij. 
M. ft. pil. no. xij. Sig. — One pill 
thrice daily. (B.) 



R. Tinct. Cantharidis, . . gij. 
Tinct. Ferri Chlor., . . £vj. 
M. Sig. — 20 drops in water thrice 
daily. In impotence with spermator- 
rhoea, of great utility. (H. C. Wood.) 



Spina Bifida. 

Iodine, injected into the sac, gss of tinct., or gr. ss, with potassium iodide 
gr. v, aquae 3J, has cured numerous cases (B.) ; iod. gr. $, pot. iod. gr. y^ ad 
aq. gj (Wa.). Collodion, as a means of compression (B.). 

Spinal Concussion. 

Lead-water and Opium, as lotion over the seat of injury (A.). Leeches, if 
pain persistent (A.). 

Spinal Congestion. 

Ergot, gives excellent results (Brown-Sequard). Tu?pentine, hot epithems, 
useful (Wa.). Antiphlogistic measures, with rest and absolute diet; wet cups 
or leeches to the column ; cool affusions to the spine while patient in a warm 
half-bath (Ros.). [Compare Meningitis.] 



SPINAL IRRITATION — STAINS. 721 

Spinal Irritation. 

Aconite, as ointment locally (R.). Belladonna preparations, locally, gen- 
erally are better than Aconite (R.). Ignatia, in small doses diminishes irri- 
tability of cerebro-spinal axis (Pf.). Strychnine, persistently, will ameliorate 
wandering neuralgic pains due to irritability of nervous system (B.). Ergot, 
large doses for congestion (Hammond). Conium, in functional derangement 
of the cord, with excessive irritability of the reflex function (Wa.). Firing, 
sometimes very beneficial (B.). Electricity. "An inverse galvanic current 
gives much relief (Hammond). Blisters, with hot-water bag to spine, large 
doses of strychnine, phosphorus, phosphoric acid, and opium, are the methods 
based upon the anaemic theory of the disease. Out of 156 cases 133 were 
thoroughly cured (Hammond). [Compare Meningitis, Myelitis.] 

Spinal Paralysis and Softening. 

Ergot, to starve the inflammation by occluding the spinal arteries (Ham- 
mond). E lectricily, best ; galvanic current from spine to nerves and muscles 
(Ros.). Treatment must be palliative and supporting only, in softening (H.). 

Splenic Affections. 

Mercury Biniodide, gr. j ad unguent, ^j, rubbed in before a hot fire, has 
given excellent results in chronic malarial enlargements of spleen (Wa.). 
Quinine, in simple malarial enlargement (B.) ; gr. xv or xx or more daily, 
one of the most effectual remedies (Wa.). Ergot, the most effective remedy 
for enlarged spleen (Da Costa). Ammonium Iodide, effective in chronic 
splenitis, with unguent, hydrarg. iod. rubri externally; also small doses fre- 
quently repeated in all splenic derangements from malaria (B.). Iodine, 
locally in chronic forms (B.). [Compare LeucocytH/EMIA.] 

Sprains. 

Arnica, is very useful ; the infusion internally and externally (P.) ; the tinct. 
diluted as lotion is very effectual (Wa.). Aconite, the liniment to painful 
sprains often affords speedy relief (Wa.). Turpentine, the oil as a liniment 
(P.). Ammonium Chloride, in solution, as lotion, or with bread as poultice, 
to remove discoloration from sprains (Wa.). Rhus Toxicodendron, the tinct. 
IJss to Oj of water a good external application to sprains. Oil of Bay, as 
stimulating liniment (P.). Cold Douche, salt maybe added. The force must 
be regulated by the condition of the tissues (R.). Rest, the most essential 
measure, should be perfect. Warm fomentations, or cold affusion, opiates, 
and plain diet (D.). A roller bandage with splints, often required to secure 
rest of the part. 

Stains. 

Nitrate-of -silver Stains may be removed by washing with Potassium Cyanide 
>>ijss ; Iodine, gr. xv. ; Water, giij ; or, after moistening the spots, drop on 
them a few drops of Tinct. Iodine, and wash out with a solution of Sodium 
Hyposulphite, ^ss-^j (B.). Blood-stains, if on dark-colored materials are 
best seen by an artificial light. After a few hours they become of a rusty, 
reddish-brown color, which they maintain for years. The microscope shows 
the characteristic corpuscles. These stains when on iron are difficult to dis- 



722 STAMMERING — STOMATITIS. 

tinguish from rust ; the latter is not soluble in water, while blood is extremely 
so. Heat applied to the metal will cause the blood to peel off, unless the 
stain has been exposed long enough to have rust mingled with the blood. 
A solution of blood in water, heated, forms a coagulum which is soluble in 
hot caustic potash, the solution thus formed is green by transmitted light, 
and red by reflected light. Menstrual blood cannot be distinguished from 
that resulting from a wound (Husband). 

Stammering. 

Vocal Training. The rhythmical method, the most successful ; the chief 
end in view is to regulate the precipitate, irregular form of respiration. Long 
continuance necessary, six months, a year, or more, in special institutions 
(Ros.). The patient must be taught the use of language anew, treated with 
especial kindness, and never subjected to mockery or punishment. See Potter 
on Defects of Speech, Lea Prize Essay, Philadelphia, 1882. 

Sterility. 

Aurum, cures sterility when dependent on chronic metritis or amenorrhcea 
or coldness, more certainly than any other remedy. Auri chlor. gr. ^ (B.). 
Potassium Iodide, when due to syphilis (R.). Dilation of os and cervix care- 
fully when sterility depending on obstruction, with dysmenorrhea (H.). Ster- 
ility is frequently associated with uterine displacement (Meadows); less often 
with atresia. In persons of good health may be caused by an acid discharge 
from the uterus, which kills the spermatozoa; for this Vichy water internally 
and per vaginam, and alkaline baths (Charrier). Is due to aspermatism of the 
husband in more cases than generally believed (Gross). 

Stings and Bites. 

Ammonia or Alkalies, a weak solution, in stings of insects, to neutralize the 
formic acid (R.). Ammonia, as nervine stimulant in snake-bites, more useful 
than brandy or any other stimulant : tti.x-xx of liquor ammoniae in water or 
wine, every half-hour or oftener ; also externally or hypodermically, 1 part to 
2 aquae into a vein (Wa.). Carbolic Acid, a weak solution sponged over the 
body, to keep off mosquitoes (R.). Arsenic, 1 part to 5 of black pepper, is 
the " Tanjore Pill," highly esteemed in India for bites of venomous snakes 
(Wa.). Chloride of Lime, a filtered solution injected into wound from snake- 
bite, successful in seventeen cases (Binz). Silver Nitrate, the sharpened stick 
applied to every sinuosity of the wound. Excision safer (Wa.). Sugar, ap- 
plied to stings of wasps, said to relieve almost instantly (Wa.). Ipecacuanha, 
as poultice or paste, allays pain and irritation ; is regarded by some as almost 
specific (Wa.). Stimulants, in snake bites, freely ; most important. Liquor 
ammoniae the best ( Wa.) ; stimulants are indicated in snake-bites, but there is 
no remedy of any value (Gross). Sting, should always be removed if left in 
the wound ; pressing upon it with the barrel of a small key will expose it. 

Stomatitis. 

Potassium Chlorate, locally and internally. Large doses necessary (gr. 
x-xx) ; in ulcerative stomatitis of nursing women, and aphthae; of no value 
in mercurial form (R.). Hydrastis, fluid extract locally in mercurial and 



STRABISMUS — SYCOSIS. 723 

aphthous stomatitis (B.). Carbolic Acid, concentrated, in glycerin, carefully, 
as a mild caustic in aphthous stomatitis (Wa.). Alcohol, Brandy-and-water 
an excellent lotion (B.). Acids, Mineral, pure Hydrochloric on pine wood 
to ulcers (B.). Eucalyptus, a decoction of the leaves an efficient local appli- 
cation (B.). Glycerin of Tannin, in ulcerative stomatitis (R.). Copper Sul- 
phate, solution painted over edges of gums in ulcerative stomatitis; generally 
dry alum better (R.). Alum, in ulcerative, applied dry with the finger several 
times a day, especially when disease affects one-half the jaw (R.). Salicylic 
Acid, to ease the pain of catarrhal stomatitis. One part (dissolved in sufficient 
alcohol) to 250 parts of water (R.). [Compare Aphtha, Cancrum Oris.] 

Strabismus. 

Belladonna, for the strabismus of encephalitis (P.). Atropine, with strong 
convex glasses, to suspend accommodation for months, or years if necessary ; 
may cure convergent strabismus in its earlier stages, in children of 3 years of 
age or younger (Green in C). Operation, required in most cases, especially 
when of congenital origin. 

Strophulus. 

Glycerin, locally, combined with bismuth, and digitalis (Wa.). Lancing 
the gums is proper (H.). 

Sunstroke. 

Water, Cold affusion when patient is stricken down unconscious (R.) ; 
absolute rest and quiet, free air, loose clothes. Potassium Bromide, in cold 
water enemata. Stimulants when frequent and feeble pulse. Chloroform, if 
convulsions. Leeching, in stage of reaction ( Wa.). 

Suppuration. 

Sulphides, small doses (gr. ss-j), frequently repeated, are very serviceable 
(B.). Calcium Sulphide, when ichor secreted instead of pus ; also arrests 
suppuration, or if that is impossible will hasten maturation (R.). Quinine, 
recommended in profuse suppuration (R.) ; to sustain system when suppura- 
tion prolonged (B.). Sarsaparilla, is very useful (P.). Phosphates, Parrish's 
to repair waste from suppuration (B.). Iodide of Manganese and Iron, the 
syrup, in cachectic states resulting from suppuration (B.). Alcohol, an excel- 
lent antiseptic dressing (B.). [Compare Abscess, Boils, Carbuncle, 
Pyemia.] 

Surgical Fever. 

Aconite, quickly and repeatedly in early stages, during chill or soon after, 
the safest treatment (P.). Salicylic Acid, or Salicylate of Sodium, especially 
useful as an anti-pyretic (B.). Chloral, gr. xx-xxx of the hydrate every 2 
hours, no better treatment (Wa.). 

Sycosis. 

Nitric Acid, gj to Oj aquae, as wash, used frequently (R.). Boracic Acid, 
£jss finely powdered and incorporated with gj of vaseline, is found most 
useful (Wa.). Mercury, citrine ointment has been extensively employed, also 



724 SYNCOPE — SYPHILIS. 

the oleate of mercury, both with good results (Wa.). Arsenic, the oleate is 
found beneficial, and the Solution of Arsenic and Mercury ', Donovan's solu- 
tion, internally is highly useful. Mercurial Ointments are extensively em- 
ployed (Wa.). Sodium Sulphite, 3] ; glycerini, gj ; aquae, £iij ; locally, when 
of parasitic origin (Wa.). [Compare Condylomata, Mentagra.] 

Syncope. 

Cinnamon, the oil, as a powerful stimulant, sometimes employed (P.). Al- 
cohol, as brandy, or wine, when heart suddenly enfeebled from fright, etc. (R.). 
Amyl Nitrite, in some forms, especially in anaemic subjects, its inhalation 
speedily restores consciousness (O'Neill). Atropine, gr. y-J^-^o subcutane- 
ously, the best means of resuscitation, there being no medicine which so 
promptly exalts the force and rapidity of the heart's action (Harley). Am- 
monia, internally, or breathed into the air-passages (R.) ; the carbonate as 
"smelling salts" (Wa.). Lavandula, the compound tincture (Wa.). Chlo- 
rofor?n, internally, for hysterical people, as cardiac stimulant (R.). Position, 
leaning forward, with head as low as possible ( R). Galvanization of pneu- 
mogastric (B.). Cold Water over the face, and volatile substances to the nose 
(R.). Cold affusion always (Wa.). 

Synovitis. 

Potassium Iodide, with iron and quinine, in syphilitic patients with consti- 
tution broken down (D.). Iodine, in chronic, painted around joint ; the solu- 
tion injected into white swellings (R.). Quinine, and free stimulation in all 
cases of pyaemic synovitis, such as occurs in acute rheumatism of gonorrhoeal 
causation, occasionally in typhoid fever, and may from a trifling injury in 
strumous subjects. Mercury, and Morphine, the oleate locally (R.) ; an ele- 
gant and efficient application (B.) ; in syphilitic cases Mercury internally when 
acute symptoms have subsided (D.). Aconite, for pains in inflamed joints(R.). 
Silver Nitrate, locally, to vesication almost, often very beneficial (Wa.). Car- 
bolic Acid, injected into joint (B.). Alcohol, and water, equal parts, an excel- 
lent evaporating lotion (B.). Blisters, a flying blister every night in chronic 
synovitis (R.). Cod-liver Oil, in strumous cases (B.). Surgical Treatment. 
Splints to keep limb motionless in all cases arising from injury ; during 
acute stage splint should be fastened at some distance above and below joint, 
and not touch joint itself. Straight position, leeches to joint, or cupping 
near it; ice, evaporating lotions or hot fomentations. Blisters inapplicable 
until acute stage subsides (D.). If suppuration occurs the joint must be dealt 
with as any other abscess cavity (MacCormac). Heat, as fomentations or 
poultices, in the acute form. Bandage, or Strapping, to cause absorption of 
fluid ; bandages (cold water) after alternate bathing with hot and cold water, 
in chronic. [Compare Coxalgia.] 

Syphilis. 

Mercury, the mainstay in earlier and later stages; the protiodidein pills of 
gr. \ each, one after each meal increased by one every third day, until teeth 
sore or bowels disordered, then drop two pills from each dose (Keyes). The 
best remedy for primary and secondary, not so in tertiary, or in chancroid; 



SYPHILIS. 725 

small doses are best, to stop short of ptyalism (B.). Blackwash, calomel or 
citrine oint. very useful in mucous sores, tubercles, and elevated indurations ; 
ohilitic ozaena, psoriasis, rashes, condylomata, etc., the bichloride, gr. ij- 
v in fi) alcoholis, painted over syphilitic mouth lesions daily (Keyes). The 
serious secondary and tertiary symptoms can be produced both by syphilis 
and by mercury ; the phenomena produced by mercury are singularly similar 
to those which result from syphilis. Mercury believed to be a true vital an- 
tidote against the virus R.); used for at least two years can eradicate it 
Keyes . Nitric Acid, in secondary forms ( R. ) ; holds a high place as an 
internal remedy (Wa.) ; when sponginess of gums excessive, ^iv-gij aq. teasp. 
4 times daily ; also use locally St : as cautery for the initial lesion, the fum- 
ing acid, if done at all, should be early and thoroughly, followed by Black 
Wash locally on lint (Bulkier). Potassium Iodide, approached by no remedy 
in constitutional syphilis ; also for mercurial cachexia, syphiloma of nervous 
rn, and many disorders of syphilitic origin. -Will certainly arrest ulcera- 
tion of nares, palate, etc., if given in large doses, gr. xx-£j every 4 hours (R. ; 
is of little value in early stages ; in later should be combined with mercury 
Iodine, as gargle for ptyalism ; the tincture applied to syphilitic sores 
of the throat iR.j; or gss of tincture to giv syr. fusci ; a teaspoonful well 
diluted ter die, after meals, when Pot. Iod. cannot be borne (St.). Iodoform, 
powdered and dusted over ulcers (B.). Aurum, after mercury and the 
iodides, in old cases of secondary and tertiary, ulceration of the throat, ozaena, 
phthisis, syphilitic bone-diseases B. ; its beneficial action incontestable (Tr.). 
Stillingia, with nitric acid in chronic cases of broken-down constitutions from 
mercury and iodides ; has been most satisfactory (B.i. Cascara Amarga, is 
said to have remarkable powers as an alterative in syphilis, but to be useless 
if alcohol and tobacco are used at the same time. Sanguinaria, in secondary 
and tertiary, is held to be very useful (P.). Sarsaparilla, a most important 

r iy, as adjunct to, and in abuse of mercury (P.) ; with guaiac and meze- 
reon, as the compound decoction of sarsaparilla, in tertiary form (B.). See 
Guaiac, below. Belladonna, with mercurial ointment, for secondary ulcera- 
of rectum P. ; tincture ^iv ad ^ij aqu^e, a teaspoonful 4 times a day in 
water, instead of mercurials St. . Iron, the iodide in constitutional syphilis, 
to promote constructive metamorphosis B. ; where anaemia exists (R.) ; the 
potassio- tartrate, gr. xv-xx, every 4 hours, especially in the gangrenous form 

- . Guaiacum, in tertian* only; or as vehicle for potassium iodide and 
mercuric chloride (B.). Carbolic and Salicylic Acids, locally to syphilitic ab- 
e-, carbolic best (B.). Zinc Chloride, Iodide, Nitrate, locally to syphil- 
itic ulcers (R.). Denutrition. The Arabic " hunger-cure " efficient, but un- 
popular (B.). Turkish Baths, or wet packing, ameliorate and aid cure of 
constitutional syphilis (B.) Hygiene, is of the greatest importance in syphilis 
(Bulkley). Cod- liver Oil, remarkably improves condition resulting from pro- 
longed use of mercury and iodides, the syphilodermata, and squamae ; inter- 
nally and by inunction (R.). [Compare Chancre, Condylomata, Ulcers, 
Ptyalism.] 

Prescriptions. 

K . Hydrarg. Chlor. Corr., gr. viij. 

Potassii Iodidi, . . J viij. 

Syr. Sarsaparillae Co., . ^fviij. 
M. Sig.— " The Three Eights,"— 
a teasp. thrice daily. 



rjt . Masse Hydrargyri, . gr. ij. 

Ferri Sulph. Exsiccat., . gr. j. 

Extr. Opii Aquosi, . gr.J, 

In pill, thrice daily. ( Otis.) 



726 



TABES MESENTERICA — TASTE. 



R . Hydrargyri Bichloridi, 

Ammonii Chloridi, . aa gr. iij. 

Tinct. Cinchonae Comp., 5iij. 

Aquae, .... §iij. 
M. Sig. — A teasp. thrice daily. 
Each 3 contains gr. T ^ of corrosive 
sublimate. (Bumstead.) 



R 



. Potassii Iodidi, 


• 5»j- 


Ammonii Carb., 


3 SS - 


Tinct. Cinchonae Comp., 


ziv. 


Glycerini, 


% 


Syr. Aurantii Cort., 


5JJSS. 


M. Sig. — A teasp. in p 


lenty of 


iter after each meal. 


(UTeyes.) 



R. Hydrarg. Chlor. Mitis, . :jij. 
Lycopodii, . . . r^ij. 

M. Sig. — Use as snuff thrice daily, 
in lesions of the nostrils. (Diday.) 



R. Hydrarg. Iodidi Rubri, gr. ij. 
Ammonii Carbonatis, . gr. xx. 
Potassii Iodidi, . . ziij. 
Tinct. Gent. Comp., ad£iv. 
M. Sig. — A teasp. in water after 
each meal. 

{Fox, for the Mixed Treatment.} 



r. 



Hydrarg. Iodidi Rubri, 
Potassii Iodidi, . 
Tinct. Aurantii Cort., 
Syrup. Aurantii Cort., aa £j. 



gr. iij. 



Aquae, . 
M. Sig.— A 
after meals. 



3vnj. 
teasp. thrice daily 
( Otis •, for the same.) 



R. Hydrarg. Bichloridi, . gr. iv. 

Tinct. Benzoini, . . 5ss. 

Aquae Cologniensis, . %]. 

Aquae Rosae, . . ?ivss. 
M. Sig. — Apply locally with sponge 
to skin for 20 minutes. For squamous 
syphilides. (S. W. Gross.) 



Tabes Mesenterica. 

Lime, the chloride and phosphate (R.) ; the chloride is a powerful remedy, 
if kept up (Wa.). [See Scrofulosis.] Iodine, by inunction with cod-liver 
oil (El.) ; locally over glands; carefully, lest inflammation be increased (R.). 
Potassium Iodide in small repeated doses, valuable (Wa.). Mercury. Cor- 
rosive Sublimate with bark (gr. j-jjij tinctura cinchonae) after meals, for 
chronic glandular disease (D.). Phosphates, for malnutrition (B.). The 
hypophosphites act slowly but surely (Wa.). Iron and Iodine, in various 
forms are the most useful remedies in scrofulosis, but medicine is powerless 
without strict hygienic measures (A.) ; the Iodide or Phosphate of Iron and 
Cod-liver oil, as for tubercle elsewhere (El.). Fel Bovinum, is worthy of 
trial, though at best a palliative (Wa.). Cod-liver Oil, is the best remedy to 
promote assimilation (B.); of great service (R.). • Chaubnugra Oil, is of 
benefit, used by inunction (Wa.). Aliment. Raw meat, cream, chocolate, and 
cocoa, are valuable nutriments in these cases (El.). Peptonized foods are of 
inestimable value (Wa.). Hygiene. Change of air, especially to sea-air, is. 
all-important (EL). [Compare Scrofulosis.] 



Taste, Disordered. 

Mercury or Podophyllin, as purgative for cankery taste unconnected with 
alcoholism ; or half glass of pure cold water daily half an hour before break- 
fast (R.). 



TEETH THIRST. 727 

Teeth. 

Potassium Iodide, in doses of gr. x, thrice daily, often cures looseness of 
teeth from periostitis of alveolar processes (Wa.). Iodine, tincture painted 
over gums close to the teeth when the gums begin to recede ; also to remove 
tartar (R.). Cinchona, powdered bark often used in tooth-powders (R.). Col- 
lodion, on cotton, as stopping for carious teeth (P.). Liquor Soda Chlorates, 
gvj ad ^xij aquae, a highly useful application in fetid discharges from carious 
teeth (Wa.). [Compare Dentition, Odontalgia.] 

Testicles. 

Mercury, the ointment, locally in indurations and enlargements of testes 
(Wa.). Corrosive Sublimate, with cinchona or sarsaparilla in sarcocele (D.). 
Water, cold applications in neuralgia of testes, with tonics and neuralgic treat- 
ment generally ( D.). Suspensory Bandage, with rest, in many affections of the 
testes (D.). [Compare Hydrocele, Orchitis, Varicocele.] 

Tetanus. 

Strychnine, of decided service (P.); cured 8 cases of traumatic form, in 
doses of gr. i to ^ (S.); is conclusively curative, especially in chronic and 
spontaneous, rather than in traumatic. Strychninae Sulphat., gr. -^ to -J^ (B.). 
Aconite, has benefited many cases (P.) ; its success warrants further trial (W.). 
Belladonna, successfully used in many cases ; the extract, internally, and 
locally to wound (Wa.) ; gr. T ^ atropine injected into muscle (B.) ; bleeding, 
vapor-baths, and large doses of belladonna have cured tetanus (Tr.). Nico- 
tine, by rectum or hypodermically, appears to be useful in many cases (R.) ; 
much evidence for it as the best remedy (P.); effective but dangerous (B.). 
Physostigma better (Wa.). Potassium Bromide, not less than gss during the 
day, with chloral at night as a hypnotic; out of 21 cases but 3 died. Its 
physiological action indicates it to be the best remedy known (W.). Chloral, in 
large doses (gr. xx) no remedy more effectual (B.) ; has sometimes cured (R.) ; 
best used in combination with potassium bromide (W.). Gelsemium, cured 
several cases (P.). Hyoscyamine, gr. ^V gradually up to gr. y 1 ^, ameliorates 
(B.). Physostigma, has been used with excellent results (P.); the fluid 
extract by mouth if possible, at very beginning, and must be pushed until just 
short of arresting breathing (B.) ; evidence is discrepant (W.). Apomorphine , 
may prove antagonistic (P.). Curare, hypodermically, has much evidence for 
its power (P.). Cannabis Indica, used with marked success in traumatic form 
(P.). Difficult to obtain an active extract (W. ). Anesthetics. Ether, to relieve 
pain (B.). Chloroform, in small and frequently repeated doses, also by fric- 
tion, has been useful in many instances (Wa.). Amy I A T itrite, used in 3 cases 
with marked benefit as spinal sedative (W.) ; has been used with success (R.). 
Morphine, hypodermically, deeply into tetanized muscles (B.) ; of no value 
(Wa.). Conium, is indicated, but has not been successful (B.). Water. 
Warm baths, and cold, or ice, afford only temporary amelioration (B.). Spinal 
Ice Bag, extremely useful (R.). Division or stretching of any nerve-trunk 
connecting wound with spinal cord. [Compare Spasms.] 

Thirst. 

Acid Drinks, promote secretion of saliva in fevers (R.). Tepid Drinks, are 
useful in the thirst of diabetes (R.). Ice, sucked, allays thirst (R.)- 



728 THROAT, SORE — TINEA CIRC1NATA. 

Throat, Sore. 

Aconite, when temperature high, half-drop doses of tincture, every j£ hour 
for 2 hours, then every hour, will almost certainly prove efficacious (R.) ; val- 
uable in ordinary sore throat (P.). Belladonna, is very admirably adapted to 
the treatment of ordinary sore throat. When much fever, combine with Aco- 
nite (R.,P.). [See Catarrh, Acute.] Mercury, in acute tonsillitis, which 
see (R.). Nitre, dissolved in mouth, to abort a sore throat (Wa.). Tannic 
Acid, as powder, gargle, spray ( P.). Glycerin of Tannin, after acute inflamma- 
tion; in ulceration of aphthous sore throat daily when tendency to catarrh (R.). 
Ipecacuanha, the wine as spray, in non-inflammatory sore throats and hoarse- 
ness from congestion of vocal chords (R.). Capsicum, 3J of tincture to O l / 2 
aquae as gargle, in some sore and malignant sore throats (R. P.). Potassium 
Chlorate, in grain doses every half-hour (A. A. Smith). Alum, dry, or in 
solution (R.). Myrrh, as gargle in ulcerated sore throat (P.). Cimicifuga, 
in simple (R., P.), and malignant forms when mucous membrane dry and 
spotted with inspissated mucus (R.). Arsenic, in medicinal doses, in slough- 
ing of throat or malignant sores (R.). Iodine, tincture, locally to sores, whether 
syphilitic or not (R.). Rhus Glabra, a very efficient gargle, a decoction, gj- 
ad Oj, boiled to O^, with Potassium Chlorate, t ^ss (W.). Nitric Acid, undi- 
luted to sloughs (R.). Silver Nitrate, locally, in early stage of inflammation 
may cut it short (R.). Sulphurous Acid, by inhalation, spray, or fumigations 
for malignant sore throat, scarlatinal or otherwise (R.). Water, cold compress 
nightly, to harden the throat when tendency to catarrh (R.). Ice, constantly 
sucked (R.). [Compare Tonsillitis, Pharyngitis, and formulae for 
Gargles, on page 493.] 

Tic Douloureux. 

Arsenic, cures, influences nutrition (B.). Phosphorus, useful; gr. T ^ to 
T ^j every 3 hours (R.). Belladonna, Aconite, Spigelia, Iodides, Morphine, 
Cimicifuga, Gelse?nium, Turpentine* Galvanism (B.). [See under NEURAL- 
GIA.] Croton-chloral, palliative in doses of gr. v every y 2 hour till gr. xxx 
taken (W.). Stramonium, gr. % to y 2 every 3 or 4 hours for 4 or 5 doses, 
often affords decided relief; stop if narcotic symptoms appear (P.). Lauro- 
cerasus, sometimes removes (P.). [Compare Hemicrania, Neuralgia.] 

Tinea Circinata— (Ringworm of the Body). 

Mercury, the bichloride, I part to 250 of water, as parasiticide solution, 
after depilation (A.). [See also T. Tonsurans.] Carbolic Acid, a very effi- 
cient application ; £j ad gj glycerini, locally (B.) ; or equal parts of Carbolic 
Acid and Glycerin, is a very efficient application. Sulphurous Acid, better 
and safer ( A.) ; must be fresh to be of use (Bulkley). Cocculus Indicus, the 
decoction locally, after washing the skin well (P.). Oil of Cade, the best 
depilatory known (A.). Arsenic will not cure, but may do service as a nerve 
tonic or an improver of nutrition, in connection with other remedies (Bulkley). 
Cuprum Acetate, gr. x ad J£j adipis, as ointment, is very effective (B.). Sodium 
Hyposulphite, §j ad gxij aquae, locally, used by Dr. Tilbury Fox. Mercury. 
Calomel ointment (3J ad gj) useful (B.). Hydrarg. nitrate as strong citrine 
ointment, rubbed in twice daily, often effectual. Hydrarg. oxid. rubrum, as 
ointment, often cures ringworm on body or limbs, when other remedies fail 
(Wa.). Cocculus, ointment from kernels, or decoction (P.). Iodine, liniment 



TINEA DECALVANS — TONGUE. 729 

once applied (R.) ; with oil of tar (1 to 4 of latter) locally, is excellent (Wa.). 
Kamala, used locally by the Hindoos (P.). Tar Ointment, is used with good 
effect (P.). Acetic Acid, applied to cut it short (R.). Cod-liver Oil, a powerful 
auxiliary in weakly and cachectic subjects (Wa. ). Diet and Hygiene are 
important. Food should be nutritive and abundant, especially animal fats. 
Daily baths, out-of-door exercise. Fungus, is the Tricophyton tonsurans (A.). 

Tinea Decalvans — (Alopecia Areata). 

Parasiticide Lotions, must be used after epilation, and washing of head 
daily with soft or black soap. Stimulants (as Collodium with Ether Cantha- 
ridalis, equal parts), after fungus is destroyed (A.). Tonics are necessary, 
especially to the nervous system iBulkley). Fungus — Microsporon Audouini 
(A.) ; but I have never seen it, though having made repeated and thorough 
searches (Bulkley). 

Tinea Favosa — (Favus). 

Mercury. Hydrarg. chlor. corr. gr. xx ; cerat. simplicis ^j ; efficient when 
used early (B. ); or gr. ij ad gj aquae after each epilation (R.). Sulphurous 
Acid, Sulphites, and Hyposulphites, as parasiticides. R . Sodii hyposulphitis 
giij ; ac. sulphurosi dil. ^ss ; aquae q. s. ad gxvj 1 Startin). Carbolic Acid, Cod- 
liver oil, locally (B.). Oils, to facilitate removal of scabs ; head to be greased 
freely to prevent spreading. A mild mercurial pomade, or quinine in glycerin 
best (R.)- Cleanliness, and free use of soap and water, is a sine qua non, 
and in some cases of tinea may be alone sufficient to produce curative results. 
Isolation of person, and brushes, towels, etc., necessary to prevent infection. 
Fungus — Achorion Schonleinii (A.) ; a very rare affection in this country 
(Bulkley). 

Tinea Tonsurans — (Ringworm of the Scalp). 

Mercury. Hydrarg. chlor. corr. gr. xx ad gj unguent, simplicis, an effective 
application when used early (B.) ; must be employed with great caution. 
Sulphurous Acid, with glycerin (R.). Carbolic Acid, £j ad ^j glycerini (B.). 
Viola Tricolor, the leaves are employed in Italy for tinea capitis (P.). Coc- 
culus Indicus (P.). [See T. ClRClNATA.] Potassium Sulpho-cyanide, ^ss 
with jg glycerini, gviij aquae, as lotion (R.). Iodine, 31J ad gj of oil of wood 
tar I R.). Arsenic Iodide, the best constitutional remedy ; gr. -^ increased to 
gr. %■ for a n adult: gr. -^V to fa for children, with alkaline lotions locally 
(Wa.). Lead, in chronia porrigo capitis; the ointment of the iodide (B.) ; 
will complete a cure after alkaline lotions (Wa.). Fungus — Trichophyton 
tonsurans (A.). [Compare Tinea Circinata.] 

Tongue. 

Potassium Chlorate, gr. v internally and ^j-ij ad O] aquae locally ; in ulcers 
of tongue (Wa.) ; also in rawness of tongue in advanced phthisis. Potassium 
Iodide, in syphilitic ulcers of tongue (D.) ; and in hypertrophy ('A.). Potas- 
sium Bromide, ^j to §yj w T ater as wash, may soothe morbid sensibility of the 
tongue (A.). Borax, gr. xl ; glycerini §j ; aquae ^iv. As application in 
cracked tongue (Wa.). Iodine, the tincture locally by a fine brush, or as a 
gargle with 7 or 10 parts of water and some honey, has given uniform suc- 
cess in malignant ulcers (Wa.). Conium, thought to act specifically with 

61 



730 TONSILLITIS — TONSILS. 

benefit in ulcer of the tongue (Wa.). Cinnamon, the oil as a powerful stimu- 
lant in paralysis of tongue (P.). Ginger, Cochlearia, Pyrethrum, as gargle: 
Cloves, Mezereon, Pepper, as masticatories, in paralysis (P.). Framurn, should 
be divided in tongue-tie ; use blunt-pointed scissors, directing the points down, 
close to the jaw, so as to avoid wounding the ranine artery (D.) ; better to 
cut as little as possible, and that directly backwards, as the artery of the frge- 
num may proceed from the sublingual (Holmes). [Compare Glossitis, Ran- 
ula] 

Tonsillitis. 

Aconite, when accompanied by fever and elevated arterial tension, relieves 
greatly ; gtt. ss-j every ]/ 2 hour or hour (B.) ; every % hour for 2 hours, 
then every hour, will almost certainly prove efficacious (R.). Belladonna, of 
surprising efficacy ; gtt. v of every I or 3 hours in t ^ss aquae (P.). Mercury, 
often speedily removes. Calomel gr. ^, or hydr. cum creta, gr. \ every 2 
hours ; not in chronic forms (B.) ; gr. \ of gray powder every hour when ton- 
sils almost meet, has marked effect. The oleate of mercury and morphine in 
obstinate and painful tonsillitis (R.). Silver Nitrate, locally may abort, if ap- 
plied early (R.) ; the solid stick, once thoroughly applied in first stage, rarely 
fails to prevent suppuration (Howard). Guaiac, disagreeable, but very ef- 
fective (P.) ; ^ss doses of tincture every 4 hours has remarkable power; 
should be given in emulsion with mucilage or yolk of an egg (B.) ; makes an 
excellent gargle, see page 493 for formula. Tinctura Guaiaci and Glycerin, 
equal parts, in teaspoon ful doses every hour or two, gives excellent results in 
acute tonsillitis. Alum, dry or in solution (R.). Potassium Iodide, locally 
(gr. j— v— §j), is useful (B.). Potassium Chlorate, in grain doses every half 
hour, very efficient (A. A. Smith). Capsicum, the dilute tincture in a gargle, 
or in powder applied on a swab, is useful in severe tonsillitis, especially in 
that accompanying scarlatina (W.). Quinine, gr. x-xv will sometimes abort 
(B.). Tannic Acid, is useful (P.) ; as gargle, see page 493. Ice and wet 
pack, extremely grateful (B.). Cold Wet Compress, nightly, useful (R.). 

Tonsils, Enlarged. 

Ammonium Iodide, >^ss in ^j glycerin, applied every night by a camel's hair 
brush, very efficacious (Wa.). Baryta Iodide, in hypertrophy of the tonsils, 
effects a rapid diminution in their size, even when indurated for years (Hale). 
Liquor Ferri Perchloridi, gj-ij ad Jjj, painted over tonsils twice daily, is one 
of the most effective astringents (Mackenzie). Aluminium Sulphate, a sat- 
urated solution applied daily by a brush, as a mild caustic (W.). Ergot or 
Ergotine, injections into tonsils (Meigs). Zinc Chloride as caustic, the most 
efficient and least annoying method ; a saturated solution applied on a wire 
cotton-holder to each crypt and held there a few seconds ; a few applications 
will shrink the gland in a week. Tannin, a strong solution touched daily to 
tonsils (H.) ; a few sips of a saturated solution (^ss in ^iij aquae) slowly 
sipped, will stop bleeding, if profuse (A.). Silver Nitrate, touched daily to 
tonsils, will sometimes make them shrink (H.). Catechu, a serviceable astrin- 
gent gargle ; the infusion ^vj with tincture of kino gij, as gargle. (Wa.). 
Oxgall, locally, is praised (Wa.) ; is of real utility (W.). Citric A cid, rubbed 
daily to tonsils, is highly praised in enlargement thereof. • Excision of a part 
of tonsil (H.). Mackenzie's double guillotine removes both tonsils at once. 
Hemorrhage seldom happens ; ice will generally check it (A.). Surgical mea- 



TONSILS TYPHLITIS. 73 I 

sures should receive unprejudiced consideration, as the medicinal treatment 
is tedious in the extreme. 

Tonsils, Ulcerated. 

Coptis, the infusion as a gargle (B.). Sulphurous Acid, dilute, locally by- 
spray, or a solution of sulphite of sodium in water (3J-JJ) (B.). Potassium 
Iodide, will arrest syphilitic ulcerations at once (B.). Carbolic Acid, a 5 per 
cent, wash with tincture of myrrh, a good application by sponge to throat 
(Wa.). Cimicifuga, a decoction of the root as a gargle (Wa.), 

Torticollis. 

Cimicifuga, has curative efficacy (P.). Capsicum, a handful of the crushed 
pods infused for 36 hours in a pint of hot or cold water, and applied on lint 
covered with gutta-percha (R.) ; gives striking results (Wa.). Opium, as lini- 
ment, with friction, or an opium plaster, is often serviceable (Wa.). Galvani- 
zation of affected muscles, and faradization of opposed ones quickly relieves 
(B.). 

Trismus. 

Aconite (A.), Atropine (R.), hypodermically. Cannabis Indica, has been 
used successfully in trismus neonatorum (B.). Opium, v\y% doses of lauda- 
num, with castor oil and warm bath, in trismus infantum. Treatment of any 
kind seldom effectual (D.), never (EL). Ether, Chloral, Gelsemium, Physos- 
tigma (B.). [See Tetanus.] 

Tumors, 

Mercuric Bromide, in ]/ z gr. doses, has benefited abdominal tumors (Wa.). 
Chloroform, in diagnosis of abdominal tumors when deep-seated, and when 
walls of the belly are hard and rigid ; also in phantom tumors (R.). Hyoscy- 
amus, the leaves as cataplasm or fomentations to painful tumors, afford great 
relief (Wa.). Electrolysis, employed with more or less benefit in sebaceous, 
lipoma, bronchocele, enlarged glands, etc. (Wa.). Iron, the liquor ferri per- 
ch] oridi is found to be valuable as a curative application to fungous or hem- 
orrhoidal tumors (Wa.). Galbanum, as plaster to indolent, non-malignant 
tumors, to diminish, or cause their absorption (Wa.). [Compare Cancer, 
Cysts, Glandular Enlargement, Goitre, Polypus, Uterine Tumors, 
Wen.] 

Tympanitis. 

Turpentine, often greatly benefits (P., Wa.) ; g) every 6 hours in tympanitis 
of typhoid, with prostration but without diarrhoea (R.). Asafcetida, in hys- 
terical, internally or as enema, beneficial (P.) ; also in that of fever (Wa.). 
Capsicum, gr. ss-ij, every 4 hours (P.). Cocculus Indicus, a few doses of 
tincture will often succeed in the tympanitis of peritonitis and enteric fever 
(P.). Ginger, with drastic purgatives (P.). Aspiration, in extreme cases 
and as a last resort. [Compare Typhoid Fever, Peritonitis.] 

Typhlitis. 

Opium, of undoubted curative power (B.). Purgatives, are inadmissible; 
Epsom salts may be used, but no drastics (B.). Leeches, should never be 



732 TYPHOID FEVER. 

omitted when tenderness and fever begin (B.). Ice-bag, over the swell- 
ing (B.). 

Typhoid Fever. 

Baptisia, is very useful in the early stage (W.). Mineral Acids, are very 
useful generally, especially HC1 Acid (Wa.). Nitro-hydrochloric Acid, is to 
be preferred over all other plans of treatment, 20-drop doses in simple elixir; 
Sulphuric is useful for intestinal hemorrhage (Da Costa). Sulphurous Acid, 
is highly praised by Dewar, and has real antidotal power ; Trtijss-rrtxx every 
4 hours according to age, continued for a week or ten days, until the patient's 
complaints show him to be saturated. If diarrhoea be present, add Sulphuric 
Acid and Opium (Wilks). [See formulae below.] Opiu?n, small doses at 
night, for insomnia with delirium ; also as injection for the diarrhoea * R.) ; in 
one case, when vital powers seemed hopelessly depressed, gr. ^ opii caused 
improvement (Wa.) ; for spreading tenderness (peritonitis), give io-minim 
doses of the deodorized tincture, also gr. j in suppository every four hours 
(Da C). Veratrum Viride, to reduce temperature (R.) ; delirium ferox (B.) ; 
strongly recommended (Wa.) ; its efficacy difficult to believe (S.). Potassium 
Bro??iide, is as much a specific for typhoid fever as quinine sulphate is for 
ague, aborting the fever in 8 or 10 days (Hawkins). Carbolic Acid, 3], with 
Tincture of Iodine £ij, of which iiy- iij every 2 or 3 hours is a very good plan 
of treatment (Da C). Turpentine, invaluable, when hemorrhage and ex- 
treme tympanitis (P., R.); rn,xxx-lx in starch mucilage, rrtx of liquor opii 
( P. ) ; utv-x frequently for hemorrhage or Tn, x every 2 hours in advanced stage, 
with dry tongue (R.) ; coma, stupor, etc.: often arouses the vital powers 
(Wa.) ; Tiivij with gr. ^ of morphine ; of especial value when marked fever 
and congested lungs, as well as for the tympany (Da C). Chloral, is the best 
drug for nervous symptoms, but must not be used when the heart is weak 
(Da C). Arnica, highly extolled ; its " picture M shows definite powers in 
this disease (P.) : small doses in asthenic conditions (B.) ; when vital powers 
greatly depressed (Wa.). Belladonna, contracted pupils; low, muttering de- 
lirium (B.); thought to counteract the poison of typhoid (Wa.). Mercury, 
corrosive sublimate gr. T J^ every 2 or 3 hours, for the diarrhoea. Calomel in 
small doses at onset (R.) ; gr. x in one dose the first day, gr. iij per diem for 3 
or 4 days, the German " specific treatment'' (B.). Bismuth, gr. x-xx of the 
subnitrate with gr. %-) of Opium every 3 hours for the severe diarrhoea 
(Da C). Ergotin, gr. ij-vj hypodermically, or ^j of the fluid extract of Er- 
got, for intestinal hemorrhage (Da C). Tartar Emetic, with opium, when 
wakefulness and delirium. Minute doses (gr. ^), frequently, are of great 
service (B.). Digitalis, of value in many cases as a sustainer of heart power, 
but may be dangerous in the later stages (Anstie, Murrell). Quinine, may 
have efficacy in typho-malarial ; is less effective as the typhoid element pre- 
dominates ; useless in purely continued fevers (B.) ; is justly abandoned, but 
may be used to maintain the circulation, in tonic doses, gr. vj-x in the 24 
hours (DaC). Antipyrine, for hyperpyrexia, also Thymol, gr.ss-ij in solution 
(Da Costa). Digitalis, used by the Germans when there is no cardiac weak- 
ness. Gr. xj-xxij, as antipyretic, over a period of 36 hours (P.). Se?penta- 
ria, useful when much depression exists. Cautiously, if intestines at all irri- 
table (B.). Hydrastine, when copious sweats (P.). Lead Acetate, with opium 
for the purging (R.). Also Almn (R.). Ergot, for intestinal hemorrhage, 
hypodermically, if symptoms urgent (R.). Sodium Chloride, should not be 
withdrawn from the food (Wa.). Aromatic Spirit of Ammonia, for great 



TYPHOID FEVER. 



733 



accumulation of mucus in the throat (DaC). Copper Sulphate, gr. ^, with 
Opium, gr. \, for the diarrhoea (Da C.). Strychnine, is the remedy for the 
functional palsies (Da C). Purgatives, only the very mildest, and they with 
the greatest caution (Wa.). Water, a most important agent. Cold baths 
when temperature above 102 (B.) ; in mild cases, cold wet compresses or 
wet sheets, or washing with cold water; in severe cases, affusion, shower, or 
general cold bath, 50 to 55 Fah. , or better 95 cooled gradually to 6o° (R.). 
Medicine will never abort a case of true typhoid ; its natural duration is from 
28 to 30 days (Sir William Jennerj. Stimulants, freely, with quinine, for 
pyaemic cases, snowing joint complications. See under Synovitis. Aliment. 
Milk alone, or alcohol with milk, eggs, broth (B.). Coffee, a better stimulant 
than alcohol (P.). Alcohol is needed to sustain the heart's action (Da C). 
Milk must be used with great caution, if the curd be undigested great evils 
arise; give essence of meat alone (Sir William Jenner). Avoid the extremes; 
an absolute milk diet required if intestinal symptoms are grave ; no solid food 
until health is restored fully ; a scalded-milk diet exclusively may be depended 
on. Adjuvants, water, especially the abdominal compress, cleanliness, venti- 
lation, absolute rest and quiet. Discharges should be received in vessels con- 
taining carbolic acid or a solution of corrosive sublimate, and buried instantly. 
[Compare Hemorrhage, Intestinal, Rectal Ulceration, Tympanitis.] 



Prescriptions. 



K. 



Tinct. Iodi, 
Ac. Carbolici, . aa p. aeq. 

M. Sig. — gtt. j-ij every 4 or 6 
hours. In typho-malarial fever. 

{Bartholow.) 



R 



x. 



Quininae Sulphatis, . gr. 

Ac. Hydrochlor. Dil., . ^ss. 
Vel Ac. Sulphur. Dil., . Sss. 
Syr. Aurantii, . • 3J- 

Aquae Carui, . ad£v'). 

M. Sig. — A tablesp. in an equal 
quantity of water, every 3 or 4 hours. 
{Murchison.) 



R. Ac. Sulphurosi, 

Ac. Sulphur. Dil., 

Tinct. Opii Deodor., 

Syr. Aurantii, 

Aquae, . 

M. Sig. — For infants, one-sixth to 
be taken every 4 hours. ( Wilks.) 




R . Ant. et Potassii Tartrat., gr. j-ij. 

Morphinae Sulphat., . gr. jss. 

Aquae Laurocerasi, . Jj. 
M. Sig. — A teasp. every 2, 3, or 4 
hours. [Bartholow.) 



R . Ac. Sulphurosi, . 

Ac. Sulphur. Dil., 

Tinct. Opii Deodor. 

Syr. Aurantii, 

Aquae, 
M. Sig. — One-sixth 
every 4 hours. 




R. Ac. Sulphurosi, . . ^ij. 
Syr. Aurantii, . . ^iij. 
Aquae, . . ad gvj. 

M. Sig. — One-sixth every 4 hours. 

( Wilks.) 

R . Ac. Sulphurosi, . . m xv. 
Syr. Aurantii, . . jiij. 
Aquae, . . ad 3)- 

M. Sig. — For infants, one-sixth 
every 4 hours. ( Wilks.) 



734 TYPHUS FEVER — ULCERS AND SORES. 

Typhus Fever. 

Baptist a, is said to have proved very useful W.). Bella.: to cleanse 

and moisten the tongue ; controls the delirium, slows and strengthens the 
pulse, reduces the temperature, shortens course of disease R., P.). In the 
early stages, relieves severity of symptoms P. ; contracted pupils <B., Wi.). 
Arnica, very highly extolled (P., Wsl). H >ius, mild brain symptoms 

(P.). Opium, fulfils many important indications; never when contracted 
pupil (Wa.). Mineral Acids. Hydrochloric, nitric, sulphuric ; their use 
recommended in all countries Wa.). Tartar Emetic^ with opium in the 
delirium with insomnia R... [See Typhoid.] Chloral, to produce sleep, 
and allay violent delirium (R., Wa. ; its use has often been followed by ame- 
lioration of the symptoms Wa.). Antipyrine or Quinine, as antipyretics, it 
being more necessary- than in typhoid to keep the temperature within safe 
limits B. . Podophyllin, gr. Y^-% as mild laxative at onset, when consti- 
pation, congestive headache, biliary derangement P. ). Digitalis, in large 
doses, a favorite remedy in Germany ; P. i. Rkatany, as tonic, in advanced 
stages 1 . P.I. Serpentaria, in low stages, delirium, watchfulness ; tongue dry 
and brown, or black. Combine with ammonium sesqui-carbonate (P.) ; given 
occasionally to excite diaphoresis, and support the vital powers | Wa. . Cam- 
phor, a remedy of considerable value ; contra-indicated when flesh-red tongue, 
tender abdomen, diarrhoea (Wa. . F:r "See Typhoid Fever.] C 

better than alcohol for the adynamia (P.). Stimulants, are not needed under 
the use of mineral acids and a supporting diet, in many cases Wa. ; are 
needed sooner than in typhoid, as the adynamia is more profound and appears 
sooner B. . Diet, nutritious persistently. Beef-tea, egg-nog; nutrient enemata. 
Isolation, imperative, as the disease is eminently contagious [B.). [Compare 
Delirium, Typhoid Fever.] 



Ulcers and Sores, 

Arsenic, improves roaent ulcer iB. ». Belladonna, has a remarkable influ- 
ence over various ulcerative processes (P.). Mercury, Calomel ointment or 
black wash in scrofulous or tuberculous lupus, and in open scrofulous sores 
R. ; corrosive sublimate. I per cent, solution, as application to syphilitic 
ulcer- Fox ; the Ung. Hydrarg. Nitratis, for serpiginous ulcerations, diluted 
one-half, or the Iodide, gr. xx-xl ad 51 Vaselini, in syphilitic ulcerations 
(Keyes . Lime, as carbonate or lime-water to check discharge ; the sulphide 
when thin ichorous discharge ; the phosphate has influence on scrofulous 
sores R. . Phytolacca, as a local application (B.). Hamamelis, employed 
with satisfaction in varicose ulcers Pfj. Opium or Morphine, with glycerin, 
as an application to relieve pain iR. ; gr. j-ij, daily, also locally, has a de- 
cidedly curative value in phagedenic and indolent ulcers ; not so useful in 
so-called u irritable " ulcers (Pf., P."). Tannin, or glycerite of Tannin, to coat 
over wounds, or discharging sores (R.). Potassium Chlorate, in solution as 
a wash to clean and stimulate foul ulcers (R. t ; in impalpable powder, a better 
application than is Iodoform B.). Cinchona^ powdered bark dusted over 
foul, indolent, sloughing, and gangrenous ulcers, promotes healing (R.). Co- 
nium, locally, by means of a poultice, will ease pain and improve the sore 
. R. . Chlorine Solution, as awash for sloughing and indolent sores R. . 
Iodide of Starch, cold as a poultice (R.). Lead, the soluble salts as lotions to 



ULCERS AND SORES. 



35 



unhealthy, over secreting sores (R.). Pyrogallic Acid, an excellent applica- 
tion in venereal ulcers (Vidal). Chloral, in lotion, gr. v-xx ad ^j aquae, for 
sluggish sores (Keyes). Nitric Acid, as escharotic, applied with a glass rod; 
oil to protect surrounding tissues ; arrest by alkaline wash, ^j -Oj is a good 
acid lotion for washing (B.); the lotion to indolent and painful ulcers (R.). 
Hydrastis, internally and externally, employed with excellent results in rodent 
ulcer, and ulcers of legs, rectum, and uterus (P.). Sanguinaria, locally, to 
repress fungous granulations of indolent ulcers, I to 80 parts glycerini (P.). 
Carbolic. Acid, and Salicylic, locally (B.). The glycerin of carbolic acid a 
good application to fetid sores (R.). Balsams of Peru and Tolu, excellent (P.). 
Camphor, dusted over indolent sores (R.). Charcoal, locally to sloughing 
sores (R.). Alcohol, to cover sores with thin protecting layer of coagulated 
albumen (R.). Alum, dry or in solution to relaxed and abundantly-secreting 
sores (R.). Turpentine, internally for ulceration of bowels (P.). Collodion, 
as protective covering (P.). Capsictim, a weak solution useful as a stimulant 
in scrofulous or fistulous sores (P.). Savine, as acrid (not chemical) caustic 
(P. ). Potassa Fusa, or the milder Vienna paste, as escharotic ; to arrest, dilute 
acid(B.). Zinc Chloride, the most efficient escharotic consistent with safety 
(B.). Zinc Sulphate, dried, dusted over (R.). Iodoform, dusted over surface 
(B.); prevents granulation in all ulcers, and does no good except to relieve 
pain (Gross). See Potassium Chlorate above. Silver Nitrate, as caustic, 
quickly rubbed over(B.). Applied to unhealthy ulcers, also ulcers of the 
mouth (R.). Copper Sulphate, to indolent ulcers. Touch with a crystal, or 
frequently apply a solution, gr. ij-x ad 3;j (B., R.). Coptis, the infusion has 
high reputation (B.). Chimaphila, Copaiba, Catechu, Myrrh, R hat any, Rhu- 
barb, Storax, Benzoin, 7 ar water, locally, are useful (P.). Oxygen, to atonic 
painful ulcers (R.). Galvanic Couplet (B.). [See Bedsores.] Yeast, as 
poultices (R.). Section of exposed nerve-filament, in irritable ulcer, by bis- 
toury passed beneath the sore (Hilton on Rest and Pain). Cod-liver Oil, es- 
pecially for ulcerations of the glands, or indolent ulcers with excoriated edges, 
lupus, etc. Water, is sufficient as dressing in the majority of cases. Rest and 
support of great value. Cleanliness, bandaging and recumbent position in 
ulcer of legs facilitate recovery ; also daily washing to restore the lost vitality 
of parts ; elastic stockings, and the Esmarch bandage in chronic cases. [Com- 
pare Chancre, Chancroid, Bedsores, Throat, Gastric, Intestinal, and 
Uterine Ulceration, Syphilis.] 



B. 



Prescriptions. 



M 



Iodoformi, . . . gij. 
Mucil. Acaciae, . . rn_xv. 
01. Menthae Pip., . . mij. 
Glycerini, . . . lUxx. 
. Sig. — For unhealthy ulcers. 

(Bronson.) 



R. Emplas. Plumbi, 
Ung. Hydrargyri, 
Oiei Cadini, 
M. Sig. — Spread on linen 
apply to inflamed patches on palms 
from syphilis. 

(Bumstead and Taylor?) 



3 T J- 

gss. 

and 



R . Hydrarg. Chlor. Corr., . gr. xv. 
Ac. Carbolici, . . Tlixxx. 

Aquae,. . q.s. ad^iv. 

M. Sig. — For syphilitic ulcers, 
pack on cotton, and renew daily. 

{Fox.) 



R. Ung. Petrol ej, . . . gij. 
Ung. Hydrargyri, . . ^iv. 
Olei Cadini, . . . gij. 
M. Sig. — Apply after removing 
scales to chronic palmar and plantar 
lesions. 

(Bumstead and Taylor.) 



73^ UREMIA URINARY DISORDERS. 

Uraemia. 

Digitalis, the infusion, or a poultice of leaves to abdomen and back (B.). 
Jaborandi, diaphoretic; eliminates urea (B.); or Pilocarpine hypodermi- 
cally. Opium. Scanzoni and Loomis urge morphine, hypodermically, as the 
most efficacious agent (B.); in acute, not in chronic uraemia (Pf.); Cplchi- 
cu?n, as diuretic (B.). [See Dropsy.] Saline Cathartics, active are required 
(B.). Hydragogue Cathartics. 01. tiglii (gtt. i-ij), or elaterium (gr. T l ? to J), 
to procure free watery evacuations. Cautiously (B.). Transfusion, in uraemic 
eclampsia (B.). Water, the vapor-bath or hot wet-pack to induce powerful 
diaphoresis (B.). [Compare Bright's Disease, Puerperal Convulsions, 
Scarlatina, and the list of Diuretics and Diaphoretics, on pages 423 and 
426.] 

Urethritis. 

Aconite, is used to advantage in urethral fever ; also for prevention of chill 
after passage of sound (Pf., W.). Silver Nitrate, locally, very efficient in 
chronic urethritis in females (Wa.). Ta?inin, on bougies, once a week for 15 
minutes, most efficient for urethritis in the female (Wa.). Zinc Stdphate, cast 
in sticks, for introduction into the urethra (Wa.). Potassium Bicarbonate, 
with Potassium Acetate, aa gr. x in a large cap of flaxseed tea or a glass of Vichy 
water, every 4 to 6 hours ; with absolute rest in bed, a calomel purge, and urina- 
tion under hot water, sufficient for most cases of urethritis, which may arise 
from lithiasis, leucorrhcea in females, etc. Many cases of aborted gonorrhoea 
(so-called) were really simple urethritis (Otis). [Compare Gonorrhoea.] 

Urethral Stricture. 

Aconite, is of great service in spasmodic stricture (P.). Buchu, in irritable 
urethra, spasmodic stricture, and gleet (P ; ). Opium, in full dose or an opiate 
suppository, with fomentations and a warm bath, will often suffice in spasmodic 
stricture (CI.). Cathetej'ization, under an anaesthetic in spasmodic stricture if 
other measures fail to relieve. Also for gradual dilatation in organic stricture, 
the safest and most generally applicable treatment (CI.). Oil, injected before 
dilatation (Wa.). Thorough Division, by a dilating urethrotome the best ope- 
ration for a radical cure ; 600 cases thus treated without a death or permanent 
disability (Otis). 

Urinary Disorders. 

Aconite, of great service in retention from chill, sub-inflammatory (P.). Tur- 
pentine, in hematuria and chronic catarrh of the bladder, incontinence from 
atony, etc. (B.). Strychnine, sometimes employed with marked benefit in 
retention or incontinence of the old (P.). Cant harts, frequent or involuntary 
micturition, especially when coughing, in women from weakness of sphincter ; 
one or two drop doses (R.). Cannabis Indica, in retention from spinal dis- 
eases (R.). Digitalis^ holds high as a diuretic, £j or ij of the infusion night and 
morning, or oftener if necessary ; in sudden suppression from cold or damp or 
after scarlatina, if danger threatens (P.). Benzoic Acid, or the Benzoate of 
Sodium, in 10- 15 -grain doses, to render alkaline urine acid, and check the 
formation of phosphates (B.). Nitro-hydi-ochloric Acid, dilute, gtt. x-xv thrice 
daily in water, for phosphatic deposits (Mears). Ammonium Carbonate, in 
6-grain doses, 3 or 4 times a day, to make acid urine alkaline. Triticum Re- 



URINARY DISORDERS — URTICARIA. 



737 



pens, a favorite remedy with Sir Henry Thompson, in pint doses daily of its 
infusion or decoction (Jij-iv ad Oj), for strangury, cystitis, and many other 
complaints, connected with the urinary apparatus. Alkalies, to neutralize acid 
urine, and control chronic cystitis; the liquor potassae preferable to the bicar- 
bonates, tartrates, and citrates, which all have diuretic action and increase the 
frequency of micturition; Liquor Potassae mixed with the tinctures of Hyoscy- 
amus or Belladonna, may undergo chemical changes, but it materially controls 
painful and frequent micturition in bladder troubles (Thompson). Buchu, 
renders more help than any drug known in incontinence or retention from 
catarrh of bladder implicating the ureters, and even the kidneys (P.). Water, 
copious injections are beneficial in some'cases of suppression (R.). [Compare 
the List of Diuretics on page 423; — and in this section see Bladder Irrita- 
ble, and Paralysis of ; Cystitis, Diabetes Insipidus, Dysuria, Dropsy, 
Enuresis, Hematuria. Lithiasis, Nephritis, Oxaluria, Uremia, 
Urethral Stricture.] 

Prescriptions, 



R . Pulv. Scillae, 

Pulv. Digitalis, 

Hydrarg. Chlor. Mitis, aa gr. xij. 

M. ft. pil. no. xij. Sig. — One pill 

as a diuretic twice daily. (A. Clark.) 



R . Acidi Benzoici, . . gij. 

Sodii Boratis, . . ziij. 

Aquae, .... ^xij. 
M. Sig. — A teasp. in water, thrice 
daily, to keep urine acid. (Emmett.) 



R. Ext. Belladon. Fl., . 
Ext. Buchu Fl., 
Spt. ^Etheris Nitrosi, 
M. Sig. — A teasp. 3 or 4 

daily, for dysuria in women. 




R . Potassii Bicarb., . . spijss. 
Acidi Acetici, . . . Zvj. 
Aquae, .... ^iij. 
M. Sig. — Teasp. doses as required, 
as a diuretic. Each contains about 
gr. x of Potassium Acetate. 



R. Potassii Citratis, 
Sodii Bicarbonat., 
Syr. Limonis, 

Aquae, . . q. s. ad 31V. 

M. Sig. — A teasp. every 2 hours, 
to render the urine alkaline. 

(Roberts.) 

R. Tinct. Digitalis, . . ^ss-j. 

Spt. /Etheris Nitrosi, . ziij. 

Liq. Ammon. Acetat., . gss. 

Aquae, . . q. s. ad £v). 

M. Sig. — One-sixth every 3 hours, 

to re-establish the renal secretion. 

(Goodeve.) 



Urticaria. 

Chloroform, as ointment to allay itching (R.). Potassium Cyanide, ox Hy- 
drocyanic Acid (R.). [See Prurigo.] Nitric Acid, a dilute w r ash, controls 
itching and prevents wheals (R.). Benzoin, the compound tincture painted 
on the skin for itching (R.). Sodium Salicylate, gr. ij every ^ hour, is re- 
markably efficient (A. A. Smith) ; gr. xx thrice daily is effective. Copaiba, in 
full doses will produce urticaria, but drop-doses every y 2 hour will sometimes 
control it (A. A; Smith). Strychnine, with emetics and purgatives, when the 
affection is chronic (Guibout). Colchicum, in gouty persons (R.). Lead, 

62 



738 UTERINE CONGESTION AND HYPERTROPHY. 

lotions to ease itching (R.). Alkalies, (R.). [See Prurigo.] Warm Baths, 
may be employed with benefit. 

Prescriptions, 



R. Acidi Benzoici, . . gr. viij. 
Aquae, .... t ^iv. 
M. Sig. — Lotion for urticaria. 

{Squire,) 



R. Atropine Sulphat., . gr. ^g. 
Aq. Destil., Glycerini, . aa Jss. 
Pulv. Tragacanthae, q. s. 
Ft. pil. no. x. Sig. — One bis die. 



Uterine Cancer, 

Conium, useful as a palliative, ^iij-iv ad Oj aquae, as injection for extreme 
pain of uterine cancer (Wa.). Arsenic, small doses for a long time, with a 
strong iodine solution and glycerin locally (Atlee). Opium, stands first in 
the list of palliatives, quieting irritation, allaying pain (Wa.). Carbolic Acid, 
a weak solution as injection, an excellent cleanser, healer, disinfector and 
allayer of pain (R.). Bro?nine, the best escharotic for destruction of the 
mass (E.). Glycerite of Tannin , checks discharge and stench. Better still if 
mixed with glycerite of carbolic acid (R.). Iodoform, with cocoa fat as bolus 
inserted into excavation produced by cancer (R.) ; gr. v-x in each bolus (W.). 
Iodine, the saturated tincture thoroughly applied to the entire surface of the 
mass, is frequently of great use in checking hemorrhage, and seems to tem- 
porarily check the extension of the disease (E.). Chloral, as anodyne, will 
agree with most persons (E.); relieves the pains (W.). Chlorofor7n Spray, 
for some minutes (R.). Cannabis Indica, to allay the pain (Wa.). Surgical 
Measures, advisable ; medicine can only palliate. 



Uterine Congestion and Hypertrophy. 

Auru?n, salts of, often beneficial in chronic metritis with scanty menstrua- 
tion (B.). Ergotine, long continued, successful in chronic metritis; lessens 
congestion (B.); long continued has produced remarkable results in fibroids 
and polypi and chronic metritis; large, spongy, subinvoluted uterus (P.); by 
interstitial injection into the cervix, has been of great benefit (Goodell). Car- 
bolic Acid, undiluted, on cotton-wrapped probe. No better treatment for 
uterine catarrh (B.). Iodine, has proved the most valuable of all remedies, as 
local stimulant, and a reliable alterative (Thos., E.) ; and excitant of uterine 
contraction. Use a saturated tincture to any part not exposed to the air (E.) ; 
maybe injected into cervix (G.). Iodo-tannin, or Iodoformi ^j, Ac. Tannici 
^j ; a serviceable application in many inflammatory and hypertrophic condi- 
tions. Iodoform suppositories in chronic metritis (B.). Potassium Bromide, 
our main stand-by in uterine troubles ; apart from its soothing properties it 
seems to divert the blood from the womb, and to lessen uterine congestion 
(Goodell) ; a specific cure for simple subinvolution, the benefit being derived 
from the potash (Tait). Digitalis, in subinvolution (B.). Glycerin, on cotton 
tampon to cervix as local hydragogue (Thos.). Caustic Potash, and Potassa 
cum Calce, said to be effective in chronic metritis; must be used cautiously 
(B.). Chromic Acid, a strong solution to interior of uterus, a very useful ap- 
plication. Ipecacuanha, in subacute metritis of the puerperal state (Tr.). 
Iron, locally in uterine catarrh (R.); as tonic, Iron and other restoratives, a 
cardinal rule in the treatment of all uterine disorders, with Ergot, Quinine, 
Arsenic or Potassium Bromide, whenever the womb as a whole is congested 



UTERINE DISEASES UTERINE DISPLACEMENTS. 739 

or hypertrophied. Syr. Fern lodidi, with Cod-liver Oil, wins half the battle 
(G.). Zinc Valerianate, in 2 to 4-grain doses thrice daily, is one of the best 
nervines in these cases (G.). Scarification, after dry cupping, in chronic me- 
tritis (Thos.). Electricity, in chronic congestive enlargement, a galvanic cur- 
rent of moderate intensity, slowly interrupted B.>. Water, hot injections or 
douche, also cold alternately ; one of the most effective measures ; a gallon 
very hot, ter die (R.) ; — especially valuable in congestion, which is generally 
venous; — elevated hips a necessary part of treatment I E. ). Cold water is 
often better than hot iG.). Rest, to the patient and the organ, is of prime 
importance. Abdominal bandage, skirt-supporters, pessary if anteversion or 
retroversion, abstinence from sexual intercourse (Thos.). 

Prescriptions. 



R. Ext. Humuli, . . gj. 

Elix. Amnion. Valerianate 
Syr. Lactucarii, . . aa gss. 
M. Sig. — A dessertsp. at bedtime, 

or during the day when needed, as an 



R. Iodi, 

Putas. Bromidi, . . a-a gr. xx, 
Tinet. Iodi, . . 3]. 

Aq. Destillat., . . ad ^iv. 

M. Sig — lUxxx to be injected into 



antispasmodic. {Goodell., | cervix by 3-5 punctures. {Goodell.) 



Uterine Diseases. 

Cimicifuga,\.o prevent miscarriage in irritable uterus and prolapsus (R.); 
promises to be a valuable remedy in uterine affections (Wa ) ; is remarkably 
efficient in neuralgia and sympathetic pains arising from an irritable uterus, no 
matter what their precise character 1 P.). Belladonna, with tannin, as sup- 
pository in uterine neuralgia (R.<; as vaginal or rectal injections, in neuralgic 
or Inflammatory pains iTr.i. Arsenic, in irritable uterus, of decided beneht ; 
gr. Jq ter die, after meals (Wa. ). Carbonic Acid, injection up vagina for 
neuralgia (R., Wa.). Opium, with starch as injection into the rectum will 
subdue the pain of uterine diseases (R.) ; gives more speedy relief than any 
other remedy in irritable uterus, but long-continued is one of the worst (Wa.). 
Iodized Phenol, has proved the most generally efficient agent for intra-uterine 
use during eight years' experience, applied by hard rubber probes wound with 
cotton-wool. It removes cervical mucus, gives freedom from pain, softens and 
dilates the cervix, heals abrasions, removes induration, removes villosities, 
regulates the menses, improves appetite and digestion, acts as a general altera- 
tive, overcomes barrenness, etc., if used long enough, but rapid results are 
not attainable by any method of treatment (Battey). Lead, as plaster for 
pain in the back due to uterine disease (R.). Chloroform, spray, in neuralgia 
(R.). Aqua-puncture, has had extraordinary success in uterine colic (B.). 
Baths of warm salt water remarkably useful in nervous or inflammatory 
hysteralgia (Tr.). [See Abortion, Amenorrhea, Climacteric. Dysmen- 
orrhea, Endometritis. Hemorrhage Post-partum, Leucorrhcea, Men- 
orrhagia, Menstrual Disorders, Metritis, Metrorrhagia, Prolapsus 
Uteri, etc] 

Uterine Displacements. 

Anteversion without prolapse, not a mal-position (E.). Ice, locally when 
parts inflamed (R.)- Hot-water injections, to give tone to the vessels, essen- 
tial. Also valuable after reduction of mal-positions | E. ). Mechanical Means, 
only reliable or safe in retroversion and prolapse ; the sound, as a means to 



740 UTERINE TUMORS — VACCINATION. 

restore a retroverted uterus to position, cannot be regarded as free from risk, 
even in skilful hands (E.). Bessaries harmful unless expertly fitted; should 
be adjusted so as to restore the uterus to the normal line, where the circula- 
tion will be least obstructed ; not too high. Should never be employed while 
cellulitis exists (E.). [Compare Prolapsus Uteri.] 

Uterine Tumors. 

Mercury, the bichloride in small doses, long- continued, of undoubted value 
in treatment of fibrous or polypoid growths; gr. T \ every 6 hours, sometimes 
restrains the hemorrhage, when other remedies fail (Wa.). Calcium Chlo- 
ride, in 30-gr. doses thrice daily, has by prolonged use cured uterine fibroids. 
(Hewitt) ; calcifies uterine arteries, also those of the body generally, and is 
dangerous thereby (Tilt, Wells). Ergotin, hypodermically for fibrous tumor 
(R.) ; gr. ij-vj, on alternate days, give excellent results (B.) ; nine cases of 
fibroid treated by Hildebrandt with good results (P.); this method often 
causes great pain and severe local inflammation (W.) ; one grain each of Er- 
gotin and Ferri Sulphas Exsiccat., in pill thrice daily, persistently, for uterine 
fibroids, using for the hemorrhages a tampon saturated with Tincture of Iodine 
or Monsel's Solution (Parvin). Ammonium Chloride, in fibrous tumors, gives 
more benefit than any other remedy, gr. x, twice or thrice daily, for weeks 
and months consecutively (Atlee). Ferric Subsulphate, injected to restrain 
bleeding. Cautiously! (B.). Saline Mineral Waters, especially those at St. 
Catherine's, Canada, are useful (B.). Aliment, carefully regulated, chiefly of 
animal food ; with recumbent posture while flowing, and long-continued use 
of Ergot in small doses, may accomplish something (E.). [Compare Cysts.] 

Uterine Ulceration. 

Hydrastis, quickly improves; the fluid extract undiluted as topical applica- 
tion in uterine and vaginal leucorrhcea, ulcerations and erosions of cervix (B.). 
Carbolic Acid, pure, over the surface twice a week in simple ulceration (R.). 
Silver Nitrate, a serviceable application, but is often abused (B.). The solid 
stick applied to surface, after cleansing, and drying with cotton-wool (Wa.). 
Alum, as hip-bath, Ib.j ad C.j, and vaginal injection is of great utility in ul- 
cerations of the os uteri, or of the uterine cavity (Recamier). Glycerin 25, 
Alcohol 12^, and pure Creasote 1 part, an excellent application to ulcers of 
the neck. Bismuth Subnitrate, with enough Glycerin to make a thick cream, 
is the best of all applications for ulceration of the os and cervix uteri (Suesse- 
rott). Vegetable Astringetits, Infusions or decoctions of galls, oak-bark, 
hamamelis, geranium, alum-root, etc. The glycerite of tannin, tannin and 
iodoform, packed around cervix (B.). 

Uvula. 

Tannin, Rhatany or Zinc, as astringent lozenges, for relaxed uvula (A.). 
Amputation, of elongated part (A.). 

Vaccination. 

Aconite, with Belladonna ointment for erysipelatous redness after vaccina- 
tion (R.). Zinc Oxide, dusted over, to allay the subsequent local irritation 



VAGINISMUS VARIOLA. 74 1 

(Wa.) ; with Pulv. Amyli, equal parts, over the surface. Lead Acetate, gj to 
Oj water, as lotion for irritable pock (Foster). Carbolic Acid, gj, to Oj 
water, as lotion for excessive redness, with burning and itching. 

Vaginismus. 

Ether, to ascertain cause; usually a displacement, fissure, or cellulitis (E.). 
Hygiene, sun-baths, hot-water injections, fresh air, removal from husband, etc. 
(E.j. Operation (Sims'), removal of hymen with scissors and insertion of 
glass plug till parts are healed, when the cicatrix is to be divided, etc. (E.). 
Tents to gradually dilate vagina, may be impregnated with various sedatives 
(Gallard). Iodoform in a suppository, when redness and excoriation. Bella- 
donna, the extract, I part with 8 or 9 of fresh lard, if only pain (Gallard). 

Vaginitis. 

Tannin, the glycerin of tannin in chronic vaginitis of children (R.). Sil- 
ver Nitrate, gr. xl-gj aquse, applied within cervical canal, and over the va- 
ginal mucous membrane (E.). Emollient Injections, with Opium (Goodsell). 
[Compare Gonorrhoea, Leucorrhcea.] 

Varicella. 

Diet, no animal food, milk best ; which, with careful attention to the bowels, 
patient to be kept cool with light covering, and use of a mattress rather than 
a feather bed, is all the treatment required (A.). Saline Mixture, if high 
fever. Quinine, during convalescence. Cot7iplications to be treated symp- 
tomatically. 

Varicocele. 

Hamamelis, appears to have permanently cured one case (R.). Ergot, gr. 
ij-vj of Ergotin hypodermically, the needle to be inserted among the affected 
veins ; care being taken not to puncture a vein, is effective ; severe pain fol- 
lows for a few hours (R.). Water, cold douche to the perineum and buttocks, 
with suspension of testicles in cold water (R.). Radical Cure, consists in 
obliterating the veins by wire ligatures, etc. (CI.). 

Varicosis. 

Hamamelis, is employed with satisfaction in varicose veins and ulcers (Pf.). 
Digitalis, by fomentation, in acute inflammation from varicose ulcers (R.). 
Ergotin, injected along side of vein, but not within it, has cured (B.). Ban- 
dage, or elastic stocking; with cold sponging, and rubbing upwards, as pallia- 
tives (CI.). [Compare Hemorrhoids, Ulcers.] 

Variola. 

Cimicifuga, is given internally by some, who assert that it prevents pitting 
(R.). Mercury, in ointment or plaster, to prevent pitting in semi-confluent, 
or barely confluent cases (Wa.) ; formerly used (R.). Camphor, is said to re- 
store the eruption, if retrocedent ; in confluent or malignant small-pox, cam- 
phor alone, or with Opium, may be used for great depression of the vital 



742 VERTIGO — VOMITING. 

powers (Wa.). Belladonna, successfully used both as prophylactic and cura- 
tive agent (Erasmus Wilson). Gr. %-] every 3, 4, or 6 hours, to dilatation 
of pupil and some stupor; found effectual (Wa.). Carbolic Acid, is used with 
decided advantage (Wa.). [See Measles.] Has been much used on theo- 
retical grounds, but not with success (B.). Ammonium Carbonate, has had 
cheering success (Wa.). [See Scarlatina.] Quinine, small doses in ady- 
namic states, larger in hyperpyrexia (B.). Chloral, temperature high, much 
delirium, and restlessness (B.). Opium, low, muttering delirium; not so 
much used now as formerly (B.) ; morphine in the insomnia of the advanced 
stage, once or twice only, but not when copious salivation or mucous expecto- 
ration (Wa.). Silver Nitrate, on a sharp-pointed stick, inserted into each 
vesicle after rupture, to prevent pitting (B.) ; or simply paint skin with a solu- 
tion of gr. xx to the ^ (R-). Iodine, the tincture to prevent pitting, is painted 
ten times over face if on first day of eruption, 12 if on the second day, 12-16 
times if on third day (B.). Collodion, or solutions of India rubber or gutta 
percha in chloroform, to prevent pitting : or cotton-wool dipped into lime lini- 
ment, applied to face or neck (R. ). Water. Cold baths and cold pack of 
great utility (B.). Packing especially on retrocession of rash (R.). External 
Applications, as powdered starch, flour; zinc carbonate, 3 parts to 1 of zinc 
oxide with olive oil; cold or tepid water with vinegar, sponged over body 
twice or thrice daily (Wa.). Diet. Tea and dry toast, raw eggs beaten in 
cold milk, beef-tea, grapes, roasted apples, ripe fruits in season. Cold water 
may be drank freely. Fats. Bacon-fat smeared over the face, to allay itch- 
ing and prevent pitting, [Compare Vaccination.] 

Vertigo. 

Digitalis, in small doses, alternately month by month with tincture of larch, 
and with a long course of the citrate of iron and strychnine, in essential ver- 
tigo, without any other head symptoms, and with general depraved nutrition, 
the most effectual treatment (Wa.). Potassium Bromide, often controls par- 
oxysmal vertigo, without coexistent spasm, or organic brain-disease (Wa.). 
Ammonium Bromide, in an effervescing form with cascarilla, for vertigo from 
overwork, where there is usually restlessness, insomnia, depression of spirits, 
with a sense of impending evil (Wa.). Alkalies and Bitter Tonics, give the 
best results in vertigo of gastric origin. Sodium Bicarbonate, after meals, 
tonics before meals. Strychnine with Iron, thrice daily, gives good results. 
Corrosive Sublimate, in small doses, with attention to the bowels and diet. 
Cod-liver Oil, giddiness of the aged, when no serious brain-disease (R.). Is 
mostly symptomatic of disorder of the stomach, or of the liver (cholaemia) ; 
sometimes of general debility; rarely of disease of the brain (H ).. 

Vomiting. 

Ipecacuanha, in small doses, will arrest certain kinds — a curious fact ; es- 
pecially useful in certain forms; mj of vinum ipecac, every y^ hour or more 
(B., R., P.) ; in sick stomach of nervous origin, minute doses are of undoubted 
value (W.). Arsenic, in many forms of stomach vomiting, especially that of 
alcoholism, and chronic ulcer (B.), and in the vomiting of cholera (R.) ; gtt. ss 
of Prowler's solution, every x / z hour for 6 or 8 doses, often relieves vomiting 
after a debauch, the a.m. vomiting of drunkards, and that of pregnancy (A. A. 
Smith). Nux Vomica, stands next to arsenic ; is useful in many ways (B.); 



VOMITING OF PREGNANCY. 743 

may be given with Ipecac., especially when tongue coated (R.). Iris, in 
vomiting with blinding right supraorbital pain; liver deranged (P.). Bismuth, 
in many forms of vomiting in children, especially when from gastric catarrh 
(R.). Carbolic Acid, with or without bismuth (B.) ; in nervous vomiting ( W.). 
Creasote, in the vomiting of cancer, gastric ulcer, etc. (R.); gtt. j-ij (W.). 
Mercury, gr. y£ of gray powder every two hours, especially in children with 
clayey stools (R.) ; Calomel, gr. j to Oj aquse, first dissolved in £j of limewater 
— a teasp. every ten minutes for the regurgitation of food in nursing children 
(A. A. Smith). Sulphurous Acid, tti V ~3J> we ^ diluted, or less effectively, 
sodium sulphite. Sulphites often curative in vomiting of sarcinae, and acid 
matter, due to acid fermentation of starchy elements (B.). Cocculus Indicus, 
efficient in cephalic vomiting (P.). Ophim, will arrest many kinds ; best in 
that of biliary or renal calculi, dysmenorrhoea, seasickness, pregnancy. Mor- 
phia, hypoder., gr. T \ to i (P.). Bryonia, bilious vomiting and headache (P.). 
Veratrum Album, in vomiting and purging of summer diarrhoea (R.). Hy- 
drocyanic Acid, often very serviceable in nervous vomiting ; acts promptly if 
at all (R.). Hydrobromic Acid, ^ss in gj of water, four times daily, useful 
for the vomiting due to gastric ulcer. Chloroform, Tnjj-v, on sugar, for non- 
inflammatory vomiting (R.) ; see Yellow Fever for formula. Bromides, in 
cerebral vomiting only; not in the gastric form(B.); potassium bromide in 
that of uterine disease (\V. ). Cinnamon or Cloves, will check vomiting (P.). 
Calumba, in vomiting from kidney disease and renal calculi; frequently allays 
that of pregnancy and dentition (P.). Serpentaria, for bilious vomiting (P.). 
Cerium Oxalate, in that of pregnancy and from cancer (B.) ; gr. j every three 
hours (R.). Sodium Bicarbonate, ^ss-j to a pint of milk, for infants especially 
if constipated (R.). Am?noniu?n Carbonate, may relieve when vomited matter 
is acid (B.). Milk and Limewater, often relieves when other methods fail; 
also the effervescing soda powders in the vomiting of acute diseases, and the 
exanthemata (B.). Alcohol. Iced brandy or champagne in spoonful doses 
every y 2 hour in vomiting of cholera, pregnancy, and delir. trem. (B.). 
Counter-irritation, at epigastrium (R.). Nutrient Enemata (B.). [See Ene- 
MATA.] Ice, sucked, with horizontal posture, absolute rest and quiet (Wa.). 
Iced champagne, IJss every % hour (B.). Pepsin, for vomiting of food after 
meals; gr. x-xv before or during meals. Kumyss, has proved efficacious 
when no other food would remain on the stomach. [Compare the List of 
Anti- emetics, on page 415, also the articles entitled Hematemesis, Nausea, 
Sea-sickness, Vomiting of Pregnancy.] 

Prescriptions. 



R. Ac. Hydrocyan. Dil., . gj. 

Aquae Laurocerasi, . . .^ij. 
M. Sig. — A teasp. every 2 hours, 
for nervous vomiting. 



&. Ac. Hydrobromici, . . gij. 
Sig. — Half a teasp. in a winegl. of 
water, 4 times daily. 



Vomiting of Pregnancy. 

Ipecacuanha, or Nux Vomica, either will generally succeed where the other 
fails (R.) ; no other remedy of equal value to Ipecacuanha (P.). Nux Vomica, 
is useful but often fails* gtt. ss-j every hour or two in water (R.) ; in very 
minute doses (S.) ; gtt. ij-iij of the tincture every two or three hours, or gtt. x 
before each meal, with very hot water as a drink, is the best treatment (Par- 
vin). Arsenic, Fowler's solution, gtt. j before each meal, will often relieve, 
when vomiting of food, retching and straining, with blood and pain (B.). 



744 



VULVA VULVITIS. 



Creasote, checks the vomiting (R.). Carbolic Acid, drop-doses of crystals 
liquefied by heat, in mucilage ter die (Wa.), Staphisagria, has subdued when 
other remedies failed (P.)- Cerium Oxalate, gr. j every three hours (R.) ; ordi- 
nary doses far too small, give as high as io grains (B.). Morphine, hypoder- 
mically in severe vomiting (R.). Pepsin, has been used with success. In- 
gluvin, seems almost specific (B.). Potassium Bromide, is often efficacious 
(W.) ; ^ss doses thrice daily, exceedingly effective in the combined diarrhoea 
and vomiting of pregnancy. The first dose should be given an hour before 
rising. Hydrocyanic Acid, often the best remedy (P.). [See ante, Vomit- 
ing.] Copper Sulphate, sometimes effective, not more than gr. ■£■$ ter die (B.). 
Iodine or Calumba, as tincture often useful ; drop-doses every hour or two 
(B.). Bismuth, and Carbolic Acid, are effective (B.). Atropine, frequently 
effective (R.) ; never failed to give relief in many years of using it (Boys). 
Ether, sprayed over the epigastric region and the corresponding part of the 
spinal column, for 3 to 5 minutes every 3 hours, gives immediate relief (Lu- 
belsky). Pop-corn, is a god-send in this complaint, having acted marvellously 
in several cases in which I have used it (Sweringen). Aconite, in full doses, 
is often very successful (W.). Dilatation of the cervical canal, by the index 
finger, is regarded as extremely efficient, and reasonably safe. It may bring 
on abortion, if too extensive, but from records of several cases since 1875, 
it may be said that it is a safe and sure remedy (Copman). Ice-bag to spine, 
an efficient measure (R.). 

Prescriptions. 

R. Cerii Oxalatis, . 



R. Atropinae Sulphatis, . gr. j. 

Morphinae Sulphatis, . gr. iv. 

Acidi Sulph. Aromat., . £iij. 

Aquae, .... £v. 
M. Sig. — Ten to twenty drops, 
thrice daily. (Boys.) 



R. Bismuthi Subnitrat., . gr. clx. 

Cerii Oxalatis, . . gr. xl. 

Morphinae Sulphatis, . gr.jss. 

Syrupi, et Acacias, ad£i). 
• M. ft. emulsio. Sig. — A teasp. 
every hour until vomiting ceases. 

( Van Valzah.) 



Ipecacuanhas, 
CreasoJI* . 
M. ft. pil. no. 
every hour. 



xij. 



• g r - 

• g r - 

• g r - 
Sig. 



xij. 

XV. 

xxiv. 
-One 



(Goodell.) 



R. Cerii Oxalatis, . 
Ext. Hyoscyami, 
M. ft. pil. no. xij. 
twice daily. 



. gr. xxiv. 
. gr. xxxvj. 
Sig. — One pill 
(Goodell.) 



R. Chloralis Hydratis, 

Lactis, . 

Vitellum, 
Beat up well, warm, 
rectal injection. 



. gr. xx. 

. Si- 

• j- 

and use as 
(Kane.) 



Vulva. 

Sodium Hyposulphite, an unfailing remedy in lotion for aphthae of the vulva 
(R.). Arsenic, much used for eczema (T.). Lead Acetate, a concentrated 
solution in glycerin, for eczema of vulva (T.). [Compare Pruritus, Pru- 
rigo.] # 

Vulvitis. 

Alum, as lotion in vulvitis of children ; gr. lx-Oj aquae, or less strong if 
found to increase discharge (R.). Lead, solutions of the acetate or, the diace- 



WARTS — WORMS. 745 

tate as after the acute stage has subsided. Lime-watery wash (R.). 

[Compare Vaginitis.] 

Warts, 

Thuja, worthy of recommendation in the highest terms, for the cure of 
- with a narrow base and pendulous body. A strong tincture locally 
three times a day, for one or two weeks, with 5 drops in a wineglassful of 
water internally, night and morning (P.). Iron, tincture of the chloride and 
dilute HC1 acid, applied night and morning, equal parts, very effective 1 Bulk- 
ley). Nitric Acid, ^j-ij of the dilute acid to a pint of water, as wash, to 
keep small syphilitic warts constantly moist R, . Sabina, as caustic (P.); 
j-ij of alum (Wa.). Rue, the oil, with honey, locally {P.). Arsenious Acid, 
as a caustic ; enough to be used to excite active inflammation. Liq. arseni- 
calis painted over warts R. ; may be taken internally B. . Mercurial Oint- 
ment, containing 5 per cent, of Arsenic, or a plaster having in each 8 square 
inches 15^ grains of Arsenic and 77 grains of Mercury >Unna). Tannin, 
and Burnt Alum, equal parts, powdered over warts daily twice, gives good 
results. Chromic Acid, gr. ico to 5J aquae, with a glass rod, to saturate dis- 
eased growth. Remove any superfluous acid; dress with dry- lint ( R., Wa.). 
Mercuric Nitrate, locally (R-). Silver Nitrate, as caustic, but is usually too 
superficial (R.). Dermal Curette, is much used in Vienna to remove warts 
by enucleation. Strangulation, by tying a string tightly around the base, 
ie them to drop off in a few days. Heat, is a most thorough measure 
for their radical removal ; it may best be applied by touching the wart 3 or 4 
times daily with the hot end of a cigar; the first few applications only give 
pain. Caustic Alkalies, locally (R.); a saturated solution of potassa fusa, 
carefully applied by a brush or sponge fastened to the end of a stick, is to be 
preferred (E. Wilsonj. [Compare Condylomata.] 

Wen. 

Extirpation, the least troublesome and most speedily effective method. 
Run a scalpel through it, seize the cut edge of the cyst, and gently tear it out 
with a touch or two from the knife. Dressing of lint and carbolic oil to 

Cause suppuration and contraction (D.). 

Worms. 

Filix Mas, Brayera (RTousso), Rottlera (FTamala), Pepo, Gr&nati Fructus 
Cortex, as taeniafuges ; B. . Filix Mas to be taken on an empty stomach, for 
-worm, and followed by a purge R., P.). Pepo, ^ij as emulsion, taken 
::g, one of the most emcient remedies against taenia (B.). Santonin, the 
best anthelmintic ; laxative in morning, fasting all day, a dose (gr. ss-v) of 
santonin and calomel, or troches of santonin ( j-x), at bedtime, a senna draught 
next morning. For ascarides (B., P.). For round and thread-worms, in 
castor oil by mouth, or as injection (R.). Iron, the Syrup of the Iodide in- 
ternally and a solution of the tincture locally, for ascarides (B.); the tincture 
ferri sesquichlor. ^s ad Oj aquae, a good injection for thread-worms ; coagu- 
: albumen 1 R.). Quassia, the infusion an effectual injection, conjoined 
with simple bitters internally, for ascarides (R.). Pelletierine, the alkaloid 
of Granatum, is by far the best vermifuge for a tape-worm, repeated after a 
week for a second worm, as many as 3 having been found in one patient (Da 



746 



WOUNDS. 



C.) ; gr. xv-xx of the tannate, followed in a few hours by Castor Oil (R.). 
Chloroform, a very efficient taeniafuge, zj in gj of mucilage, after 20 hours' 
fasting, followed one hour later by gj of Castor Oil; this is an adult dose, zj 
should never be exceeded (Wilde). Lime Water, as injection for thread- 
worms (R.); giij— iv repeated, for ascarides (Wa.). Sodium Chloride, in ^ss 
doses on empty stomach, expels ascarides and prevents reproduction (Wa.). 
Quinine, as a tonic ; also cold sponging, out-door exercise and judicious diet. 
Useful probably by preventing the production of the abundant mucus which 
favors the growth of worms (R.); especially useful for ascarides; also as 
injection for thread-worms and taenia (Wa.). Ignatia, for convulsive symp- 
toms (P.). ICamala (Rottlera), excellent for taenia, requires no purge (P.); 
gr. cl-clxxx for an adult (W T a.). Eucalyptus, as injection, for ascarides (B.). 
Aloes, are efficacious for ascarides (P.). Ailanthus, decoction of fresh bark, 
for taenia (B.). Tonics, as cod-liver oil and iron to restore intestinal canal to 
healthy condition (R.). Turpentine, as poison to tape and thread-worms (R.) ; 
also for taenia (Wa.). Scammony, for thread-worms in rectum (R.); with 
calomel, effective (Wa.). Tannin, as catechu, kino, red-gum, rhatany, haema- 
toxylum, in injections to destroy thread-worms (R.). Alum, as solution for 
injection (R.). Ammonium Chloride, to prevent formation of thick mucus 
which serves as nidus for worms (R.). Valerian, especially when convulsions 
(R.). [Compare the List of Anthelmintics on page 419.] 

Prescriptions. 



R. Chloroformi, 

Ext Filicis Maris, . aa zj. 
Emuls. Ol. Ricini (50 per 

cent.), . . ■ . . giij. 
M. Sig. — One dose after 24 hours' 
fasting. Does just as well if Male 
Fern be omitted. 



R . Ext. Spigeliae Fl., 
Ext. Sennae Fl., 
M. Sig. — A teasp. 
to 5 years. 



. . gss. 

to a child of 3 
{Smith.) 



R. Ext. Spigeliae et Sennae Fl.,gj. 

Santonini, . . . gr. viij. 

M. Sig. — A teasp. to a child of 5 

years. {Smith.) 



R . Granati Corticis, . . gij. 

Ft. infusum. Sig. — To be taken 
before 1 1 a.m. — and followed after 2 
hours by — 

R. Ol. Ricini, . . . giij. 

01. Terebinth., . . . £j. 

Ext. Filicis Maris ^Ether., zj. 
M. ft. haustus. 
Fasting unnecessary. ( Wilde.) 



R. Magnesii Sulphat., . . 5ij. 
Sodii Chloridi, . . . gss. 
M. Sig. — A fluid ounce in half a 
glass of water, with gtt. v of Car- 
bolic Acid, night and morning, for 
ascarides. Persevere. {Barkley.) 



'Wounds. 

Arnica, very useful for external bruises and cuts, also for internal injuries ; 
unites surfaces very rapidly after amputations. The infusion or decoction best 
(P.); very effectual (Wa.). Aconite, valuable in surgical fever (P.). Car- 
bolic Acid, solutions check suppuration, and correct fetor (B.). The " anti- 
septic " treatment of wounds (Lister), especially surgical wounds. See Ag. 
vol. 1, page 187. Sulphurous Acid, in solution, diluted or not, constantly 



YELLOW FEVER. 747 

applied (R.) ; in solution or by fumigation, is regarded by some as superior 
in efficacy to carbolic acid, and less irritant (Wa.). Salicylic Acid, Thiersch 
prefers to Carbolic ; may be applied pure in powder to gangrenous and slough- 
ing wounds (B.). Mercuiy, the bichloride, gr. vijss to quart j of hot water, 
stirred with a stick, makes a solution of I to 2000 ; the best of all antiseptics 
for washing a wound or cavity, and for saturating the dressings. See List of 
Antiseptics on page 432. Boracic Acid, also applicable as Carbolic Acid (B.). 
Balsam of Peru, excellent for closing recent wounds (P.). Benzoin, the basis 
of healing "balsams" (P.). Aloes, topically as a slight stimulant; often 
purges (R.). Gum Tragacanth, a thick aqueous solution to granulating sur- 
faces, to protect them from the air (Wa.). Opium, to quiet intestinal move- 
"ments in wounds of the abdomen (R.) ; forwards the reparative processes (P.). 
Tannin, or glycerin of tannin to coat over wounds (R.). Collodion or Liquor 
Gutta-perchce, to secure primary union of incised wounds (B.); as protective 
covering (P.). Iodofor??i, powdered and dusted over sloughing wounds, irri- 
table and ill-conditioned ulcers, sores (B.). Iodoform I, Collodion 9 parts, 
painted on a superficial wound while edges are held together (Gross) ; may be 
painted over edges when stitched together : gives excellent results. Galvanic 
Couplet, to wounds of indolent form (B.). [See Bedsores.] Nitric Acid, 
as escharotic for gangrene (B. ). Turpenti?ie, one of the most efficient appli- 
cations in hospital gangrene (B.). Aloes, pulverized fine, as a dressing for 
wounds, favoring cicatrization and closing them, also relieving the pain at once ; 
requires removal only at long intervals (Millet). Poultices, are often abused. 
Yeast or charcoal best for foul wounds (B.). Alcohol, an excellent antisep- 
tic dressing when suppurating ; also favors cicatrization of open wounds (B.). 
Water, in universal use as dressing. Cold water often abused. Hot- water 
dressing as advocated by Hamilton, of New York, promises better results (B.). 
Turkish Bath, for pain in the seat of old wounds ( R.). Ice and Salt, applied to 
wound prevents inflammation (R.j. [Compare Hemorrhage, Inflammation, 
Pyemia, Surgical Fever, Gangrene, Ulcers.] 





Prescriptions. 




R. Acidi Tannici, 


gijss. 


R . Collodii, . 


• s. 


Alcoholis Absolut., . 


Olei Ricini, 


. ±ss. 
• 3 SS - 


vEtheris, .... 


Acidi Carbolici, 


Collodii, 


gxij. 


M. Sig. — Carbolized 


Collodion, 


M. Sig. — Styptic Colloid. 




for wounds. 





Yellow Fever. 

Treatment must all be done at the beginning, no time to be lost. Cold 
sponging early and frequently repeated. Calomel, Quinine and Salines at the 
start. Potassium Acetate for the kidneys. Morphine for gastric irritation, 
the feet to be in mustard water (Da Costa). Diaphoretics and Diuretics, also 
Laxatives, are very important throughout the disease (Da Costa). Mercury, 
a calomel purgative, gn ss, 2 or 3 times on the first day, followed by a warm- 
water enema, is good treatment (B.); has many advocates, and many oppo- 
nents (Wa.) ; should generally be abstained from (S.). Duboisine, gr. ^, 
subcutaneously, the most efficient hypnotic and calmative (B.). Turpentine, 
when cardiac weakness, depression of vaso-motor system, dissolved state of 
the blood; H|X— gss; small doses, with tinctura ferri chloridi, in hemorrhagic 
form (B.). Quinine, has some strong evidence in its favor as an abortive 



748 YELLOW FEVER. 

agent, one large dose (gr. xxx-xl) with opium at outset (Wa.); is not a spe- 
cific; may hasten recovery in mild cases (S.) ; gr. xx per rectum, to reduce 
temperature (B.). Liquor Calcis, with milk, has been found efficient for the 
vomiting (Wa.). Capsicum, to obviate the black vomit, is highly spoken of 
(Wa.). Chloroform, for the vomiting, a few drops to prepare the stomach for 
reception and retention of food ; effects transitory, has to be repeated before 
each meal (Wa.) ; the Ammoniated Chloroform in zymotic pyrexia; its action 
is sedative, analgesic and antipyretic ( Richardson). Carbolic Acid, by stomach 
and hypodermically, remarkably efficacious, even after the ominous " coffee- 
grounds " vomit (Lecaille). Chlorodyne, is excellent for restlessness, insomnia, 
irritability of stomach (A.). Veratrum Viride, gtt. j-x hourly, according to 
age, till pulse and temperature subdued ; successfully used in connection with 
mercury, etc. (White & Ford). Stimulants, only in typhus form (B.); in 3d 
stage must be bold, prompt and continued (Da C). Diet, of the blandest 
description (A.); milk and lime-water, half and half, in small quantities, is 
the best aliment. In convalescence, the utmost care is necessary in giving 
aliments (B.). Rest is very important (Da C). Iced Champagne, in table- 
spoonful doses every % hour, for the vomiting (B.). Purgation, throughout 
the disease (Da C). [Compare Remittent Fever.] 

Prescriptions. 



B . Potassii Carbonat., . gr. xx. 

Tinct. Opii Camphorat., gj. 
Aquae, .... Jviij. 
M. Sig. — ^j every hour or two, as 
a diaphoretic. {Dickson.) 



R . Chloroformi, 

Tinct. Camphorae, . . a"i ^ss. 
M. Sig.— Two drops as required 
for the vomiting. 



APPENDIX 



LIST OF LATIN WORDS, PHRASES, ETC., USED IN 
WRITING PRESCRIPTIONS; WITH THEIR CON- 
TRACTIONS, AND THE CORRESPONDING ENG- 
LISH EQUIVALENTS. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Abdomen 


Abd. 


The belly. 


Absente febre 


Abs. feb. 


Fever being absent. 


Accurate 


Ace. 


Accurately. 


Ad 


Ad 


To, or up to. 


Ad duas vices 


Ad 2 vie. 


At twice taking. 


Ad secundum vicem 


Ad sec. vie. 


To the second time. 


Ad tertiam vicem 


Ad 3tiam vie. 


For the third time. 


Adde 


Add. 


Add. 


Addantur 


Add. 


Let (them) be added. 


Addendus 


Add. 


To be added. 


Addendo 


Add. 


By adding. 


Ad defectionem animi 


Ad def. an. 


To fainting. 


Ad gratam aciditatem 


Ad grat. acid. 


To an agreeable sourness. 


Adhibendus 


Adhib. 


To be administered. 


Adjacens 


Adjac. 


Adjacent. 


Ad libitum 


Ad lib. 


At pleasure. 


Admove 


Admov. 


Apply. 


Admoveatur 


Admov. 


Let (it) be applied. 


Admoveantur 


Admov. 


Let (them) be applied. 


Adstante febre 


Adst. feb. 


The fever being on. 


Adversum 


Adv. 


Against. 


i Aggrediente febre 


Aggr. feb. 


While the fever is coming on. 


Agitato vase 


Agit. vas. 


The vial being shaken. 


Aliquot 


Aliq. 


Some. 


Alter 


Alt. 


The other. 


Alternis horis 


Alt. hor. 


Even- other hour. 


Aluta 


Aluta 


Leather. 


Alvo adstricta 


Alv. adst. 


The bowels being confined. 



75° 



LIST OF LATIN WORDS, PHRASES, ETC. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Alvus 


Alv. 


The belly. 




Amplus 


Amp. 


Large. 




Ampulla 


Ampul. 


A large bottle. 




Ana 


A. or aa 


Of each. 




Aqua 


Aq. 


Water. 




Aqua astricta 


Aq. astr. 


Frozen water. 




Aqua bulliens 


Aq. bull. 


Boiling water. 




Aqua communis 


Aq. com. 


Common water. 




Aqua fervens 


Aq. ferv. 


Hot water. 




Aqua fluviatilis 


Aq. fluv. 


River water. 




Aqua fontalis 


Aq. font. 


Spring water. 




Aquafontana^rfontis 


Aq. font. 


ti a 




Aqua marina 


Aq. mar. 


Sea water. 




Aqua nivialis 


Aq. niv. 


Snow water. 




Aqua pluvialis, or 


Aq. pluv. 


Rain water. 




pluviatilis 








Aqualis 


Aqualis 


Pertaining to water. 




Aut 


Aut 


Or. 




Balneum arena? 


B. A. 


Sand-bath. 




Balneum maria?, or 


B. M. 


Salt-water bath. 




maris 








Balneum vaporosum, 


B. V. 


Vapor-bath. 




or vaporis 








Balsamum 


Bals. 


Balsam. 




Barbadensis 


B. B. 


Barbadoes. 




Bene 


Bene 


Well. 




Bibe 


Bib. 


Drink (thou). 




Biduum 


Bid. 


Two days. 




Bis 


Bis 


Twice. 




Bis in die, or dies 


Bis die 


Twice a day. 




Bolus 


Bol. 


A large pill. 




Bulliat or Bulliant 


Bull. 


Let boil. 




Butyrum 


But. 


Butter. 




Ca^ruleus 


Caenil. 


Blue. 




Calefactus 


Calef. 


Warmed. 




Calomel or Calo- 


Cal. 


The mild chloride of mercury. 


melas 








Cape 


Cap. 


Take (thou). 




Capiat 


Cap. 


Let him take. 




Capsula 


Capsul. 


A capsule. 




Caute 


Caute 


Cautiously. 




Charta 


Chart. 


Paper. 




Chartula 


Chartul. 


A small paper. 




Cibus 


Cib. 


Food. 




Cochlear, or Coch- 


Coch., Cochleat. 


A spoonful, By spoonfuls 


(3J)- 


leare, or Coch- 








leatim 









LIST OF LATIN WORDS, PHRASES, ETC. 



75i 



Word or Phrase. 


Contraction. 


English Equivalent. 


Cochleare am plum 
Cochleare magnum 
Cochleare medium, 


Coch. amp. 
Coch. mag. 
Coch. med. or mod. 


A dessertspoonful (.^ij). 
A tablespoonful (^ss). 
A dessertspoonful (^ij). 


or modicum 






Cochleare parvum 

Coctio 

Cola 


Coch. parv. 

Coct. 

Col. 


A teaspoonful (gj). 

Boiling. 

Strain. 


Colaturae 


Colatur. 


To the strained liquor. 


Colatus 


Colat. 


Strained. 


Coletur 


Colet. 


Let it be strained. 


Colentur 


Colent. 


Let them be strained. 


Collutorium 


Collut. 


A mouth-wash. 


Collyrium 
Coloretur 


Collyr. 
Coloret. 


An eye-wash. 
Let it be colored. 


Compositus 
Concisus 


Comp. 
Concis. 


Compounded. 
Cut. 


Confectio 


Conf. 


Confection. 


Congius 
Conserva 


Cong. 
Cons. 


A gallon. 

A conserve, also Keep (thou). 


Continuantur remedia 


Cont. rem. 


Let the medicines be continued. 


Contusus 


Contus. 


Bruised. 


Coque, Coquantur 
Coque ad medietatis 


Coq. 

Coq. ad med. con- 


Boil, let them be boiled. 

Boil to the consumption of half. 


consumptionem 
Coque secundem 


sump. 
Coq. S. A. 


Boil according to art. 


artem 






Coque in sufficiente 


Coq. in S. A. 


Boil in sufficient water. 


quantitate aquae 
Cor, cordis 


Cor. 


The heart. 


Cortex, corticis 


Cort. 


The bark. 


Coxa 


Cox. 


The hip. 


Cras, Crastinus 


Crast. 


To-morrow. 


Cras mane sumendus 


Cras mane sumend. 


To be taken to-morrow morning. 


Cras nocte 


Cras nocte 


To-morrow night. 


Cras vespere 
Crastinus 


Cras vesp. 
Crast. 


To-morrow evening. 
For to-morrow, early. 


Cujus, Cujus-libet 
Cum 


Cuj. 
C. 


Of which, of any. 
With. 


Cyatho these 
Cyathus, vel Cyathus 


Cyatho theae 
Cyath., C. vinar. 


In a cup of tea. 

A wine-glass (^j-ij). 


vinarius 






Da, detur 


D., det. 


Give, let be given. 


De 


De 


Of, or from. 


Deaurentur pilulae 
Debita spissitudo 
Debitus 
Decanta 


Deaur. pil. 
Deb. spiss. 
Deb. 
Dec. 


Let the pills be gilded. 
A proper consistence. 
Due, proper. 
Pour off. 



752 



LIST OF LATIN WORDS, PHRASES. ETC. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Decern, Decimus 


Decern. 


Ten, The tenth. 


Decoctum 


Decoct. 


A decoction. 


Decubitus 


Decub. 


Lying down. 


De die in diem 


De d. in d. 


From day to day. 


Dein vet Deinde 


Dein 


Thereupon. 


Deglutiatur 


Deglut. 


Let be swallowed. 


Dejectiones alvi 


Dej. alv. 


Stools. 


Detur in duplo 


Det. in dup. 


Let twice as much be given. 


Dexter, Dextra 


Dext. 


The right. 


Diebus alternis 


Dieb. alt. 


Every other day. 


Diebus tertiis 


Dieb. tert. 


Every third day. 


Diluculo 


Diluc. 


At break of day. 


Dilue, Dilutus 


Dil. 


Dilute (thou), Diluted. 


Dimidius 


Dim. 


One-half. 


Directione propria 


D. P., or Direct, 
prop. 


With a proper direction. 


Dividatur in partes 


D. in p. aeq. 


Let it be divided into equal parts. 


aequales 






Dividendus, -a, -um 


Divid. 


To be divided. 


Dolor 


Dolor 


Pain. 


Donee 


Donee 


Until. 


Donee alvus bis de- 


Donee alv. bis dejic. 


Until the bowels have been twice 


jiciatur 




evacuated. 


Donee alvus soluta 


Donee alv. sol. ft. 


Until the bowels shall be opened. 


fuerit 






Donee dolor nephrit- 


Donee dolor neph. 


Until the nephritic pain is re- 


icus exulaverit 


exulav. 


moved. 


Dosis 


D. 


A dose. 


Drachma 


Dr. or % 


A drachm (60 grains). 


Durante dolore 


Dur. dolor. 


While the pain lasts. 


Eadem (fern.) 


Ead. 


The same. 


Eburneus 


Eburn. 


Made of ivory. 


Ejusdem 


Ejusd. 


Of the same. 


Electuarium 


Elect. 


An electuary. 


Emesis 


Emesis 


Vomiting. 


Enema 


En. 


A clyster or enema. 


Enemata 


Enem. 


Clysters. 


Et 


Et 


And. 


Evanuerit 


Evan. 


Shall have disappeared. 


Exhibeatur 


Exhib. 


Let it be exhibited. 


Extende 


Ext. 


Spread. 


Extende super alutem 


Ext. sup. alut. moll. 


Spread upon soft leather. 


mollem 






Extractum 


Extr. 


An extract. 


Fac 


F. 


Make. 


Fiat 


Ft. 


Let be made (sing.). 


Fiant 


Ft. 


Let be made (pL). 



LIST OF LATIN WORDS, PHRASES, ETC. 



753 



Word or Phrase. 


Contraction. 


English Equivalent. 


Fac pilulas duodecim 


F. pil. xij 


Make 12 pills. 


Farina 


Farina 


Flour. 


Fasciculus 


Fasc. 


A bundle which can be carried 
under the arm. 


Febre durante 


Febr. dur. 


During the fever. 


Febris 


Febr. 


Fever. 


Femoribus internis 


Fern, intern. 


To the inner thighs. 


Fervens 


Ferv. 


Boiling. 


Fac cataplasmatem 


Ft. cataplasm. 


Make a poultice. 


Fiat ceratum 


Ft. cerat. 


Let a cerate be made. 


Fiant chartulse xij 


Ft. chart, xij 


Let 12 powders be made. 


Fiat collyrium 


Ft. collyr. 


Let an eye-wash be made. 


Fiat emplastrum ves- 


Ft. emp. vesic. 


Let a blister be made. 


icatorium 






Fiat emulsio 


Ft. emuls. 


Let an emulsion be made. 


Fiat enema 


Ft. enema. 


Let an enema (an injection for the 
rectum) be made. 


Fiat injectio 


Ft. inject. 


Let an injection (for the urethra) 
be made. 


Fiat lege artis 


F. L. A. 


Let it be made by the rules of art. 


Fiat massa, et divide 


Ft. mas. div. in pil. 


Let a mass be made, and divide it 


in pilulas xij 


xij 


into 12 pills. 


Fiant pilulse xij 


Ft. pil. xij 


Let 12 pills be made. 


Fiat pulvis 


Ft. pulv. 


Let a powder be made. 


Fiant pulveres xij 


Ft. pulv. xij 


Let 12 powders be made. 


Fiat pulvis in chartu- 


Ft. pulv. in chart, xij 


Let a powder be made to be divided 


las xij dividenda 


div. 


into xij little papers. 


Fiat solutio 


Ft. sol. 


Let a solution be made. 


Fiant suppositoria iv 


Ft. suppos. iv 


Let 4 suppositories be made. 


Fiant trochisci xxiv 


Ft. troch. xxiv 


Let 24 troches be made. 


Fiat unguentum 


Ft. ung. 


Let an ointment be made. 


Fiat venesectio 


Ft. venesec. 


Let a bleeding be done. 


Fictilis 


Fict. 


Earthen. 


Filtra 


Filtra 


Filter (thou). 


Filtram, Filtrum 


Filt. 


A filter. 


Fistula armata 


Fistul. arm. 


A syringe ready for use. 


Fluidus 


Fluid., Fl. 


Liquid. 


Formula 


Form. 


A prescription. 


Frustillatim 


Frust. 


In small pieces. 


Fuerit 


Fuerit. 


Shall have been. 


Gargaiysma 


Garg. 


A gargle. 


Gelatina quavis 


Gelat. quav. 


In any kind of jelly. 


Gradatim 


Grad. 


By degrees, gradually. 


Grana sex pondere 


Gran, vj pond. 


Six grains by weight. 


Granum, Grana 


Gr. 


Grain, Grains. 


Gramme 


Grm. 


Gram. 


Gratus 


Grat. 


Pleasant. 



63 



754 



LIST OF LATIN WORDS, PHRASES, ETC. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Gutta, Guttae 


Gtt. 


A drop, Drops. 


Guttatim 


Guttat. 


By drops. 


Guttis quibusclam 


Gtt. quibusd. 


With a few drops. 


Harum pilularum 


Har. pil. sum. iij 


Let three of these t pills be taken. 


sumantur tres 






Haustus 


Haust. 


A draught. 


Haustus purgans 


H. p. n. 


A purgative draught after my own 


noster 




(formula). 


Hebdomada 


Hebdom. 


A week. 


Herba 


Herb. 


An herb. 


Herbarum recentium 


Herb, recent. 


Of fresh herbs. 


Heri 


Heri 


Yesterday. 


Hie, Haec, Hoc 


Hie, Haec, Hoc 


This. 


Hirudo 


Hirudo 


A leech. 


Hora 


H. 


An hour. 


Hora somni 


Hor. som. 


At the hour of sleep. 


Hora undecima ma- 


Hor. xj matut. 


At the eleventh hour of the morn- 


tutina 




ing. 


Horae decubitus 


Hor. decub. 


At bedtime. 


Horse unius spatio 


Hor. j spat. 


After one hour. 


Horis intermediis 


Hor. interm. 


In the intermediate hours. 


Idem 


Id. 


The same. 


Idoneus 


Idon. 


Proper. 


Imprimis 


Impr. 


First. 


Incide, Incisus 


Inc. 


Cut (thou), Being cut. 


In dies 


Ind. 


Daily, or From day to day. 


Infunde 


Infun. 


Pour in. 


Infusum 


Infus. 


An infusion. 


Injectio 


Injec. 


An injection. 


Injiciatur enema 


Injic. enem. 


Let a clyster be given. 


In pulmento 


In pulm. 


In gruel. 


Instar 


Instar 


As big as. 


Inter 


Inter 


Between. 


Internus, -a, -um 


Int. 


Inner, or Internal. 


Intus 


Intus 


Inwardly. 


Jam 


Jam 


Now. 


Julepus, Julepum, 


Jul. 


A julep. 


Julapium 






Jusculum 


Juscul. 


A broth. 


Juxta 


Juxta 


Near to. 


Kali praeparatum 


Kal. ppt. 


Prepared Potash, or the Carbonate 
of Potassium. 


Lac, Lactis 


Lac. 


Milk, of Milk. 


Lagena 


Lag. 


A flask, or bottle. 


Lana 


Lana 


Flannel. 


Languor 


Lang. 


Faintness. 


Lateri dolenti 


Lat. dol. 


To the painful side. 



LIST OF LATIN WORDS, PHRASES, ETC. 



755 



Word or Phrase. 


Contraction. 


English Equivalent. 


Lectus 


Lect. 


Abed. 


Libra 


Lb. or ft) 


A pound. 


Linimentum 


Linim. 


A liniment. 


Linteum 


Lint. 


Lint. 


Liquor 


Liq. 


A solution. 


Lotio 


Lot. 


A lotion. 


Macera 


Mac. 


Macerate. 


Magnus 


Mag. 


Large. 


Mane 


Mane 


In the morning. 


Mane primo 


Mane primo 


In the very early morning. 


Manipulus 


M. or Man. 


A handful. 


Manus 


Manus 


The hand. 


Massa 


Mass. 


A mass, or pill-mass. 


Matutinus 


Matut. 


In the morning. 


Medius 


Med. 


Middle. 


Mensura 


Mensur. 


By measure. 


Mica panis 


Mic. pan. 


Crumb of bread. 


Minimum 


M. or Min. 


A minim. 


Minutum 


Minut. 


A minute. 


Misce 


M. 


Mix. 


Mistura 


Mist. 


A mixture. 


Mitte 


Mit. 


Send. 


Mittatur 


Mit. 


Let (it) be sent. 


Mittantur 


Mit. 


Let (them) be sent. 


Mitte sanguinem ad 


Mit. sang, ad uncias 


Take away blood to 12 ounces at 


uncias duodecim 


xij salt. 


least. 


saltern. 






Modicus 


Modic. 


Middle-sized. 


Modo praescripto 


Mod. praesc. 


In the manner prescribed. 


Mora 


Mora 


Delay. 


More dictu 


Mor. diet. 


In the manner directed. 


More solito 


Mor. sol. 


In the usual manner. 


Morturarium 


Mort. 


A mortar. 


Ne tradas sine num- 


Ne tr. s. num. 


Do not deliver without the money. 


mo 
Necnon 


Necn. 


Also. 


Nisi 


Nisi 


Unless. 


Non 


Non 


Not. 


Non repetatur 


Non repetat. 


Let it not be repeated. 


Noc, Noctis 


Noc, Noct. 


The night, of the night. 


Nocte maneque 


Noct. maneq. 


At night, and in the morning. 


Nucha 


Nucha 


The nape of the neck. 


Numero 


No. 


In number. 


Numerus 


No. 


Number. 


Nux Moschata 


Nux Mosch. 


A nutmeg. 


Octarius 


O., Oct. 


A pint (gxvj). 


Octavus 


Octav. 


Eighth. 



756 



LIST OF LATIN WORDS, PHRASES, ETC. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Octo 


Octo 


Eight. 


Oleum Lini sine igne 


01. Lini sine ig. 


Cold-drawn Linseed Oil. 


Oleum olivae opti- 


Ol. 0. opt. 


Best olive oil. 


mum 






Omni hora 


Omn. hor. 


Every hour 


Omni bihorio 


Omn. bih. 


Every two hours. 


Omni quadrante horae 


Omn. quadr. hor. 


Every j^ hour. 


Omni mane 


Omni mane 


Every morning. 


Omni nocte 


Omn. noct. 


Every night. 


Opus 


Opus 


Need, or occasion. 


Ovum 


Ov. 


An egg. 


Pan n us 


Pan. 


A rag. 


Pars, Partis 


Par., Pt. 


A part, Of a part. 


Partes aequales 


Pt. aeq. 


Equal parts. 


Partitis vicibus 


Part. vie. 


In divided doses. 


Parvulus 


Parvul. 


An infant, A parvule. 


Parvus 


Parv. 


Little. 


Pastillus, Pastillum 


Pastil. 


A Pastille. 


Pediluvium 


Pediluv. 


A foot-bath. 


Penicillum cameli- 


Penicil. cam. 


A camel's-hair pencil, or brush. 


num 






Per 


Per 


Through, By. 


Peracta operatio 


Peract. operat. emet. 


When the action of the emetic is 


emetici 




finished. 


Per deliquium 


Per deliq. 


By deliquescence. 


Per fistulam vitream 


Per ristul. vit. 


Through a glass tube. 


Pergo, Pergere 


Perg. 


To go on with. 


Phiala prius agitata 


P. P. A. 


The bottle having been first shaken. 


Phiala 


Phil. 


A vial, or bottle. 


Pilula 


Pil. 


A pill. 


Poculum 


Pocul. 


A cup. 


Pocillum 


Pocill. 


A little cup. 


Pondere 


P. 


By weight. 


Pondus civile 


P. civ. 


Civil weight (avoirdupois). 


Pondus medicinale 


P. med. 


Medicinal weight. 


Pone aurem 


Pone aur. 


Behind the ear. 


Post singulas sedes 


Post sing. sed. liq. 


After every loose stool. 


liquidas 






Potus 


Potus 


Drink. 


Praeparata 


Praep. 


Prepared. 


Primo mane 


Primo mane 


Very early in the morning. 


Primus 


Primus 


The first. 


Pro 


Pro 


For. 


Pro ration e aetatis 


Pro rat. aet. 


According to the age of the patient. 


Pro re nata 


P. r. n. 


Occasionally. According to cir- 
cumstances. 


Pugillus 


Pug. 


A pinch. 



LIST OF LATIN WORDS, PHRASES, ETC. 



757 



Word or Phrase. 


Contraction. 


English Equivalent. 


Pulmento 


Pulm. 


Gruel. 


Pulvis 


Pulv. 


A powder. 


Pulverizatus 


Pulvz. 


Powdered. 


Pyxis 


Pyxis 


A pill-box. 


Quadrans, — antis 


Quad. 


A quart. 


Quantum libet 


Q. lib. 


As much as you please. 


Quantum placet 


Q.p. 


<< tt a tt tt 


Quantum vis 


Q.v. 


<« tt n tt a 


Quantum volueris 


Q. vol. 


a a a <i a 


Quantum sufficiat 


Q.s. 


As much as is sufficient. 


Quantum satis 


Q.s. 


t* tt tt tt tt 


Quaqua hora 


Qq. hor. 


Every hour. 


Quaque 


Qq. 


Each, or Every. 


Quartus 


Quart * 


Fourth. 


Quater 


Quater 


Four times. 


Quatuor 


Quat. 


Four. 


Quibus 


Quibus 


From which. 


Quinque 


Quinq. 


Five. 


Qumtus 


Quint. 


The fifth. 


Quoque 


Q.q. 


Also. 


Quorum 


Quor. 


Of which. 


Quotidie 


Quotidi 


Daily. 


Ratio 


Ratio 


Proportion. 


Recens, -entis 


Rec. 


Fresh. 


Recipe 


R 


Take. 


Redactus in pulverem 


Red. in pulv. 


Let it be reduced to powder. 


Redigatur in pulve- 


Redig. in pulv. 


it tt a 


rem 






Regio umbilici 


Reg. umbil. 


The umbilical region. 


Reliquus 


Reliq. 


Remaining. 


Repetatur 


Rept. 


Let it be repeated. 


Repetantur 


Rept. 


Let them be repeated. 


Respondere 


Respond* 


To answer. 


Retinere 


Retin. 


To keep. 


Saltern 


Saltern 


At least. 


Saturatus, -a, -um 


Sat. 


Saturated. 


Scatula 


Scat. 


A box. 


Scilicet 


Scil. 


Namely. 


Scrupulum 


Scrup. or 9 


A scruple (20 grains). 


Secundum artem 


S. A. 


According to art. 


Secundum naturam 


S.N. 


According to nature. 


Secundus 


Secund. 


Second. 


Sedes 


Sed. 


The alvine evacuation. 


Semel 


Semel 


Once. 


Semis, or Semissis 


Ss. 


A half. 


Semi-drachma 


Semidr. 


Half a drachm. 


Semi-hora 


Semih. 


Half an hour. 



758 



LIST OF LATIN WORDS, PHRASES, ETC. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Septem 


Sept. 


Seven. 


Septimana 


Septiml. 


A week. 


Sesuncia 


Sesunc. 


An ounce and a half. 


Sesquihora 


Sesqh. 


An hour and a half. 


Sex 


Sex 


Six. 


Sextus 


Sext. 


Sixth. 


Si 


Si 


If. 


Signa 


Sig. 


Write, or Mark (thou). 


Signetur nomine pro- 


Sig. nom. prop. 


Let it be written upon with its 


prio 




proper name. 


Simul 


Simul 


Together. 


Sine 


Sin. 


Without. 


Singularum 


Sing. 


Of each. 


Singulorum 


Sing. 


Of each. 


Si non valeat 


Si. non val. 


If it does not answer. 


Si opus sit 


Si op. sit 


If necessary. 


Si vires permittant 


Si vir. perm. 


If the strength will bear it. 


Sit 


Sit 


Let it be. 


Solus 


Sol. 


Alone 


Solve 


Solv. 


Dissolve. 


Solvo, Solvere 


Solv. 


To dissolve. 


Solutus 


Solut. 


Dissolved. 


Somnus 


Somnus 


Sleep. 


Spiritus vini rectifica- 


wSpt. vin. rect. 


Rectified spirit of wine {i.e. Alco- 


tus 




hol). 


Spiritus vini tenuis 


Spt. vin. ten. 


Proof spirit. 


Spiritus vinosus 


Spt. vinos. 


Ardent spirit (of any strength). 


Statim 


Stat. 


Immediately. 


Stet, or Stent 


St. 


Let it (or them) stand. 


Stratum superstratum 


s. s. s. 


Layer upon layer. 


Subactus 


Subact. 


Subdued. 


Sub finem coctionis 


Sub fin. coct. 


When the boiling is nearly finished. 


Subinde 


Subind. 


Frequently. 


Sumat talem 


Sum. tal. 


Let him take one like this. 


Sume 


Sum. 


Take. 


Sumat 


n 


Let him take. 


Sumatur 


u 


Let it be taken. 


Sumantur 


« 


Let them be taken. 


Sumendus 


n 


To be taken. 


Summitates 


Summit. 


The summits. 


Superbibendo haus- 


Sup. bib. haust. 


Drinking afterwards this draught. 


tum 






Supra 


Supra 


Above. 


Tabella 


Tab. 


A lozenge. 


Talis 


Tal. 


Such a one. 


Tempori dextro 


Tempor. dext. 


To the right temple. 


Tempus, -oris 


Temp. 


Time, or Temple. 



LIST OF LATIN WORDS, PHRASES, ETC. 



759 



Word or Phrase. 


Contraction. 


English Equivalent. 


Ter 


Ter 


Thrice, or Three times. 




Ter in die, or Ter 


T. i. d., or T. d. 


Thrice daily. 




die 








Tere 


Tere 


Rub. 




Tere simul 


Tere sim. 


Rub together. 




Tero 


Tero 


I rub. 




Tertius 


Tert. 


Third. 




Tinciura 


Tinct. or Tr. 


Tincture. 




Tinctune Herbarum 


Tinct. Herb. Recent. 


Tinctures of Fresh Herbs. 




Recentium 








Tres 


Tres 


Three. 




Triduum 


Trid. 


Three days. 




Tritura 


Trit. 


Triturate. 




Trochiscus, Tro- 


Troch. 


A lozenge or troche, Lozenges 


or 


chisci 




troches. 




Tussis 


Tus. 


A cough. 




Ultimo (or Ultima) 


Ult. prcesc. 


The last ordered. 




praescriptus 








Una 


Una 


Together. 




Uncia 


Unc. or £ 


An ounce. 




Ut dictum 


Ut diet. 


As directed. 




Utendum 


Utend. 


To be used. 




Uto, Uti 


Uto, Uti 


To make use of. 




Ya> vitreum 


Vas vit. 


A glass vessel. 




Vehiculum 


Vehic. 


A vehicle, or menstruum. 




Vel 


Vel 


Or. 




Venaesectio brachii 


Yenaesec. brach. 


Bleeding in the arm. 




Vesper, -eris 


Ye>p. 


The evening. 




Vices 


Vic. 


Turns. 




Vinum 


Vin. 


Wine. 




Vires 


Vir. 


Strength. 




Vitellus 


Vitel. 


Yolk. 




Vitello ovi Solutus 


Vitel. ovi Sol. 


Dissolved in the yolk of an tgg. 




Vitellus ovi 


Vitel. ovi 


Yolk of egg. 




Vitreum, Vitrum 


Vitr. 


Glass. 




Vomitione urgente 


Vom. urg. 


Vomiting being severe. 





Note. — For the dangerous abbreviations, see ante, page 475, under the title 
Prescription Writing. 



760 



HYPODERMIC FORMULA. 



HYPODERMIC FORMULA. 



Apomorphine. 

R . Apomorphinae Muriat., 

Div. in pulv. xvj. One to 
-mjcx of water as required. 



g r - J- 
four in 



Aqua-puncture. 

R. Aquae Destillatae, . • j§j< 

Sig. — ^ss-^j as an injection. 



Arsenic. 



R . Liq. Potassii Arsenitis, q. s. 
Sig. — Tr\.ij-x, hypodermically. 



R . Liq. Arsen. et Hydr. Iodidi, q. s. 
Sig. — rn.v-xx, hypodermically. 



Amyl Nitrite, 

R. Amyli Nitrit., . . 5jj. 

Sig. — rrtiij-v at a dose, which may 
be repeated in £ an hour if necessary. 



Atropine. 



R 



Atropinae Sulphatis, . gr. ij. 

Aquae Destillatae, . . §j. 
Solve. Sig. — For hypodermic use, 

■mjij = g r - A» mU =gr. nhs- 



Caffeine, 



R . Caffeinae Citratis, . gr. xxiv. 

Aquae Destillatae, . gj. 
Solve. Sig. — Trtxx contain gr. j. 



Carbolic Acid. 

R. Ac. Carbol. Purif., . . gr. x. 
Aquae Destil., . . . Jj. 
M. Sig. — TTtviij contain gr. £ of 
the acid, which may be given up to 
gr. ij or iij. 



Chloral. 



R 



Chloralis Hydratis, . 
Aquae Destil., . 
M. Sig. — m_xxx contain gr. 
Chloral Hydrate. 



3 1V * 
xv of 



Chloroform. 

R. Chloroformi Purif., . . gss. 
Sig. — ntv-xv can be used at one 
deep injection. (See ante y page 675.) 
The spirit is safer, in somewhat larger 
doses. 



Conine. 



R . Coninae Hydrobromat., . gr. 
Aquae Destillat., . . Jj, 
M. Sig. — Trj,x contain gr. ^. 



Cocaine. 



R t Cocainae Hydrochlorat., . gr. 

Aquae Destillatae, . • " Sl« 

Solve. Sig. — myj contain gr. ss. 



Curare. 

R. Cufarae (Merck), . . gr. j. 
Acidi Acetici, . . . tit v. 
Aquae Destillatae, . ad ttic. 
M. et filtra. Sig. — ntx contain 

g r - tV 



HYPODERMIC FORMULA. 



76l 



Curare. — ( Continued.) 

R . Curarinae Sulphat., . . gr. j. 
Aquae Destillat., . . gss. 
M. Sig. — Tn_iv contain gr.. 3^. 



Daturine. 



R . Daturinae, . . . gr. ss. 
Aquae Destil., . . . §j. 
Solve. Sig. — Tnjv contain gr. ^J^. 
Dose, rnjv-x. 



Digitaline. 



gr. ss. 



R . Digitalinae, 

Alcoholis, 

Aquae Destil., . aa ^ij. 

Solve. Sig. — -nxiv contain gr. T |^. 
Dose, miv-viij. 



Duboisine. 



R . Duboisinae Sulphat., . . gr. j. 
Aquae Destil., . . . Jj. 
M. Sig. — nxiv contain gr. r J^. 



Ergot and Ergotine. 

R. Extr. Ergotae Fluid., . 
Filtra. Sig. — Dose, ttt.x. 



gss. 



R. Extracti Ergotae (Squibb), . zj. 
Aquae Destillat., . . • 3J- 
Solve et filtra. Sig. — Trix contain 
gr. j. Dose, ttix-xx. 



Eserine. 



R . Eserinae Hydrochlor. 
Aquae Destil., 



g r -J- 
giv. 



Solve. Sig. — ntiv contain gr. -fa. 



Hydrocyanic Acid. 

Be. Acidi Hydrocyan. Dil., q. s. 
Sig. — 7Ti.iv, a maximum dose. 



Hyoscyamine. 

R . Hyoscyaminae, . . gr. j 

Ac. Sulphur. Dil., . . ttt. v . 
Aquae Destil., . . . ^j. 

M. Sig. — TTiv contain gr. ^. 



Mercury. 

R. Hydrarg. Chlor. Corr., . gr. j. 
Aquae Destillat., . . gj. 
M. Sig. — t»ix contain gr. -fa. 



oJ ss - 
3Jss. 

3 V - 



R. Hydrarg. Chlor. Corrosivi, 

Ammonii Chloridi, . aa gr. iij. 
Misce et solve in — 

Aquae Destillatae, . 
Dein adde — 

Albuminis Ovi, 

Aquae Destillatae, . 
Filtra, et adde — 
Aquae Destil., . q. s. ad ^x. 
Sig-— rnj contains gr. ^. Dose, 
Tnjij-x. 

R. Hydrarg. et Sodii Iodidi, gr. iij. 

Aquae Destillatae, . . ^iijss. 

Solve. Sig. — nix contain gr. J. 
Dose, rn.x every second day. 



Morphine. 

R. Morphinae Sulphatis, . gr. xvj. 
Aquae Destillatae, . . gj. 
Solve et filtra. Sig, — irivijss con- 
tain gr. £. (Magendie's.) 



gr. xvj, 
ttinj. 



R. Morphinae Sulphatis, 
Acidi Carbolici, 
Aquae Destillat., . 
Solve et filtra. Sig. — rrtvijss con r 
tain gr. \. 

{Antiseptic Magendie's.} 



64 



762 



HYPODERMIC FORMULA 



Morphine and Atropine. 

R. Morphinae Sulphatis, . gr. xvj. 
Atropinae Sulphatis, . gr. ss. 
Acidi Carbolici, . . "Hliij. 
Aquae Destillat., . . %). 
Solve et filtra. Sig. — TTivijss con- 
tain gr. I of Morphine Sulph., and 
gr. j^-q of Atropine Sulphate. 

(Potter.) 



R. Morphinae Sulphatis, . 
Atropinae Sulphatis, . 
01. Amygdalae Amar., 
Aquae Destillat., . 
Solve. Sig. — nix contain 



g r 
g r -j- 
gtt. j- 

g r - i 



XXIV. 



g r - 



1 
35 



Morphine Sulphate, and 
Atropine Sulphate. 

(Didama's Solution?) 



Pilocarpine. 

R. Pilocarpinae Nitratis, . gr. xvj, 
Aquae Destillat., . . gj. 
M. Sig. — ttlv contain gr. \. 



Potassium Iodide. 

R. Potassii Iodidi, . . . gj. 
Aquae Fontanae, , . giv. 

Solve. Sig. — Dose, ntvj-xx. 



Quinine. 

R. Quininae Disulph., 

Ac. Sulphurici Dil., 

Ac. Carbolici, . 

Aquae Fontanae, 
Solve. Sig. — £j contains gr. vj. 
(Lente). Is irritant. (B.) 



gr. 1 (5o). 

mc (100). 
mv (5). 



R. Quininae Hydrobrom., gr. xlviij, 
Aquae Destillat., . g\v. 

Solve. Sig. — ""Ixx contain gr. iv. 



R . Quininae Bimur. Carbamidat., 

Aquae Destillatae, . aa £iv. 
Solve. Sig. — th,x contain gr. v. 



Strychnine. 

R . Strychninae Sulphat., . gr. j 
Aquae Destillatae, . . gj. 
Solve sine alcohol. Sig. — ntx con 
tain gr. ^. 



R. Strychninae Sulphatis, . gr. j. 

Aquae Destillatae, . . lUccl, 

Solve. Sig. — niv contain gr. -£$, 
Dose, tn.v-viij. 



Notes. — Solutions for hypodermic use should be neutral in reaction, neither 
acid nor alkaline; and freshly prepared, especially solutions of the alkaloids, 
which develop a penicillium^ which grows at the expense of the alkaloid. 
Aqua Fontanel, if filtered, is a better menstruum than Aqua Destillata which 
has been kept for a week, and frequently exposed to the atmosphere. To run 
the least risk of producing a sore at the point of injection, use very fine 
needles, and deliver the injection into the areolar tissue beneath the skin, 
instead of into the skin, as lay parties generally do for themselves. I have 
given injections of Morphine and Atropine to a dying girl 3 and 4 times daily 
for two months, and never produced a sore. Always force out all fluid, and 
wipe the needle-point dry between the fingers, before returning it to the case ; 
the sebaceous matter on the fingers keeping it free from rust. There is an 
area of several inches square, on the upper and exterior aspect of the thigh, 
just below the great trochanter of the femur, which is remarkably insensible, 
being sparingly supplied with cutaneous nerves. (See Fig. 307, Gray's Anat- 
omy -, 10th English edition.) An injection delivered in this area will not be 
felt by the patient. Avoid puncturing a vein ; if you do so, watch the patient 



GENITIVE CASE ENDINGS. 



763 



and prepare an injection containing gr. -^ of Atropine Sulphate, to administer if 
dangerous symptoms arise. Never, except under special circumstances, ad- 
minister the salts of Morphine or Atropine hypodermically to children less 
than 15 years of age. \Sanil O. L. Potter.'] 



GENITIVE CASE ENDINGS, ETC. 



Nom. 


Gen. 


Exceptions. 


a 


ae 


Cataplasma, Enema, Physostigma, Aspidosperma and Gargarysma, all 
have the genitive in -atis. Coca is unchanged, though the genitive 
Cocae is written by some authorities. Folia is plural, gen. Foliorum. 


us 
um 

OS 

on 


i 


Rhus, Rhois ; Flos, Floris : Bos, Bovis; Limon, Limonis; Erigeron, 
-ontis. 
Fructus, Cornus, Quercus, Spiritus, do not change. 


as 


atis 


Asclepias, -adis ; Mas, Maris. 


is 


idis 


Pulvis, -eris : Arsenis, -itis : Phosphis, -itis ; Sulphis, -itis, and all salts 
ending in -is, have genitive in -itis. * 





onis 


Mucilago, -inis ; Ustilago, -inis ; Solidago, -inis. 


1 


lis 


Fel, Fellis ; Mell, Mellis. 


en 
ps 
rs 

r 

X 


inis 
pis 
rtis 
ris 
cis 


Words which do not change in the Genitive. 

*Amyl. fCannabis. {Fructus. {Quercus. 
*Apiol. *Catechu. fDigitalis. *Sassafras. 
♦Azedarach. *Coca. fHydrastis. *Sago. 
fBerberis. *Cundurango. *Jaborandi. fSinapis. 
*Buchu. {Cornus. *Kino. {Spiritus. 
*Cajuputi. *Curare. *Matico. fSumbul. 

* Indeclinable. f 3d Declension. % 4th Declension. 

But some authorities give Apiolum, -i; Sumbul, -i; Amyl, Amylis; 
Coca, -ae. 



Verbs. 

The Verbs used in prescription-writing are nearly all in the imperative 
mood, giving directions to the compounder, and having their object in the 
accusative case. Such are — 



764 VERBS — PARTICIPLES — PREPOSITIONS. 

Adde, add. Fac, make. Recipe, take. 

Cola, strain. Filtra, filter. Signa, write. 

Divide, divide. Macera, macerate. Solve, dissolve. 

Extende, spread. Misce, mix. Tere, rub. 

A few verbs are found* in the subjunctive mood, taking their subject or 
predicate in the nominative case. The most usual are — 

Fiat, let be made. Bulliat, let boil. 

Fiant, let be made. Capiat, let take. 

Coletur, let be strained. Detur, let be given. 

Coloretur, let be colored. Dividatur, let be divided. 

Sumatur, let be taken. Sit, let it be. 



Participles. 

Participles or Verbal Adjectives are occasionally used, and should agree 
with their respective nouns in gender, number and case. Such are the 
following, viz. — 

Dividendus, -a, -urn, to be divided. 
Sumendus, -a, -nm, to be taken. 
Adhibendus, -a, -um, to be administered. 



Prepositions. 

Those in the first column require the noun following to be in the accusa- 
tive case, — those in the second column require the ablative case. 

Ad, to, up to. Cum, with. 

In, into. Pro, for. 

Supra, upon. Sine, without. 

Ana, of each, — governs the genitive case. 



Sundry Words and Phrases, in most frequent use. 

Bene, well. Non, not. Ad saturandum, to satura- 

tion. 
Bis, twice. JVumerus, number. Numero, to the number of. 

Quantum sufficiat, as much as 
Deinde, Dein, thereupon. Octarius, a pint. necessary. 

Pro re natd, according to 
Et, and. Semel, once. need. 

In partes (Equates, into equal 
Gradatim, gradually. Simul, together. parts. 

Redactus in pulverem, let be 
Guttatim, by drops. Statim, at once. pulverized. 

Secundum artem, according 
In dies, daily. Ter t thrice. to art. 



CHLORODYNE. 



765 



CHLORODYXE. 



A COMPARISON OF ITS INGREDIENTS. ACCORDING TO TEN 
FORMULA THEREFOR, THE QUANTITIES BEING CAL- 
CULATED FOR EACH FORMULA TO A FOUR- 
OUNCE MIXTURE, OR tti 1920. 



Quantity of each article in a 5iv mixture as per the 


formulae of 




J_ 






* 




• 

- 


— 

.5 
g 


— - 
- 
V 

— 

C 

2 


d 

s. 

5 
■ 


■ 
— 


* 

a 
U 

« 


5= 

— 
— 


a 

a 

— 
— 


B 

ei 
S 


— 
— 
z 




s. 


X 


u 


p 


z 


— 


^ 


~ 


C3 


s 



Articles. 



Morphine Muriate gr. 

Chloroform TTL 

Chloral gr. 

Ether TTI 

Cannabis Indica, Tinct. TTL 

Cannabis Indica, Extr gr. 

Hydrocyanic Acid, 2 p. c TTL 

Of. Menthae Pip.... TTL 

Capsicum, Fluid Extr TTL 

Capsicum, Tinct TTL 

Capsicum, Oleo- res TTL 

Alcohol TTL 

Hydrochloric Acid TTL 

Sugar. Burnt gr. 

Glycyrrhizae. Extr — gr. 

Acacia. Mixture TTL 

Tragacanth, lfuci1._ T!\ 

Theriaca. or Syr. Fusci TTL 

Syrup TTL 

Glycerin TTL 

-assafrasCo TTL 

Aqua TTL 



1 
236 

59 



::: 

2 



16 16 33 
192 240 372 



* 



1:2 
6 



236 



■9° 



Bra 



147 .. 



236 
1033 



Total No. of Minims. 



Adult Dose. 



Morphine in TTLxv. 



m 



r- 



760 

7*> 

818 



33H 

375 



'--'- -i~- 



4 

126 



:- 
8 



3" 

1010 
62 



14 l6 I^y 

207 24O 247 

I20 62 

207 20 



126 



128 



+2 

7 

7 

'690 



903 



Hi ::. 



123 

2 



247 



154 






fa 



6a 



62 

495 



M4 

495 



2 
120 
120 

"80 



So 
4 

'5 



:_=:: 



1920 1920 1920 1920 1920 1920 1920 1920 1920 1920 



5-10 5-30J 3- IO ( 5- J 5 5-3° 5"3° 5-15 6° I2 ° 



Tk H % X K A H 



Tk 



Note. — See ante, page 140, for remarks on this preparation, and the number of formulae 
representing iL 

* Author of "A Companion to the Br. Pharmacopoeia. " 
f See Hartshorne's M Essentials," 5th ed., p. 625. 
% Made by Eli Lilly & Co., Indianapolis. ** Parke, Davis & Co., Detroit. 

\ 2d ed, page 430, tt Elixir Chloroformi Compositus (McNutt). 



766 



PATENT MEDICINES. 



* PATENT MEDICINES. 

Note. — These formulae have been published from time to time in various 
journals and formularies, and are supposed to represent the preparations 
designated. The name of the author is appended in each case when known. 



a 



Ayer's Cherry Pectoral. 

Morphinae Acetat., . gr. i 

Vini Antim. et Potass. Tartrat. 
Vini Ipecacuanhae, aa^iij. 

Tinct. Sanguinariae, . zij. 
Syr. Pruni Virginian., . Jiij. 



Pierce's Golden Discovery. 



»J- 



a 



Brandreth's Pills. 

. Podophylli Radicis, . gr. x. 

Extracti Podophylli, . gr. x. 

Extr. Phytolaccae Baccae, gr. xxx. 

Pulv. Caryophylli, . gr.x. 

Cambogiae, . . . gr. ij-v. 

Ol. Menthae Piperitae, . mjij. 

Croci, . . . gr. ij. 

Misce, fiat massa, et div. in pil. xxiv. 

[Hager.) 



R 



Hamburg Tea. 

Sennae Foliorum, 
Mannae, 
Coriandri, . 



pt. vnj. 
pt. iv. 
pt.j. 



R. 



Hamlin's Wizard Oil. 

Spt. Camphorae, 

Spt. Ammoniae, 

Olei Sassafras, 

Olei Caryophylli, 

Chloroformi, 

Olei Terebinthinae, . 

Alcoholis, 



S. 



aa t ^ss. 
- &)• 

aa .^ss. 



R. 



Perry Davis's Pain Killer. 

Tinct. Capsici, . . . 5j. 
Spt. Camphorae, . • o^* 
Guaiaci Resinae, . . ^ss. 
Alcoholis, . . . 3iij. 

Tict. Myrrhae, q. s. ad coloret. 



J. Ext. Lactuci, . 


. 5J- 


Mellis, . 


!2* 


Tinct. Opii Deodorat. 


. gss. 


Alcoholis Diluti, 


• §"*• 


Aquae, 


• 3«j- 




{Hager.) 


Pierce's Favorite Prescription. 


J. Sabinae, Cinchonas, 




Agarici Albi, 


aagij. 


Cinnamomi, . 


. gr. xv. 


Coq. in aq. suff., ut ft. 


de- 


coct., 


. gviij. 


Deinde cola, et adde — 




Sacchari Albi, 


. gss. 


Acaciae, 


• 3J- 


Solve, et addantur — 




Tinct. Opii Deodorat. 




Tinct. Digitalis, . 


aa Zss. 


01. Anisi, gtt. viij, in Al- 


coholis, 


• piss. 


Misce. 


{Hager.) 



Van Buskirk's Sozodont. 



R. 



z,ss. 



Saponis Albi, . 

Alcoholis, 

Aquae, 

Glycerini, 

Olei Gaultheriae, 

Olei Caryophylli, 

Olei Menthae Piperitae, 

aa q. s. ad saporem grat. 
Cocci Cacti, q. s. ad coloret. 



R. Calcis Praecipitat., 
Magnesii Carbonatis, 
Iridis Florent. Radicis, 

aa p. aeq. 
M. et trit. {Hoffmann, 



THE TREATMENT OF POISONING. 



767 



Hostetter's Bitters. 



R 



K. 



Sacchari Albi, 




Aurantii Corticis, 




Calami, 




Cinchonae, 




Gentianae, 




Calumbse, 


aa ibj. 


Rhei Pulv., . 


• giv. 


Cinnamomi, . 


• m- 


Caryophylli, . 




Alcoholis Diluti, 


. Cij. 


(Med. Bulletin, 1884.) 



M 



Rad way's Ready Relief 

Tinct. Capsici, 
Aquas Ammonias, 
Alcoholis, 
Linimenti Saponis, 



aa 



§?:. 

• S n J- 

(Hager.) 



Rad way's Resolvent. 

R . Villi Zingiberis, 

Vini Cardamomi, . aa t ^iij. 

Sacchari Albi, . . . q. s. 

M. (Hager.) 



R 



"Walker's Vegetable Vinegar 


Bitters. 




c. Aloes Socotrin., 


• Z [ 'h 


Guaiaci Resinae, 


^iv. 


Sassafras Mucil., 


. §j. 


Aceti, 


. 3ij. 


Aquae, 


. q. s. 


Coque, et ft. decoctum, 


ad 5xix, 


deinde cola, et addantur — 


Sodii Sulphatis, 


■ &• 


Acaciae, . 


. SU- 


Spt. Anisi, 10 p. c, . 


• #j- 


Alcoholis, 


• S- 


M. Dose 31J. 


(Eberback.) 



Note. — For St. Jacob's Oil, see ante, page 40 ; and for Laville's Anti- Gout 
Re?nedy y see page 157. 



THE TREATMENT OF POISONING. 



The most energetic poisons are Hydrocyanic Acid, some reptile poisons, 
Strychnine, and Nicotine. (See pages 29,271, 372.) Those usually selected 
for criminal purposes are Arsenic, Colchicum, and Tartarized Antimony, the 
symptoms of which resemble those of natural disease. 

General Principles of Treatment. JeaunePs General Antidote. — R . 
Liq. Ferri Sulphatis (sp. gr. 1.45) ^ijss ; Magnesias Calcinat. ^ij ; Carbonis 
Animalis gj ; Aquae §xx. The ingredients should be kept separate — the so- 
lution of the sulphate in one vessel, the others together. When needed, the 
former should be added to the latter and violently agitated. Dose, gjss-^iij. 
This is a perfect antidote to Arsenic, Zinc, Digitaline, etc. It delays the 
action of salts of Copper, Morphine, and Strychnine, and slightly influences 
compounds of Mercury. It is valueless for Cyanide of Mercury, Tartar 
Emetic, Hydrocyanic Acid, Phosphorus, or the caustic Alkalies. 

Bellini, of Florence, considers the Iodide of Starch a valuable antidote to 
alkaline Sulphides, earthy Sulphides, vegetable and caustic Alkalies, and Am- 
monia. In the first two cases, he considerers it superior to all other antidotes. 

A fresh mixture of the Sulphide of Iron, Magnesia, and the Sulphide of 
Sodium, is a perfect antidote for salts of Copper, the Bichloride of Mercury 
(Corr. Sub.), and the Cyanide of Mercury. 

If the nature of the poison is unknown, a harmless yet in most cases effect- 
ual antidote is : R . Magnesias, Carbonis Ligni, Ferri Oxidi Hydrati, aa 
partes aequales ; Aquae q. s. Give ad libitum. 



768 THE TREATMENT OF POISONING. 

Castile Soap, dissolved in 4 times its bulk of hot water, drunk by the cupful, 
is one of the best remedies in many cases, especially poisoning with metals, 
corrosive acids, or corrosive vegetable substances. It is injurious in cases of 
alkali poisoning. 

Albumen. White of egg, dissolved in water, is especially useful for me- 
tallic substances. Vinegar, for alkalies, and many narcotics. Coffee, made 
strong (black), in general antidoting narcotic poisons. Ca?nphor, the princi- 
pal antidote to all vegetable poisons, especially the corrosive. Milk. Oil, 
Mucilaginous Szibstances, for corrosive acids, and alkalies. Charcoal, for 
Arsenic, Corrosive Sublimate, etc. 

Emetics. — Zific Sulphate is the best(R.); gr. v-gss ; is non-nauseating. 
Apomoiphine, gr. ^ hypodermically, when narcosis prevents administration 
by stomach. For children, Antim. Tart. gr. ^,in a little sweetened water. 
Use but little water in mixing the antidotes. 

Antidote Bag, designed by Martindale of London, contains the following- 
named articles, labeled with directions for use, viz. — 

Dialysed Iron. Spt. Ammoniae Aromat. Amyl Nitrite. 

Syrup of Chloral. Oil of Turpentine. Zinc Sulphate. 

Chloroform. Acetic Acid. Ipecacuanha. 

Spt. Chloroformi. Tinct. Digitalis. Potassium Bromide. 

Calcined Magnesia. Tannic Acid. 

Also a Hypodermic Syringe and Solutions therefor of — 

Morphine Acetate. . , . Pilocarpine Nitrate. 

Ai • c 1 1, ^ Apomorphine. c , , " x . 

Atropine Sulphate. » v S.rycnn ne Nitrate. 

Acids. Alkalies, for those least irritating. Magnesium Oxide, Slaked Li?ne y 
chalk, or magnesia ; plaster from wall, with water, milk, oil, white of egg. 
Bland mucilaginous and oily fluids, and poultices (R.). Acetic. — Magnesia, 
or its carbonates. Arsenious; see Arsenic Carbolic. —Stomach-pump; a 
strong solution of the official Syrup of Lime. Atropine is a good physiologi- 
cal antagonist (B.). Characteristic symptoms, very dark, black urine. When 
used locally to excess, apply a strong solution of Sodium Carbonate ; also as 
a wash for the mouth, if necessary. Carbonic ; see Gas. Hydrocyanic 
(Dilute). — rrtxl have killed. Ammonia, in any form ; cold douche ; Calcium 
or Sodium Chloride, gtt. xxx-xl, in water; Aqua Chlori is the antidote. In- 
halations of Chlorine or Ammonia; artificial respiration. MURIATIC, NlTRlC, 
or Sulphuric. — Albumen, Carbonate of Magnesium, Calcium, Potassium, or 
Sodium, Chalk, Soap, or whiting, in milk ; Oil. No water in Sulphuric cases. 
Oxalic. — Calcium Ca?-bonate the antidote (R.); Magnesium Oxide (R.). 
Prepared Chalk, plaster from ceiling, or common whiting, made into a creamy 
paste with a little water. Biand mucilaginous drinks, and poultices to the 
abdomen. Avoid potash or soda, and all alkaline carbonates. " Salts of 
Lemon," or of" Sorrel," is Potassium Oxalate, used for removing ink stains; 
it should be treated as Oxalic Acid. 

Aconite (compare Belladonna). Stimulants, emetics, Castor-oil or other 
purgatives ; powdered animal Charcoal, in water ; coffee. Bland fluids, and 
poultices, for abdominal irritation. Digitalis, to restore heart's action (Fother- 
gill). 

Alcohol. [Compare Alcoholism and Delirium Tremens in Part III.] 
Cold water smartly sprinkled over face, or cold douche from a height on the 



THE TREATMENT OF POISONING. 769 

head (R.). Stomach-pump; warmth to cardiac and gastric regions, and ex- 
tremities. Artificial respiration. 

Alkaloids. Tannic Acid, holds a high place (P.). 

Alkalies. Dilute Acids, especially Vegetable Acids; fixed oils (R.). 
Vinegar unites with them, producing innocuous acetates (L. ). 

Alum. Ammonium, or Potassium Carbonates, etc. 

Ammonium. ( Common Sources of Danger, Spt. of Hartshorn, Smell- 
ing Salts, Liquor Ammonia? kept for cleaning purposes by housekeepers.) 
Vinegar, Lemon-juice, Orange-juice, followed by demulcents. If vapor has 
been inspired, inhale Acetic or Hydrochloric Acid. 

Antimony. Alkalies, Tannin, or strong tea and coffee (R.). Astringent 
infusions ; Magnesium and Sodium Carbonates ; milk ; large draughts of warm 
water; emesis by tickling ; Magnesia in milk, especially for Chloride of Anti- 
mony. Tannic Acid especially valuable (P.). 

Arsenic (Arsenious Acid). Gr. ij have been fatal. Magnesium Bicarbo- 
nate, or other alkalies (R. ). Charcoal t ^ss, or more (R.). Magnesium Oxide 
(R.). Emesis by Zinc Sulphate %) (avoid tartar emetic), or by feather tick- 
ling. Albumen. Oil and Lime-water mixed (Taylor), before and after emesis. 
Milk or other bland fluids to aid emesis in washing stomach. Castor-oil after 
emesis. Linseed-tea and Magnesia. Dialysed Iron is a good antidote, espe- 
cially for chronic poisoning. After free emesis, the Ferri Oxidum Hydratum 
(add Liq. Ammon. to Tinct. of Iron) ; Ferri Subcarbonate just as good; ^ij 
followed by Ol. Ricini (Leale) ; or Hydrated Magnesia; or Magnesia and 
sugar (Carl), as antidotes. Poultices and fomentations over abdomen. Com- 
mon sources of danger are arsenical wall-papers, arsenic mistaken for " salts " 
or " magnesia," or adulerated confectionery ; Paris Green ( Arsenite of Copper) 
taken with suicidal intent. 

Barium. Fixed oils; Calcium, Magnesium, Potassium, or Sodium Sul- 
phates. 

Belladonna, or Atropine (Compare Aconite). Opium a direct antidote, 
gtt. iij-v, or more. Brandy, astringent infusions, Coffee. Cold to head, elec- 
tricity, flagellation, pepper. Alkalies, especially Magnesium Bicarbonate, in 
poisoning by alkaloids (R.). Ammonia, breathed into air-passages (R.). 
Charcoal, §ss or more necessary (R.). Physostigma possibly (R.). 

Bees and Insects. Aq. Ammonias, solution of Sodium Bicarb., or Chlo- 
ride, or Carbolic Acid, applied to the wound ; or m.xv of a 2 per cent, solution 
hypodermically, Liq. Ammon. Acetatis internally. [Compare Stings, in main 
Index, Part III.] 

Cannabis Indica. Stimulation by Brandy, evacuation of stomach, Strych- 
nine and Faradic Electricity are antagonistic, also Lemon-juice freely. 

Camphor. Stimulants, as wine, and Opium. 

Cantharis. Emesis. No oils, but oleaginous injections into bladder. 
Warm bath, Camphor, Milk copiously, Broths, Enemata of demulcents, 
Opium. 

Chloral. Strychnine, the antidote (R.). Hot bath, or pack, frictions, 
stimulants, artificial respiration. Coffee, fresh air, warmth over cardiac region. 
In fact, the treatment of narcotism. 

Chlorine. After emesis with warm water, give milk, white of egg, flour 
and water, or Lime-water ; Aqua Ammoniae. 

Chloroform, or Ether. Fresh air, cold affusions, flagellation, coffee, elec- 
tricity, artificial respiration. Amy I Nitrite, as antidote (Schiiller). Atropi?ie, 
hypodermically as antagonist to Ether (Amidon in N. Y. Med. Record, May 
2d, 1885) ; is equally efficient in chloroform narcosis, as I have found by ex- 



7/0 THE TREATMENT OF POISONING. 

perience (Potter). Invert patient, draw tongue well forward with forceps 
then compress and relax chest; the position to be maintained until breath and 
pulse are good (Nelaton). Ice in rectum. Faradization of respiratory muscles. 
If swallowed, use stomach-pump, then Ammonia and warmth. Liq. Amnion. 
injected (rn,x-xlaq.) into veins, — Bartholow says unsuccessfully. 

Colchicum. Treatment same as for Aconite. 

Conium. Alcohol, etc. ; external warmth after evacuation from stomach. 

Copper. Albumen, gluten, milk, sugar, Potassium Ferrocyanide. No 
vinegar. In absence of eggs, give a thin paste of flour and water. 

Creasote. Mucilage, Oil, are antidotes. Amjnonia when great depres- 
sion. 

Digitalis. The treatment is similar to that for Aconite. Emetics, brandy, 
horizontal position; galvanism, in bad cases. 

Fish. Capsicum, Chloroform, Potassium Chlorate freely ; Liq. Ammon. 
Acet, Opium. 

Gamboge. Potassium or Sodium Carbonate, or Magnesium in milk ; mu- 
cilaginous drinks, Opium. 

Gases. Carbonic Acid. — Galvanism, Oxygen inhaled; artificial respira- 
tion indispensable. Ammonia inhalations. Sponge with brandy or alcohol 
and water. Open air, horizontal position, clothing removed, cold douche, 
hot water to feet, stimulants, frictions. Subsequently, warm bed, open win- 
dows; Condy's fluid about room; stimulants sparingly; cold acid drinks ad 
libitum. Sulphuretted Hydrogen. — Chlorine Gas, well diluted with com- 
mon air. 

Gelsemium. Galvanic current, stimulants, Brandy and Cayenne Pepper, 
warm baths, frictions, hot bricks to feet. 

Glass, coarse or in powder, — Much bread in crumbs to envelop it, then 
emetics. 

Gold. Ferric Sulphate, Mucilage. 

Hyoscyamus. See Belladonna. 

Iodine. Starch or flour given in tepid water; white of egg and milk; free 
emesis, so long as liquid rejected tinges blue a solution of starch. Sodium 
Bicarbonate. 

Iron. Carbonates of Ammonium and Sodium; Magnesia; Mucilaginous 
drinks. 

Lead. Albumen, milk; alkalies, especially Magnesium Bicarbonate (R.). 
Lukewarm drinks, or Sulphates of Sodium or Magnesium, or freshly precip- 
itated Ferric Sulphate (R.)- Promote vomiting; stomach-pump (R.). Sul- 
phuric Acid and Magnesium Sulphate, for the constipation. The cachexia is 
much relieved by a combination of Sulphate of Quinine, Sulphate of Iron, 
and dilute Sulphuric Acid (B.). Potassium Iodide, gr. xv-xx 3 or 4 times 
each day (B.); as after-eliminative, in chronic cases (R.). When great pain 
at defecation give Extr. Belladon., gr. y&, Rhei, gr. ij, in pill twice daily 
(Da Costa). Alum, the most effective agent for the colic. [See Colic for 
formula.] Or to a pint of boiling milk add 90 grs. of alum, powdered ; sep- 
arate the curd, and sweeten with sugar. Sig. — A wineglassful every hour or 
two (B.): Electricity, in the paralysis (dropped wrist), a slowly-interrupted 
current until it causes reaction. Cure to be completed by the faradic current 
(B.). Strychnine, in paralysis, gives good results (B.). Sulphides, as baths, 
in chronic form (R.). 

Marked Diagnostic Signs. — Drop- wrist (paralysis of extensor muscles) ; 
dark -blue line around edges of gums. 

Lime. Calcium Chloride. Albumen, mucilaginous drinks, oils, milk, flour, 
and water. No acids. 



THE TREATMENT OF POISONING. 771 

Mercury. Gr. iij of Corrosive Sublimate have proved fatal. Albumen, 
Yolk-of-egg, vegetable astringents, gluten, flour, milk ; Potassium Iodide, as 
after-treatment. The Hydrated Protosulphide of Iron, if given within twenty 
minutes, is said to be a chemical antidote. Potassiu?n Iodide, converts the 
metal into soluble combinations (B.). Bismuth, locally in salivation (B.). 
Sodium Sulphite, locally gj-S aquae (B.). Tannic Acid, locally, as gargle 
in salivation. R. Acidi Tannici, gj, Mel. Rosae gij, Aquse ^vj. M. Gargle 
(B.). Belladonna, to diminish secretion in ptyalism, v-x drops of tincture 
every 4 to 6 hours (B.). Hyoscyaniine, for tremor, gr. -^ gradually to -^(Oul- 
mont). Alkalies, Bicarb, of Magnesium best(R.). Baths, simple or sul- 
phurous (R-). Charcoal, ^ss or more necessary in poisoning by Corrosive 
Sublimate (R.). Cod-liver Oil, in chronic cases (B.). Nitric Acid, gtt. ij of 
the dilute acid in water ter die ; also gargles of lukewarm water, acidulated 
with same (R.). Sulphurous Acid, int. and as gargle (R.). 

Mezereum. Albuminous and mucilaginous drinks; milk, oils, and fats; 
albuminous enemata; cool poultices to abdomen; Opium. 

Mushrooms. Emetics, if soon after; Purgatives, if some time has 
elapsed. After general treatment, Stimulants, unless inflammatory symptoms 
present themselves. Poultices to abdomen. Tannic Acid has been recom- 
mended. 

Opium or Morphine. — Common Sources of Danger. — Soothing Syrups 
for quieting of children. (The American Journal of Pharmacy estimates the 
loss from this cause at 150,000 every year.) Paregoric. Overdosing with 
Cough-mixtures. 

Treatment. — Vegetable astringents ; strongest, hot black Coffee. Cold 
douche, flagellation, artificial respiration, persevered in for hours. Bella- 
donna, Hyoscyamus or Stramonium. Faradism of phrenic nerves ; Stimulants. 
Comp. Tinct. Iodine. Emetics by mouth are usually useless, may be given 
as enemata; or Apo?norphine , gr. ^ to \ as emetic (hypoder. y ig), must be 
administered before narcosis has set in (B.). Stomach-pump probably best, 
after which Vegetable Acids, to counteract the narcotism. Cream of Tartar 
and water, Vinegar and water, Lemon-juice, etc., every ten minutes (R.). 
Atropine, gr. %-Yz hypodermically (R.); gr. x \-§ every 15 minutes up to three 
doses (B.); in large amounts till pupil dilates, a successful antagonist (R.). 
No one is warranted in omitting Belladonna (P.). A my I Nitrite, inhaled, has 
proved eminently successful in a case in which Belladonna or its alkaloid proved 
useless to restore the patient. Ammonia, as intra-venous injection for failure 
of heart's action from Opium and Chloroform narcosis, etc. (B.); breathed 
into air-passages (R.). Potassium Bromide, controls the disagreeable cerebral 
effects and vertigo resulting from Opium (R., B.). Water, hot water and ice 
alternately to nape of neck, in stupor of opium-narcosis (B.). Copper Sul- 
phate, as emetic, prompt and effective (B.). Zinc Sulphate, gr. vj as emetic, 
well diluted with water (B.). Effervescent Emetics, effective but dangerous 
(B.). Caffeine, hypodermat. (B., P.). Heat, alternately with cold (B.). Char- 
coal, gss or more (R.). 

Phosphorus. Emesis by Cupric Sulphate; Magnesia in Linseed-tea; 
Carbo Animalis ; mucilaginous drinks ; Liquor Calcis. Avoid all oleaginous 
mixtures. Poultices to epigastrium. Sulphate of Copper, the best emetic, 
combining to form the less active phosphide (B.). Turpentine emulsion with 
hydrated Magnesia, freely (B., R.) ; Tn_xxx in mucilage, every % hour, excel- 
lent (P.). Transfusion, has been employed to repair blood (B.). 

Physostigma. Minimum fatal dose, grain i t 2 q. Chloral, the antidote (R.), 
if administered very early. Belladonna, gr. -^ to J^ Atropinse, hypodermi- 



7J2 THE TREATMENT OF POISONING. 

cally, repeated until effects are evident. The nine-thousandth of a grain of 
Atropine, injected five minutes before giving a minimum fatal dose of phy- 
so^tigma, prevents its fatal effects (R.). 

Picrotoxine, or Cocculus Indicus. Chloral, the antidote (B.). 

Potassium Salts. Potassium Bromide. Nervous Stimulants — Brandy, 
Opium. Potassium Nitras (Saltpetre), — No chemical antidote. Emetics 
and stomach-pump, demulcent drinks, Opium, milk, aromatics, emollient 
enemata. 

Quinine. Emetics and cathartics, Opium, Coffee, Brandy, or wine, diuret- 
ics and sudorifics as after-eliminatives. 

Reptiles. (Compare Stings.) Ligate limb above wound; cleanse thor- 
oughly, and cauterize with mineral acids or strong Carbolic. The wound 
should be forcibly sucked by a person with perfect mucous surface. Inter- 
nally, Arsenic, when rapid prostration (R.) ; Ammonium, diaphoretics, So- 
dium Bisulphate, Whiskey, largely. Agave Americana. I£. Potas. Iodidi 
gr. iv, Hydrarg. Chlor. Corr. gr. ij, Bromi. gv, Aqu?e £j ; gtt. x in ^^ of 
Brandy; repeat if necessary (Hammond). Ammonia, by intra- venous injec- 
tion, is shown to be unavailing by Brunton and Fayrer (B.) 

Rhus (Poison Oak or Ivy), — Carbolic Acid, locally, a 5 per cent. sol. Sul- 
phide of Potassium , baths, j$] to Cxx. Lobelia, as infusion, 3jj ad Oj, a good 
application locally. Grindelia, the fluid extract, 1 part to 10 of water, as 
lotion ; may be used undiluted. Cocaine, a 10 per cent, oleate, or a 5 per 
cent, solution in water, as a local application, promptly relieves the symptoms. 

Silver Nitrate. Alkalies, especially the Magnesium Bicarbonate (R.). 
Sodium Chloride, largely diluted, effects a double decomposition, precipitating 
the silver as the harmless insoluble chloride (R.). The resulting irritation 
may be allayed by milk, which should serve as food until the stomach is re- 
stored. 

Silver, Metallic. Albumen, Milk. 

Stramonium. See Belladonna. 

Strychnine or Nux Vomica. Fatal dose of Strychnine gr. ]^ for adult, 
gr. y 1 ^ for child. Chloral, the antagonist, especially when given soon. Phy- 
sostigma, as an antidote (R.). Chamomile Oil, remarkably subdues reflex 
excitability in frogs after poisoning by Strychnine or Brucine (P.). Tobacco, 
2l good antagonist. The Stomach-pump, if available before tetanic symptoms. 
Animal Charcoal, largely ; Tannin freely ; Solution of Iodine. Chloroform 
Inhalations, injections of Curare, or Urethan, or Methyl and Ethyl com- 
pounds of Strychnine, Brucine, or Thebaine. Artificial respiration; fats; 
Nitrite of Amy I, inhaled; Magnesia (R.). Tube into oesophagus, and flexible 
catheter into larynx (R.). Veratrum Viride has cured a bad case; a teasp. 
was given at once, then gtt. ij every 10 minutes (R.). Ice to spine. Tobacco 
enemata. Lobelia, Potassium Bromide, Monobromated Camphor, hot bath. 
Valerian mitigates the spasms (P.). Curare, warmly recommended, but its 
claims are doubtful (P.). Nicotine, many cases prove its curative power (P.). 

Tin. Albumen, Ammonium and Sodium Carbonates, Milk. 

Tobacco. Strong Coffee and Brandy; warmth and friction; artificial 
respiration. 

Vegetable Poisons. Generally albuminous or mucilaginous drinks, oils, 
etc. Stimulants, Opium, ice ; cool poultices and fomentations to abdomen. 

Veratrum Viride. Digitalis, Opium, Stimulants. 

Zinc. Albumen, mucilaginous drinks, milk, Tannin. Potassium and So- 
dium Carbonates, if given early. Soapsuds given freely. Warm water in 
copious draughts. 



DIFFERENTIAL DIAGNOSIS. 



773 



DIFFERENTIAL DIAGNOSIS. 

[Adapted chiefly from Da Costa's Lectures.] 

Table No. i. 

Forms of Bright's Disease. 

( Tabulated from Da Costa, and Hoffmann &* Ultzmann.) 





' 


(i) Acute Nephritis. 


(2) Chron. 1 

Parench. 

Nephritis , 

{targe 

white 

kidney). 


(3) Chron. 
Desquam. 


(4) 


( 5) 
Amyloid 

or Waxy 

Kidney. 


Clinical Headings. ■ 


Desq. or 
Catarrhal 
Nephritis. 


Acute 
Parench. 

Nephritis. ; 


Nephritis 
kidney). 


M 

- J 


Quantity •< 


Normal 
or — 


— 


— or 4- 


Normal 
or 4- 


Normal 
or — 


Normal 
or + 


Reaction 


Acid. 


Acid. 


Acid. 


Acid. 


Acid. 


Acid. 




Color | 


Wine 
yellow. 


Dark 
smoky. 


Brown 
yellow. 


Clear. 


Pale. 


Pale. 


Sp.Gr | 


Normal 
or — 


High. 


— 


— 1.010 1.015-1.030 


— , above 

I.OIO 


Urea j 


Normal. 


— 


— 


Normal. 


— 


Normal 
or — 


Chlorides 


Normal. 


— 


— 


Normal. 


— 


— 




Albumen^perct.) < 


i-io to 1-5 


i to 6 


M to 2 


1-10 to Yi 


1 to 6 


i-ioto % 

of 
globuline. 


Casts < 


Hyaline 

and 
Epithel. 


Blood 
Epithel. 
Hyaline. 


Granular 

Hyaline. 

No blood. 


Very few. 


Fatty. 


Few and 
hyaline. 


Sediment 
{tnacroscopical) < 


Mucus. 
Blood. 


Brown 

cells. 
Urates. 


Kidney 

Epithel'm. 

Blood. 

Lymph. 


Seldom 
any. 


Free oil. 


Seldom 
any. 


Dropsy ■< 


Seldom. 


Great, 

especially 

of face. 


Never 
absent. 


In last 
stages. 


Great. 


Trifling. 


Uraemia \ 




Often 
great. 


Not 
marked. 


Great. 


Rare. 


Rare. 




Other Symptoms.. - 


Stiff joints 
Sacral 
pain. 

Lassitude. 


Fever. 


Tempera- 
ture low. 
No fever. 
Inflam. of 

serous 
membr's. 
Cardiac 

hyper. 


Retinitis. 

Tense, 

quick 

pulse. 
Hyper, of 

heart. 


Face pale, 

puffy. 

Cardiac 

hyper. 


Emacia- 
tion, sal- 
low face, 
enlarged 
liver and 
spleen, 
thirst, 
diarrhoea. 


Prognosis ■ 


Favorable 


Recovery 
or No. 2. 


Recovery 
(?)orNo.4 


Unfavor- 
able, but 
course 
perhaps 
long. 


Always 
fatal. 


Depends 
on con- 
stitutional 
disease 
present. 



Note. — The signs + and — respectively denote a specific gravity greater than 1.024, or 
less than 1.018. 



774 



DIFFERENTIAL DIAGNOSIS, 



Table No. 2. 
Cancer. 



Cancerous {Malignant) Tumors, 
Are of constitutional origin. 
Have no cyst, but invade and convert 

the surrounding tissues. 
Cancer material is short-lived from 

rapid deterioration, but is rapidly 

reproduced. 
Severe increasing pain. 
Extend to remote parts, reappearing 

chiefly in lymphatic glands. 
Cancerous cachexia of general health. 
Recur after extirpation, fatal in end. 



Non-malignant tumors. 
Origin, some local error of growth. 
Limited by a cyst; may compress, 

but do not invade adjacent tissues. 
Have uncertain period of increase, 

after which may remain stationary. 

Usually no pain. 

Are local, have no disposition to 

spread. 
Impair functions of parts pressed on. 
Do not recur. 



Scirrhus. 
Is hard. 

Appears mostly on female breast. 
Hard kernel, movable under skin. 

Becomes fixed to adjoining structures, 

which it puckers. 
Single and grows slowly. 
Course slow — 2-4 years. 
Never in the young. 



Encephaloma. 

Is soft and brain-like. 

Most frequently on the limbs. 

At first deeply seated, hard to recog- 
nize. 

Spreads through loose textures, which 
it pushes aside and distends. 

Has numerous tumors, grows rapidly. 

Generally fatal in 1-2 years. 

Often in the young, even at birth. 



Endocarditis. 
Blowing sound. Excited heart action. 
Slight if any increase of percussion 

dulness. 
Impulse strong. 
Sounds normal, or more distinct, 

except at site where murmur is 

heard. 



Table No. 3. 
Carditis. 

Pericarditis. 
Friction sound. Excited heart action. 
Marked increase in effusion stage. 



Wavy and feeble. 
Feeble and muffled; 
sounds. 



no blowing 



Table No. 4 
Cerebral. 

Concussion. 
Patient can be roused ; pupils act. 



Breathing seldom stertorous. 
Urinary action normal. 

Symptoms appear closely after acci- 
dent. 



Compression. 

Complete insensibility ; motionless 
pupils. 

Breathing usually stertorous. 

May be either retention or inconti- 
nence. 

Frequently do not. 



DIFFERENTIAL DIAGNOSIS. 



775 



Chancre. 
about 3d 



Commences 

coitus. 
First as a papule, abrasion, or crack. 

Generally indurated (rarely not). 

Develops slowly. 

Discharge slight, unless irritated. 

Is soon limited and seldom phagede- 
nic. 

Edges sloping, not undermined. 

Scanty serous secretion. 

Sore remains solitary, and cannot be 
multiplied. 

Followed by numerous buboes, rarely 
suppurating, never furnish inocu- 
able pus. 



Table No. 5. 
Chancre. 

Chancroid. 
In 24 hours to 3 days. 



week after 



First as a red spot, then a pustule, 
then a soft suppurating sore. 

Not on an indurated base. 

Develops rapidly. 

Suppurates profusely. 

Tends to invade surrounding tissues, 
or become phagedenic. 

Edges undermined. 

Discharge is pus, and copious. 

May be transplanted at will, and is 
seldom single. 

A single bubo may appear and sup- 
purate. 



Table No. 6. 
Cholera. 



Asiatic. 

Preceded by painless diarrhoea. 

Not directly from error in diet. 

First pain, shooting down thighs. 

Prostration rapid and overwhelming, 
and out of ratio to evacuations. 

Rapid reduction of surface tempera- 
ture ; high temperature in cavities. 

Evacuations like rice-water from first. 



Cramps commence in extremities. 
Veins congested; tongue, lips, and 

extremities livid purple. 
Urine albuminous. 



Si?nple. 

Seizure sudden. 

Generally is from error in diet. 

First pain, abdominal colic. 

Prostration gradual, less marked than 
the vomiting and purging. 

Gradual reduction of surface tempera- 
ture; internal temperature normal. 

Discharges bilious, causing burning 
and smarting pain ; only colorless 
at very last. 

Cramps commence in abdomen. 

Not so. 

Not so. 



Table No. 7. 
Croup and Diphtheria. 



Croup. 

Premonitory hoarse, metallic cough, 

without illness. 
A child's disease. 
Tenacious mucus, covers the swollen 

membrane. 
A local disease. 



Diphtheria. 
Promonitory illness, shivers, fevers, 

sore throat, without cough. 
Attacks adults as well. 
Distinguished by a false membrane. 

A blood poison ; great general depres- 
sion. 



7/6 



DIFFERENTIAL DIAGNOSIS. 



Table No. 8. 



Epilepsy and Hysteria, 



Epilepsy. 

Sudden, complete loss of conscious- 
ness. 

Livid face, frothy saliva escapes, eye- 
lids half open, eyeballs rolling, 
teeth grinding, tongue biting ; more 
or less insensibility of pupils to 
light. 

Countenance is distorted. 

Patient shows no feeling. 

Aura epileptica. 

Short paroxysm, followed by heavy 
comatose sleep and dull intellect. 

Frequently occurs at night. • 

Not necessarily of uterine connection, 

though a paroxysm often occurs at 

the menstrual period. 



Hysteria. 
Gradual and partial or apparent. 

Face flushed, or complexion unaltered, 
no froth on lips, eyelids closed, 
eyeballs fixed, no grinding of teeth, 
or biting of tongue ; pupils react 
readily. 

Is not. 

Sighs, or laughs, or sobs. 

Globus hystericus. 

Longer paroxysm, not sleepy, but 
usually wakeful and depressed 
in spirits. 

Rarely occurs at night. 

Often connected with uterine or men- 
strual disorders. 



Table No. 9. 
Gout and Rheumatism. 



Gout. 
Chiefly affects small joints, especially 

the metatarsal joint of the great toe. 
From 35-50 years; rarely before 

puberty. 
Most frequent in men, and result of 

idle, intemperate and luxurious life. 
Is strongly hereditary. 
Chalk stones (urate of soda) in ext. 

ear, on tops of fingers, or elsewhere. 
Uric acid in the blood, absent from 

urine. 
A fit often affords temporary relief. 
Is confined to temperate zone. 



Rheumatism. 
Large joints chiefly implicated. 

Generally in young adults. 

Affects both sexes equally, and 

equally the poor and the rich. 
But slightly so. 
Not so. 

Lactic acid in the blood. 

Quite the contrary. 

Is ubiquitous — prevails in all climates. 



Table No. 10. 
Hematemesis and Hemoptysis. 



Hematemesis. 

If from the stomach, the blood is of a 
dark color, and is vomited. 

Often mixed with food, not froth. 

Preceded by nausea and stomach dis- 
tress, and blood is passed with the 
stools. 



Hemoptysis. 

If from the lungs, it is bright red, and 

generally coughed up. 
Generally frothy, mixed with sputa. 
Preceded by pain in the chest and 

dyspnoea. No blood in the stools. 



DIFFERENTIAL DIAGNOSIS. 



777 



Table No. ii, 



Pleurisy and 

Pleurisy. 

Sharp pain, friction sound, dry cough, 
impaired chest motion. 

In stage of effusion, obliteration of in- 
tercostal spaces, enlargement of the 
side, viscera displaced. 

Dulness, with enfeebled or absent res- 
piration, voice, and fremitus. 

Sputa frothy, rarely any rales. 
Febrile symptoms slight usually. 

Temperature irregular, rarely high. 



Pneumonia. 

Pneumonia. 

Dull pain, crepitant rale, cough fol- 
lowed by expectoration. 

In stage of hepatization none of these 
signs are present. 

Dulness, with marked bronchial res- 
piration, distinct thoracic voice, in- 
creased vocal fremitus. 

Sputa rusty color, rales common. 

Febrile symptoms severe. 

Sudden elevations and falls, high tem- 
perature not uncommon. 



Table No. 12. 



Phthisis. 



Tubercular. 
First symptom, a dry, short cough. 

No exciting cause apparent. 



Hereditary' cases are of this class. 

Frequently preceded by enlarged or 
suppurating glands, or other evi- 
dence of scrofula. 

Voice changes from tubercular deposit. 



Non- Tubercular. 

First stage follows catarrh, bronchitis, 
or some other acute disease. 

Is referable to some exciting cause, as 
cold, inflammation, or inhaling of 
heavy dust. 

Not hereditary. 

No evidence of scrofula. 



No change of voice. 



Scarlet Fever. 

Incubation I day to 
weeks. 

Fever, great heat of skin, 
and frequent pulse, 
unabated during erup- 
tion. 

Brilliant stare. 

Eruption on second 
day, not rough, first ! 
on neck and chest, 
spreads rapidly, white 
streak on pressure with ! 
nail. 



Table No. 13. 
Exanthemata. 

Measles. 
Incubation, 7-14 days. 

Same fever rather in- 
creased by eruption. 



Liquid watery eye. 

On fourth day, on face, 

rough, spreads gradu- 
ally, streak lasts short 

time. 



Small-pox. 

Incubation, 6-20 days. 
Average 10. 

Fever often violent, 
bounding pulse, pain 
in loins, greatly re- 
lieved by eruption. 

At end of third or on 
fourth day on lips 
and forehead. 



778 



DIFFERENTIAL DIAGNOSIS. 



Scarlet Fever. 

Uniform, or large 
patches, interspersed 
raised spots and some 
vesicles, rash scarlet, 
on its seventh day very 
complete desquama- 
tion in large patches. 

Sore throat, rarely 
coryza or bronchitis. 

" Raspberry " tongue, 
red. 

Cerebral symptoms fre- 
quent and grave. 

Temperature may be 
io5°-U2° to iothday, 
subsides gradually, 
falls on 5th, 10th, and 
15th days. 

No secondary fever. 

Pneumonia rare, pleu- 
risy more frequent. 

Sequelae : Bright's dis- 
ease, dropsy, deafness, 
conjunctivitis, phthi- 
sis, chronic diarrhoea ; 
glandular enlarge- 
ments. 



Measles. 

Crescentic patches, last 
about 5 days, then 
partial desquamation, 
scales very fine. 



Coryza and bronchitis 
very constant, rarely 
sore throat. 

Tongue coated, may be 
red at edges. 

Not so. 

io3°-io6° before erup- 
tion, remains high for 
1-2 days after, then 
falls suddenly. 

None. 

Pneumonia a frequent 
complication. 

Sequelae : chronic bron- 
chitis, phthisis, con- 
junctivitis. 



Small-pox. 
Papular, then vesicular, 
finally pustular ; pus- 
tules maturate on 8th 
day of eruption. 



Sore throat often and dry 
cough. 

Coated and swollen, 
may be red at edges. 

Cerebral symptoms are 
frequent. 

Before eruption often 
106 , then rapidly 
sinks to ioo° in 36 
hours ; rises during 
secondary fever. 

Always secondary fever. 

Pneumonia not a very 
frequent complication. 

Sequelae : chronic diar- 
rhoea, glandular en- 
largements, various 
eye diseases. 



Table No. 14. 
Typhus and Typhoid. 



Typhus Fever. 
Attacks quickly, incubation 9 days. 

Occurs at any age. 

Rare among the higher classes, except 

those exposed. 
Mulberry eruption on 4th or 5th day, 

on extremities, lasts till close. 

Brain chiefly affected ; bowels are 
often but little so; abdomen 
natural, evacuations dark, but 
never bloody (these are occasion- 
ally reversed). 

Contracted pupils, dusky face. 



Typhoid {Enteric) Fever. 

Commences slowly, incubation about 
13 days. 

Most common in youth and child- 
hood, rarely after 40. 

As common among rich as the poor. 

Rose eruption, few, on abdomen, and 
in successive crops, which fade and 
disappear. 

Bowels chiefly affected, evacuations 
ochre-color and watery, sometimes 
hemorrhage, or even ulceration, ab- 
domen tumid. 

Dilated pupils, cheeks flushed. 



DIFFERENTIAL DIAGNOSIS. 



779 



Typhus Fever. 
Pulse and temperature rise to 120 and 
105° till 3d day, high for 6 days, 
then fall. 

Las:s 2-5 weeks. 
Relapses rare. 

Death from coma, or congestion of 
lungs, in 1st or 2d week. 

Arises from destitution, over-crowd- 
ing, bad ventilation, is contagious, 
and generally epidemic. 



Post-mortem : not constant, most fre- 
quent are dark blood and enlarged 
spleen, soft heart. 



Typhoid {Enteric) Fever. 

Pulse and temperature rise and fall 
independently, and without uni- 
formity, but both are usually high 
to 15th day. 

Lasts 4-6 or more weeks. 

Relapses frequent. 

Death from asthenia, pneumonia, 
hemorrhage, or perforation of in- 
testine, in or after 3d week. 

Bad draioage, poisoned drinking 
water, putrid animal matter, want 
of ozone, certain electrical condi- 
tions ; is not contagious, often 
sporadic. 

Post-mortem : morbid Peyer's patches, 
enlarged mesenteric glands, ulcer- 
ated mucous coat of intestines ; 
enlarged and soft spleen, ulcerated 
pharynx. 



Table Xo. 15. 
Yellow and Bilious Fevers. 



Yellow Fezer. 

Short duration ; ends in 3-7 da 

Incubation 5-9 days. 

A disease of one paroxysm, termi- 
nating in recovery or collapse. 

Very severe nausea and vomiting, 
early epigastric tenderness. 

Black vomit. 

Hemorrhages from various parts. 

Tongue clean, or slightly coated. 

Pulse variable, slow at end. 

Injected and humid eye. 

Supra-orbital pain, pain in back and 
in calves of legs. 

Rarelv delirious, mind clear gener- 
al. 

Urine albuminous, usually sup- 
pressed. 

Rapid convalescence, no sequela?. 

Little muscular prostration. 

High mortality, epidemic. 

Treatment unsatisfactory. 

: inflamed or congested 
stomach, enlarged yellow liver, 
filled with oil globules, muscular 
fibres of heart are often disinte- 
grated. 



Bilious Remittent. 
5 9 days or more. 
Incubation may extend to months. 
A disease of several paroxysms, with 

intervening remissions. 
These symptoms not so severe nor so 

early. 
Bilious vomiting. 
No hemorrhagic tendency. 
Tongue heavily coated. 
Pulse quick to convalescence. 
Eye natural. 
Headache, sense of fulness in head, 

often no loin or leg pains. 
Delirium frequent, mind dull. 

Not so. 

Slow convalescence, tedious sequelae. 
Greater muscular prostration. 
Slight mortality, endemic. 
Very amenable to treatment. 
Autopsy : stomach congested, rarely 

inflamed, liver olive or bronze hue, 

not fattv. 



780 



TEMPERATURE IN DISEASE. 



Table No. 16. 



Vomiting. 



Cerebral. 

Little or no nausea, vomiting con- 
tinues after stomach is emptied. 

No tenderness on pressure over the 
liver or stomach. 

Pulse infrequent and hard. 

Tongue clean, breath sweet, conjunc- 
tivae normal or injected, and head- 
ache primary. 

Generally obstinate constipation. 

No salivation. 



Gastric or Hepatic. 

Nausea relieved by discharge, returns 
when food is taken. 

Liver and stomach are tender, pressure 
produces inclination to vomit. 

Pulse frequent and weak. 

Tongue furred, breath offensive, con- 
junctivae often yellowish, and head- 
ache secondary as to time. 

Griping abdominal pain, diarrhoea and 
clay-colored stools. 

Increased salivation. 



NOTES ON TEMPERATURE IN DISEASE. 

Temperature, average normal, of adults, 98. 6° F. ; of children, 99 ; of 
the aged, 98.8 . Diurnal variation 1° to 1.5 F., highest in the evening. 
Above 108 F. is a fatal sign, which issue may be averted by cold baths, reduced 
by ice from 96 to about 6o° F. (A.). The clinical thermometer placed in the 
mouth, axilla or rectum, and retained in situ for five minutes, should go hand 
in hand v\ith Aconite in the treatment of inflammations (R.). [For anti- 
pyretics see the articles Fever, Inflammation, in Part III, also the list of 
these agents on page 421.] 

Clinical Thermometry is one of the principal means of positive diagnosis. 
The thermometer should be self-registering, certified, and accurately marked 
according to the Fahrenheit scale. The most reliable temperature is that in 
recto, or in the vagina; less so in the axilla and folds of skin, and still less 
\ reliable in the mouth. A correct reading of the thermometer cannot be ob- 
tained in less time than five to seven minutes. (Da Costa.) 

The Average Normal Temperature of the body is 98. 6°; which, like the 
pulse, will vary somewhat in individual cases; as a general practical result, it 
is agreed that in temperate regions the normal temperature at completely 
sheltered parts of the surface of the human body amounts to 98. 4 Fahr., or a 
few tenths more or less ; and a rising above 99. 5 , or a depression below 97. 3 
F., are sure indications of some kind of disease, if the increase or depression 
is persistent. The temperature is increased at the prime of life, is raised and 
depressed temporarily by the influence of diet, stimulants, exercise, etc. The 
minimum diurnal temp, is observed at 2 A.M., the maximum at 4 to 6 p.m. 
Any rise above 99. 5 , or fall below 97. 3 , if persistent, indicates disease ; on 
the other hand,, a normal temperature does not always indicate good health. 
The greatest recorded range of temperature in disease is 33. 4 ; the minimum 
is 89.6 , the maximum 123 . In severe and fatal cases it rarely exceeds 107 . 
It may rise 3°-4° after death, as observed in a case of typhoid fever in which 
death occurred with a temperature of 107 , which increased shortly afterwards 



TEMPERATURE IN DISEASE. ?S I 

to 110.5 . A temperature of 107 indicates malignancy, and where met with 
for two consecutive days in typhus, scarlatina, measles, pneumonia, pyaemia, 
meningitis or rheumatism, death may be expected shortly. In relapsing, re- 
mittent and intermittent fevers, and in the initial chill of an abortion, the 
temperature may reach 107 without indicating great danger. During the last 
hours of life in many diseases, the temperature rises to I09°-Iii°; for ex- 
ample,' n tetanus, sun-stroke, typhus, etc. With a temperature of 95 , col- 
lapse is imminent. 

A High Average Te?nperature (above 104 ), is found in severe pneumonia, 
scarlatina, remittent, typhus, typhoid and relapsing fevers, pyaemia, etc. A 
Moderately High Tetnperature (102 and above), is seen in peritonitis, acute 
rheumatism, pericarditis, pleurisy, dysentery, cerebro-spinal-meningitis, ca- 
tarrhs, etc. A temperature of ioo° and above, is found in chronic affections, 
incipient inflammations, and mild fevers. When, in effervescence, the heat 
increases rapidly, it will, in defervescence, decline proportionately fast, and 
vice versa. Beware of a grave affection when the temperature is of a con- 
tinuous type. A distinct interval between morning and evening temperature 
is a favorable sign. A slow and gradual increase indicates typhoid fever; in 
rheumatism and anomalous fevers the increase is more rapid, and still more 
so in acute inflammatory disease, pneumonia, angina, pleurisy, typhus, scarla- 
tina, rubeola, etc. It is usually very rapid in intermittent fever, febricula, and 
ephemeral fevers. A rapid effervescence and slow defervescence indicates 
s >me complication of disease ; the reverse order indicates great danger. When 
the temperature begins to fall from the evening to the morning, it is an indica- 
tion of improvement ; while a rise of temperature from the evening till the 
morning is a sure indication that the patient is worse. Stability of tempera- 
ture from morning to evening is a good sign, but from evening till the morn- 
ing, unfavorable. 

A Decrease of Tetnperature below the normal heat is rare. It occurs some- 
times transitorily, announcing thereby a favorable crisis, by preceding the 
return to a normal temperature. It is also met with occasionally during the 
morning remission of remittent fever; also during the apyrexia of intermit- 
tents ; in acute collapse, preceded or not by fever ; in chronic wasting dis- 
eases ; and sometimes, also, on the approach of death, especially in typhus 
fever. 

In Phthisis, the temperature is higher in the evening than in the morn- 
ing : later, higher at early bedtime than at noon, and high again at dusk. 
This is a valuable and delicate test of the progress of tuberculization. 

In Typhoid Fever, the accession is by a rise of one degree each day, with 
the diurnal variation. If the evening temperature does not exceed 103. 5 , the 
disease will probably be mild; but a temperature of 105 in the evening in- 
dicates a severe type and much danger. A sudden reduction to 95 in the 
third week denotes intestinal hemorrhage; a lingering temperature of 101 - 
102 in the fourth and fifth weeks indicates noncicatrization of the intestinal 
ulceration. 

In Scarlatina, the rise of temperature is rapid, 104. 7 may be reached in 
a few hours. It seldom rises above 105 and never above 106 ; it is con- 
tinual until the eruption begins to fade, when remissions take place, unless 
complications arise. 

In Measles, 103 is the usual temperature, with daily variations, increas- 
ing with the eruption and catarrhal symptoms. A high temperature lasting 
beyond the tenth day denotes complications. 

In Diphtheria, the temperature by the end of the third day will, in uncom- 



782 OBSTETRICAL MEMORANDA. 

plicated cases, not exceed I03°-I04°. It falls temporarily with the exuda- 
tion. Defervescence in the severe, favorable cases, is from the twelfth to the 
fourteenth day; in the milder cases not before the sixth. In some fatal cases 
it occurs early, from the third to the fourth day. In asthenic cases, the tem- 
perature of the surface falls, while that of the interior remains high — ioo° in 
the axilla, and 103 in the rectum. During convalescence, the temperature 
is low, and readily depressed, but may be raised by intercurrent maladies. 
Any increase after the first five days, or a continuous high temperature after 
the first ten days, is unfavorable. A sudden rise may indicate complications. 
Co- Relations of Pulse and Temperature. — As a general rule the co-relation 
of pulse and temperature may be stated as follows, namely : an increase of 
temperature of one degree above 98 F. corresponds with an increase of ten 
beats of the pulse per minute, as in the following table ; 

Temperature of 98 corresponds with a pulse of 60. 



99 u 


it 


a 


70. 


IOO° 


t( 


n 


80. 


IOI° 


*< 


a 


90. 


102° 


u 


tt 


IOO. 


I0 3 ° 


a 


a 


I IO. 


IO4 


a 


tt 


I20. 


I0 5 ° 


a 


a 


I30. 


106 


a 


a 


I4O. 



OBSTETRICAL MEMORANDA. 

Pregnancy. — Duration about 275 days; usually reckoned as about 280 
days from the first day of the last menstruation. The extremes of 405 cases 
at the Hotel Dieu were 6 months, and 1 1 months 8 days. Many rules for the 
calculation of the date when labor may be expected are given; as good a one 
as any is to count backward three calendar months from the last day of the 
last menstruation, then add 7 days to obtain the date of expected confinement 
(Nsegele). The P'rench law makes a child illegitimate if born within 200 
days after marriage, or over 300 days after the husband's death. 

Evidences of pregnancy may include : suppression of the menses ; nausea 
and vomiting, morning sickness ; salivation ; changes in the appearance of 
the breasts and nipples; changes in the position of the uterus, which descends 
during the first two months, rising from the third month, until, at the fifth, its 
fundus is level with the umbilicus, at the eighth nearly to the sternum, settling 
down at the ninth month : oedema of limbs ; neck of uterus becomes shortened, 
the os patulous. The most positive signs are : quickening, if the statements 
of the women are creditable; ballottement ; and above all, the pulsations of 
the foztal heart. 

Labor. Preliminary Signs. — Abdominal tumor sinks lower, occasional 
uterine pains and contractions, freer respiration, discharge of glairy fluid from 
vagina, frequent desire to urinate, hemorrhoids, oedema of legs. 

Essential 6Y£7z.f.— Paroxysmal pains, at regular intervals; os uteri generally 
low, neck effaced, os affected by each pain (easily ascertained by keeping 
finger on it). Dilatation of os uteri, requiring longer to acquire the size of 
a half-dollar, than from thence to completion. Shiverings and vomiting, 
tremblings and fainting, especially at complete dilatation. 

Head Positions (4). — Right (1st), or left (2d) occipitoanterior, forehead 



OBSTETRICAL MEMORANDA. 



783 



backwards; right (3d), or left (4th) occipito-posterior, forehead forwards. 
Order of their comparative frequency: 1st, 3d, 2d, 4th. The 3d rotates into 
the 2d, the 4th into the 1st. 

Facial Positions (4). — Right (ist), or left (2d) mento-posterior, forehead 
forwards; right (3d), or left (4th) mento -anterior, forehead backwards. The 
2d rotates into the 3d, and the ist into the 4th. 

Pelvic, or Breech Positions (4). — Left dorso-anterior (ist), left trochanter 
forwards; right dorso-anterior (2d), right trochanter forwards; left dorso- 
posterior (3d), right trochanter forwards; right dorso-posterior (4th), left 
trochanter forwards. Order of their comparative frequency, 1st, 2d, 4th, 3d. 

Shoulder Positions. — Varieties (2) : dorso-anterior, and dorso-posterior, the 
former occurring twice as often as the latter. In each variety the head may 
lie in either iliac fossa; the presenting shoulder being, in dorso-anterior posi- 
tion, the left if the head is in the right fossa; in dorso-posterior position, the 
left if the head is in the left fossa, and vice versa. 



Measurements. 



AVERAGE PELVIC DIAMETERS. 





As usually given. 


Prof. E. Wallace gives — 


Antero- 
posterior. 


Oblique. 


Transverse. 


Antero- 
posterior. 


Oblique. 


Transverse. 


Brim 

Cavity 

Outlet 


4% in - 
47 " 
5.0 " 


4.8 in. 
5.2 " 


5.2 in. 

4.2 " 


4.0 in. 

4^ " 
4.0 " 


— 5.0 in. 

4^ " 
4.0 " 


+5.0 in. 

4^ " 
4.0 " 



Circumferential measurement of the brim — about 17 inches. 



DEVELOPMENT OF THE FCETUS. 
[Entries in the column headed " Month" refer to the end of each month.] 



c 



Name. 


Length in 
inches. 


Weight. 


Appearance. 


ist 

2d 


Ovum 
Embryo 


one-twelfth 
1.2 


60 grains. 


Appears as a gray gelatinous mass. 
Extremities apparent : points of ossifi- 


3d 


it 


zyi to 2>y 2 


310 " 


cation appear. 
Neck, eyes, fingers, nails begin to form ; 
sexes distinct. 


4th 


Foetus 


6y 2 to 7X 


9 oz. 


Hair, fat; muscles capable of contrac- 
tion. 


5 th 


tt 


8 to 10 


IO tO 12 OZ. 


Eyebrows, skin, scrotum; nails nearly 
solid. 


6th 
7th 


it 

tt 


11 to 12 

12^ to 14 


I lb. 

2% lbs. 


Pupillary membrane formed, lips closed. 
Eyelids open, testes begin to descend, 
foetus is viable. 


8th 


it 


15 to 17 


4 to 5 lbs. 


Skin red, smooth, covered with down. 


9th 


li 


19 to 24 


7 to 7 X lbs. 


Testes near scrotum, left often therein. 



7 8 4 



ASPHYXIA AND APNCEA, 



DIAMETERS OF THE FCETAL SKULL AT TERM. 



Diameter. 


Where measured. 


Inches. 


Fronto-mental 


Apex of forehead to chin 


3X 

SX-5^ 

4*3-5 

3X 
3X-4 


Occipito-mental 


Occipital protuberance to point of chin... 
Occiput to centre of forehead 


Occipito-frontal 


Sub-occipito-bregmatic. 

Cervico-bregmatic 

Bi-parietal 


Midway between occiput and foramen 
magnum to centre of ant. fontanelle.... 

Ant. margin of foram. mag. to centre of 
ant. font 


Between the parietal protuberances 

Between the ears 


Bi-temporal 







[Compare the articles in Part III entitled — Abortion, After-pains, 
False- pa ins, Hemorrhage Post-partum, Laboh, Lactation, Preg- 
nancy, Puerperal Disorders, Vomiting of Pregnancy, etc.]. 



asphyxia and apncea. 



From Drowning. — Remove the person from the water as rapidly and 
gently as possible, turn the face downwards for a moment, and depress the 
tongue, in order that water, mucus, etc., may be removed from immediately 
over the entrance of the windpipe. Give the patient plenty of fresh air, fully 
exposing neck and chest to the breeze, unless inclement. Turn gently on the 
face, one forearm being under the forehead, and raise the body up that the 
water may have free discharge from the mouth. Place patient upon the side 
and apply stimulants (ammonia, etc.) near the nostrils; or the cold douche, in 
order to excite respiration. 

The above measures being ineffectual, convey the body to the nearest con- 
venient spot, strip it carefully and dry it, and place it on a warm bed, with 
head and shoulders slightly raised, and at once employ one of the following 
methods, known as Silvester's and Marshall Hall's. 

Silvester's Method. — Pull the tongue forward, to prevent obstruction to 
entrance of air into the windpipe ; produce expansion of the chest by drawing 
the arms from the sides of the body and upwards until they almost meet over 
the head. Then bring the arms down to the sides again, causing the elbows 
almost to meet over the pit of the stomach, and thus producing contraction of 
the chest. This imitation of the act of respiration should be continued at the 
rate of fifteen or sixteen times a minute, as in health. 

Marshall HalVs Method. — The person should be placed flat on the face, 
gentle intermittent pressure being made with the hands on the back, the body 
turned on the side, or a little beyond, then on the face, and the same pressure, 
etc., continued as at first. The whole body must be worked simultaneously. 



ASPHYXIA AND APNCEA. 785 

The same number and frequency of these artificial processes of respiration 
should be employed as in the other method. 

The Michigan Method. — Lay the body face down, the head upon the arm, 
and stand astride it ; grasp it then about the shoulders and armpits, and raise 
the chest as high as you can without lifting the head quite off the arm, and 
hold it about three seconds; then replace the body upon the ground, and 
press the lower ribs downwards and inwards, with slowly-increasing force, for 
ten seconds ; then suddenly let go, to perform the lifting process again. 

Whichever process be employed, the effort to restore the temperature of the 
body must be maintained, the body being well rubbed in an upward direction 
with the hands, with warm flannels, etc. ; bottles of hot water, hot bricks, etc., 
being applied to the stomach, the axillae, the soles of the feet, etc., stimulants 
and beef-tea being judiciously administered when restoration is about taking 
place. The attempts at resuscitation must be persevered in for several hours, 
if necessary. 

Laryngotomy or tracheotomy, with or without catheterization, or forced in- 
sufflations of air or oxygen, have proved successful, as also electro-puncture 
(Garratt). 

In artificial inflation, always press the larynx and trachea against the ver- 
tebral column, so as to close the oesophagus and thus prevent the air entering 
the stomach. 

After Long Submersion is Recovery Possible ? — According to Harley (p. 
881), dogs kept under water iy£ minutes always died, if water had entered 
the lungs. If it had not, the trachea being plugged, they survived a submer- 
sion of 4 minutes. When persons rise after sinking they usually get some air, 
and less speedily come into a state from which recovery is impossible. The 
greatest period between the last inspiration and the stoppage of the heart is 4 
minutes. Some think that no recovery has been made after complete cessa- 
tion of the heart's action. We infer that after complete submersion for 5 
minutes recovery is improbable, unless the person had been previously choked, 
or in a fainting state, so that no water entered the lungs. But in Anderson's 
case, the patient had been under water at least 15 minutes, and in Garratt's 
the time was variously estimated at from 15 to 60 minutes. 

When is a Case Hopejess ? — Harley says (p. 892) : " If the eyes are open, 
the pupils dilated, the conjunctiva insensible, the countenance placid, the skin 
cold, frothy mucus round the nostrils and mouth, no attempt at respiration, 
and the heart's action inaudible (when the ear is applied to the chest), the 
case is hopeless." 

Signs of Death. — The following have been suggested as methods of deciding 
whether death has occurred : 

(a.) Tie a string firmly about the finger. If the end of the finger becomes 
swollen and red, life is not extinct. 

(b.) Insert a bright steel needle into the flesh. If it tarnishes by oxidation 
in the course of half an hour, life may be considered not extinct. 

(c.) Inject a few drops of Liquor Ammoniae under the skin. During life a 
deep red or purple spot is formed. 

{d. ) Moisten the eye with Atropine. During life the pupil will dilate. 

(e.) Look at a bright light, or at the sun, through the fingers held closely 
side by side. During life the color is pink; after death a dead white. 

{f.) After death a dark spot is said to form gradually on the outer side of 
the white of the eye, from drying of the sclerotic, so that the dark choroid 
shows through. 



786 



CLINICAL EXAMINATION OF THE URINE. 



(g.) Putrefaction is an absolute sign of death. Better delay for it than run 
any risk of burying alive. 

From Foreign Bodies in Air Passages. — If round and smooth, invert 
the patient and strike on the back : laryn^otomy : tracheotomy. 

Of the New-Born. — Clean the mucus out of nostrils and throat ; cathe- 
terize the trachea, and suck up the mucus. "Marshall Hall's method;" by 
placing child on abdomen, then bringing into lateral posture, repeating slowly 
and deliberately. " Schultze's method:" by placing the thumbs upon the 
anterior surface of thorax, the indices in the axillae, and the other fingers 
along the back, the face of the child being from you; rotate the child, by 
swinging upwards, so that the inferior extremities turn over towards you. In 
a moment re-rotate to the original position. Do not support head or legs in 
the forward rotation ; their bending upon or towards the abdomen gives a 
forced expiration. 



CLINICAL EXAMINATION OF THE URINE. 

Note. — Use morning urine, or a sample of all passed during the 24 hours. 



Color - 



r Pale (and copious), 1.030-L- 
Pale (and copious), below 1.018 
Of urine and froth, very yellow 

or greenish 

Bright yellow to crimson 

Dark, odor of violets .". 

High (scanty), sp. gr.-f 



High (scanty), sp, gr. — . 



Dark, muddy, smoky. 
Black 



{Fragrant . . 
Fetid....... 
Of violets. 



indicate 

M 


s Sugar. 
Hysteria and convulsions, 




nervous disease. 


<< 


Bile, Rhubarb. 


(< 


Santonin. 


(( 
a 


Turpentine. 

Fever, Uric Acid Dia- 




thesis. 


11 


A grave symptom of 
Bright's Disease. 




Blood, strong Coffee. 
Putridity, disintegrated 
Blood, Tar, Creasote. 




Cystine, Sugar, etc. 

Alkalinity. 

Turpentine. 



Quantity (in 24 hours). Normal about 50 fl. oz., from which there may 
be considerable variation either way, according to the quantity of sweat, the 
fluidity of food used, etc. 

Specific Gravity. If possible, take the mixed urine. Normal is about 
1. 01 8, i. e. 18 grains of solids in each fl. oz. If sp. gr. is high, suspect sugar; 
if low, suspect albumen. 

Reaction, in health is always acid m 24-hours' urine. It may be alkaline 
from medicine, or disease, or shortly after a meal. If excessively acid, ex- 
amine for crystals of uric acid. If alkaline, let the test-paper dry, so as to 
ascertain whether the alkali be fixed or volatile. 

Albumen by Heat and Nitric Acid. With Acetic Acid, or dilute Am- 
monia, make the urine slightly acid. If a precipitate appear on boiling, it 



CLINICAL EXAMINATION OF THE URINE. 787 

may be Albu?nen or Phosphates. Add a drop or two of Nitric Acid. If the 
precipitate dissolve, it is Phosphates ; if not, it is Albumen. If a deposit or 
turbidity disappears on heating, it consists of Urates : if not, add a drop of 
Nitric Acid. If now dissolved, we have Phosphates ; if not, Cystine. Other 
Tests are the Potassio- Mercuric Iodide, the Sodizim Tungstate, Potassium 
Ferrocyanide, and Picric Acid Tests ; but the above described one, if care- 
fully done, will give as good results as any. 

Bile Pigment and Acids, if necessary. Vogels color-table. MarechaF s 
Test, as follows : Put ^j of urine in a test-tube, and pour one or two drops of 
Tinct. Iodi. to trickle down along the side of the tube, held horizontally 
nearly, so that the two fluids may touch, but not mix. If bile pigment bi 
present, a fine green color will at once be developed below the red Iodine 
layer. Noels Test, Pettenkofer s Test, Nitric Acid Test, Oxide of Silver Test. 

Sugar, if necessary. Urine containing sugar is usually light-colored, froths 
readily when poured from one vessel to another, and has a high specific 
gravity. Feliling ' s Test, as follows : Add to the boiling urine a few drops of 
freshly-prepared solution of Potassio-Cupric Tartrate [Fehling's Solution). If 
sugar be present, a yellow, orange, or red precipitate of Cuprous Oxide will 
form, 10 cubic centimeters of the solution being reduced by 0.05 gram of 
diabetic sugar. To prepare Fehling's Solution, dissolve 34,639 grams of pure, 
crystallized Copper Sulphate in about 200 grams of Distilled Water; also 173 
grams of chemically pure, crystallized, neutral Tartrate of Sodium in 500 or 
600 grams of a solution of Caustic Soda, of specific gravity 1. 1 2, pouring the 
first solution into the latter, slowly and a little at a time. The clear, mixed 
fluid is then diluted with distilled water up to a litre. This solution soon 
spoils, and must be kept in a dark, cool place. Much more convenient are 
Dr. Piffard's Cupro-Potassic Paste, and Dr. Pavy's Cupric Test Pellets (see 
Tyson on Urine, page 57); and still more handy are Wyeth's Compressed 
Tablets for preparing Fehling's Solution of Potassio-Cupric Tartrate, U. S. P. 
1880, a box of which costs 50 cents, and may be obtained from any good 
drug-store. The writer has used these Tablets for some two or three years, 
with extreme satisfaction. 

Pavy's Solution is a modification of Fehling's, is equally good for qualita- 
tive and volumetric testing, and is intended for those who prefer the apothe- 
caries' weights and measures to the metric system. It is made in the same 
manner as Fehling's, 100 minims corresponding to y^ grain of diabetic sugar, 
and consists of — Copper Sulphate, gr. 320 ; Potassium Tartrate (neutral), gr. 
640; Caustic Potash, gr. 1280; and Distilled Water, f^20. 

Other Tests for Sugar are Bottcher s Bismuth Test, the Fermentation Test, 
Moore's, Trommer's, the Picric Acid and the Indigo- Carmine. They are all 
useful, but will not be detailed here, as one good method is all that the average 
practitioner wants. 

Chlorides. Add a drop of Nitric Acid, and then Silver Nitrate until a 
precipitate ceases to form. Thus estimate the amount of Chlorides. 

Urea. — Place a drop of urine on platinum-foil, and to it add a drop of Nitric 
Acid, and leave undisturbed in a cool place for a minute or two. If the urea 
is in excess, crystals of Uric Nitrate form immediately. 

Mucus and Pus resemble each other so nearly under the microscope, that 
it is almost impossible for any one, except an expert, to distinguish between 
them thereby. Mucus is more cloudy and flocculent to the naked eye than 
Pus, which latter is generally of a stringy consistence and thickish yellow 
appearance at the bottom of the vessel. The supernatant liquid being poured 
off, and an equal bulk of Liquor Potassae added, the deposit, if containing 



788 



ETHICS. 



much pus, becomes gelatinized, and so tough that it cannot be poured out. If 
Mucus, Acetic Acid added coagulates it, forming delicate molecular fibres. 

Other Deposits are best examined with the microscope, and compared 
with good plates, rather than with printed descriptions. The plates in Hoff- 
man and Ultzman on Analysis of the Urine, will answer the wants of most 
general practitioners, but the text follows the metric system. The urinary 
deposits may be classified thus : 



In Alkaline Urine 
only. 


In Alkaline or Acid 
Urine. 


Organized Deposits. 


Calcium Phosphates 
Ammonium Urates 
Ammoniaco- 

magnesian, or the 
Triple Phosphates. 


Uric Acid 

Urates 

Phosphates 

Oxalates 

Cystine 


Mucus, Torulce, 
Pus, Sarcinae, 
Blood, Vibriones, 
Tube-casts, Bacteria, 
Spermatozoick, etc. 



Necessary Apparatus. A dozen test-tubes. Alcohol lamp. A small 
porcelain dish. 2 watch-glasses. A sheet of platinum foil, ^ inch square. 
3 pipettes of different sizes, to be used only for urine. A 2-oz. graduate. Uri- 
nometer. Blue and red litmus-paper. The reagents mentioned above. A 
little Grape-sugar, for use in testing the Fehling's solution; 

The foregoing directions comprise all that the average practitioner will 
usually perform in the matter of urinary analysis. For fuller directions, the 
reader is referred to one of the numerous manuals on the subject, among which 
may be mentioned Da Costa on Medical Diagnosis, chapter vii. — Tyson on 
the Practical Examination of Urine, — and Sir Henry Thompson's Clinical 
Lectures on Diseases of the Urinary Organs, Lecture xxiv. 

A " Physician"* 's Pocket Reagent Case" intended for urinalysis at the bed- 
side, is put up by Parke, Davis & Co., and sold at the low price of $1.50. It 
contains a set of Dr. Oliver's Test Papers, a color scale, specific gravity beads, 
two test tubes, a pipette, and full directions for the use of the reagents which 
are absorbed by the test papers. 



ETHICS. 



The Hippocratic Oath. — I swear by Apollo, the physician, and ^sculapius, 
and Health, and All-heal, and all the Gods and Goddesses, that, according 
to my ability and judgment, I will keep this oath and this stipulation : — to 
reckon him who taught me this Art equally dear to me as my parents, to 
share my substance with him and relieve his necessities if required ; to look 
upon his offspring in the same footing as my own brothers, and to teach them 
this Art, should they wish to learn it, without fee or stipulation ; and that by 
precept, lecture, and every other mode of instruction, I will impart a knowl- 



ETHICS. /8g 

edge of the Art to my own sons, and those of my teachers, and to disciples 
bound by a stipulation and oath, according to the law of medicine, but to 
none others. I will follow that system of regimen which, according to my 
ability and judgment, I consider for the benefit of my patients, and abstain 
from what is deleterious and mischievous. I will give no deadly medicine 
to any one, if asked, nor suggest any such counsel; and in like manner I 
will not give to a woman a pessary to produce abortion. With purity and 
holiness I will pass my life, and practice my art. I will not cut persons labor- 
ing under the stone, but will leave this to be done by men who are practition- 
ers of this work. Into whatever houses I enter, I will go into them for the 
benefit of the sick, and will abstain from every voluntary act of mischief and 
corruption ; and further from the seduction of females or males, of freemen 
and slaves. Whatever, in connection with my professional practice, or not 
in connection with it, I see or hear in the life of men, which ought not to be 
spoken of abroad, I will not divulge, as reckoning that all such should be kept 
secret. While I continue to keep this oath unviolated, may it be granted me 
to enjoy life and the practice of the Art, respected by all men, in all times ! 
But, should I trespass and violate this oath, may the reverse be my lot ! 
[Adams's Genuine Works of Hippocrates, Sydenham Society, London, 1849.] 

Extracts from the Code. 

Consultations should be promoted in difficult cases. During them no jeal- 
ousy or rivalship should be indulged. Candor, probity, and all due respect 
should be exercised towards the physician in charge. The attending physician 
should first question the patient, the consulting one afterwards putting such 
other questions as may seem fit to further elucidate the case. The discussion 
should take place in a private place, and n : ms delivered which are not 

the result of concurrence. In discussion, the attendant delivers his opinion 
first, the others in the order in which they have been called. 

A Regular Medical Education furnishes the only presumptive evidence of 
professional abilities and acquirements, and ought to be the only acknowl- 
edged right of an individual to the exercise and honors of his profession. No 
one can be considered a fit associate in consultation, whose practice is based on 
an exclusive dogma, to the rejection of the accumulated experience of the 
profession. 

Punctuality should especially mark the keeping of these engagements ; if 
one of the parties be delayed, the other should wait a reasonable time, and 
then, if the attendant, prescribe; if the consulting, he should retire, unless the 
case is urgent or he be called from a distance, when he should either pre- 
scribe for the emergency or leave a written opinion under seal. All theoreti- 
cal discussions should be avoided. Should diversity of opinion prevail, the 
majority should rule ; should the numbers be equal on each side, the decision 
should rest with the attending physician. The consulting physician should 
always justify, as far as may be consistent with truth, the course pursued by 
the attending one, and no hint impairing confidence in him, or his reputation, 
should be thrown out. A double fee should be expected in all consultations. 

Interference. — A physician should not visit or prescribe for a patient who 
has been under the care of another for the same malady, unless in, 1st, a case 
of emergency ; 2d, of consultation ;* 3d, of relinquishment, by the physician, 
of the case; 4th, or a regular notification to him that his services are not 
longer desired. When the case is assumed by another, he should indulge in 
no insinuations against the former attendant. If called because the family 



790 NEW REMEDIES. 

physician is not at hand, or is sick, he should resign the case to him on his 
arrival. In case several physicians are simultaneously called, as in acci- 
dents, the first arriving should take full charge of the case, unless the family 
attendant be present, when he should assume the charge ; if not present, he 
should be sent for, and the further treatment resigned to his hands. 

Miscellaneous. — A case should never be abandoned because it is supposed 
to be a hopeless one. 

Contumelious and sarcastic remarks relative to the Faculty, as a body, 
should always be avoided. " It's a foul bird that fouls its own nest." 

It is held unprofessional to resort to " public" advertising, to hold a patent 
upon an instrument, or to dispense or prescribe a secret nostrum. 

Gratuitous services should be given to an afflicted brother practitioner. If 
compelled to temporarily suspend his practice, on account of sickness, the 
physician who has been invited to take charge of his cases should turn the 
accruing fees over to the sick one, save in surgical or obstetrical cases. 



NOTES ON SOME NEW REMEDIES. 

AND SOME OLD ONES WHICH HAVE RECENTLY COME INTO 

PROMINENCE. 

Antifebrin, Phenyl-acetamid (CgHsNHG^Oi),— is the latest gift of the 
German laboratories to the antipyretic list of drugs (pp. 151, 421) It is a 
white, odorless and crystalline powder, almost insoluble in water, cold or hot, 
but freely soluble in alcohol and diluted alcohol. It has neither acid nor ba- 
sic properties, and resists the action of most reagents. It is employed in doses 
of gr. iv to gr. xv, dissolved in wine, or enclosed in wafers, up to a maximum 
of gr. xxx in 24 hours. Its antipyretic power is stated in general terms as 
about four times the strength of Antipyrine. Its effect upon the body tem- 
perature begins to become manifest at the end of an hour after its ingestion, 
reaching its maximum in about four hours, and passing off, according to the 
size of the dose, in from three to ten hours. The pulse-rate falls proportion- 
ately with the decline of temperature. It produces no nausea, even in large 
doses, nor have any other untoward symptoms yet been caused by it. In many 
varieties of disease with high temperature it has already proved efficient, in- 
cluding acute rheumatic fever, erysipelas, typhoid fever, septicaemia, and 
phthisis pulmonalis, — and has the additional advantage of being a cheap drug 
selling at wholesale for about 25 cents per oz. If these claims of Drs. Calm 
and Hepp, of Strassburg, become strengthened by further experience, we 
may have found at last the long-sought substitute for Quinine in pyrexia ; 
though the reported discovery of a synthetical method of making Quinine 
itself by Dr. C. Hewitt, of London, if true, would seem to leave nothing to 
be desired in this respect. After all the experiments with other antipyretics, 
the experience of the profession, as voiced by Dr. Carter at this year's meeting 
of the British Medical Association, is that Quinine must be placed at the 
head of the list. (See ante, page 421.) 

In a recent publication on the comparative value of the various antipyretics, 



NEW REMEDIES. 791 

Dr. Pavay, Chief of the Presburg Hospital, gives the palm to Antipyrine (see 
page 72), as a practical antipyretic, being equally efficient with Quinine and 
Salicin, while comparatively devoid of the secondary symptoms which detract 
so much from the value of these two agents. He uses only .^j-ij per diem, 
and denounces larger doses. Comparing its action w T ith that of other anti- 
pyretics, he says that Chinoline causes vomiting, Resorcin and Hydroquinon 
great nervous excitation, and Kairin a very unpleasant sensation in the face 
and nose, besides vomiting, cyanosis and collapse. 

Avena Sativa, the common Oat, a plant of the nat. ord. Graminaceae, — 
was official in the U. S. P. 1870, as Aven<z Farina, or Oat-meal. A concen- 
trated tincture or fluid extract has recently been extensively advertised by 
drug manufacturers as a nerve stimulant and tonic, especially efficacious in 
the treatment of chorea, epilepsy, insomnia, nervous exhaustion, alcoholism 
and the Opium-habit. The seeds contain starch, gluten, gum, etc., and form 
a nutritious food, the meal being made into a porridge, or gruel. In the 
latter form it is a good demulcent for coughs. The pericarp contains an 
amorphous alkaloid, which has doubtless some stimulant and narcotic power ; 
but the claims advanced for it, as a specific remedy for the cure of the opium- 
habit, have been strenuously denied by many competent observers. Dose of 
the concentrated tincture or fluid extract, may be stated at rn,x-^ij. 

Cocaine (see page 182). Besides the great value of this alkaloid and its 
salts for producing local anaesthesia, it is coming into daily use as a general 
stimulant, a diuretic, an analgesic and an anti-pruritic. Doses of gr. ss of the 
Hydrochlorate twice daily have marked diuretic action, and as such it should 
be decidely useful in cases of anaemia, uraemia, and weak heart with dropsy. 
Prof. Laskevitch ascribes to it the power of relieving the paroxysms of angina 
pectoris, at first only tempering their acuteness, but after a few days' use the 
attacks decrease in strength and duration, finally disappearing altogether. In 
sea-sickness it is reported to be very useful, if used in solution ; cases in which 
the tablet form was employed deriving no benefit from it. It is further re- 
ported efficacious in the insomnia and diarrhoeas of children. The writer has 
found it to be an extremely prompt and efficient application, in ointment, 
oleate or solution (5-10 per cent.), for the burning and itching of Rhus- 
poisoning, and for pruritus ani et scroti, and similar affections. Mr. Jessup 
declares that Cocaine, as used in ophthalmic practice, is often injurious, that 
it may produce glaucoma, and will increase exophthalmos. 

The internal dose of Cocaine Hydrochlorate is gr. |— ij for an adult ; gr. 



3 



gr.ss, according to age, for a child. 



Hoang-Nan (from Strychnos Gaultheriana), — is, in common with the 
other members of the Strychnos family, a tetanizing agent. It is recommended 
in leprosy, syphilis, scrofula, varicose ulcers, eczema and other skin diseases; 
and has lately received attention as a preventive of hydrophobia, if given dur- 
ing the period of incubation in daily closes of gr. xv, which suffice to produce 
the physiological effects of the drug, namely — heightened reflexes, convulsions 
and trismus [Bartkilemy). The ordinary dose is gr. }4-gr. ss, in pill. 

Ichthyol, is a preparation obtained from a bitumen found in the Tyrol, 
and regarded as the animal residue of antediluvian sea-animals and fishes. 
Ichthyol has a peculiar odor, a faintly alkaline reaction, and contains Sulphur 



792 NEW REMEDIES. 

in the proportion of ten per cent. It has been introduced by Dr. Unna, of 
Hamburg, the celebrated dermatologist, as a promptly efficient remedy in cer- 
tain chronic skin diseases, particulaly eczema and psoriasis. It mixes with 
vaseline, lard and oils, is soluble in a mixture of ether and alcohol, and is not 
irritant locally, even if covered with oiled silk. 

In one case of eczema infantile, an ointment was applied containing I part 
of Ichthyol to 5 of Vaseline, resulting in the child's sinking into a stupor 
which lasted for 12 hours. Though recovery was complete, the result of the 
application shows that care must be used in the employment of the remedy, 
as it is not devoid of danger (Sinclair). 

Lanolin, is a cholesterin fat obtained from the suds from the washing of 
sheep's wool, by a process patented in the United States by Prof. Liebreich, 
the discover of Chloral ; and though a very old medicament, being mentioned 
by Ovid, Herodotus, Pliny and Aristophanes, it is now being introduced to 
the medical world as the best basis for ointments. It contains 25 to 30 per 
cent, of water, and readily unites with no per cent, of its own weight of 
water; differing from all other fatty substances, chiefly in resisting saponifica- 
tion and the action of water, having no tendeney to become rancid. It readily 
passes through the integument, carrying with it any medicament with which 
it is charged. It is a perfectly neutral base, and hence is not liable«to decom- 
pose any ordinary substance. The difficulty about its use has been its very 
disagreeable sheepy smell, but recent samples, exhibited to the British Medi- 
cal Association, seem to have been devoid of this object mable quality. It is 
particularly useful. in chronic skin diseases where there is infiltration, and a 
penetrative action is desired for medicaments. In a few cases of acute and 
subacute eczema it has proved irritating, but as a rule it is perfectly bland. 
Where a simple protective action is desired it is inferior to Lard, Vaseline 
or Cold Cream. 

Manganese (see pac^e 256^, — is becoming more of an acknowledged rem- 
edy in derangements of the menstrual function, as irregular or scanty menstrua- 
tion, amenorrhcea, menorrhagia, and even metrorrhagia. By some authorities, 
the emmenagogue power of Potassium Permanganate is ascribed to its large 
proportion of Oxygen, which it is supposed to give up to the uterus; as, until 
recently, Potassium Chlorate was supposed to do by the system at large. 
According to the views of others who have studied its action, Manganese 
should be classed with the excito-motors, increasing arterial tension, and 
specifically acting upon the uterus. The best preparation is the Binoxide, 
in freshly-made pills of two grains each, of which 1 to 3 or 5 pills may be 
taken twice or thrice daily. The Permanganate of Potassium has generally 
been the preparation given when the effects of Manganese were desired (see 
page 257; ; but as it causes great gastric irritability, with abdominal pains and 
burning sensations, besides other decidedly unpleasant symptoms, it is a diffi- 
cult matter to get patients to take it for any length of time. 

Salol, or Phenol Salicyl, — is a new antiseptic and antipyretic, lately dis- 
covered by Prof. Von Nencki, of Berne. It is a white, greasy body, of slightly 
aromatic odor, but no taste, almost insoluble in water, but soluble in alcohol. 
It is decomposed in the organism by the pancreatic juice, appearing in the 
urine as urate of salicyl, the decomposition taking place in the duodenum, 
without any modification of its constituent parts. It, therefore, causes no 



NEW REMEDIES. 793 

nrusea whatever, but colors the urine almost black, without any untoward 
symptoms ; and is administered in quantities of £j-ij daily in divided doses. 

As an Antiseptic it is hoped that Salol will displace the disagreeable Iodo- 
form and the dangerous Bichloride of Mercury. It certainly prevents the 
development of bacilli, and is the best substance to apply to wounds. Inter- 
nally it will be of benefit in all intestinal catarrhs, in typhoid fever to disinfect 
the ulcerations; in cystitis and catarrh of the bladder, rendering the urine 
completely aseptic; — in cholera, and against intestinal parasites. As an Anti- 
pyretic, it has been used in phthisis, diminishing the temperature 7 F., from 
104 to 97 ; also in various rheumatic affections, in which it has given better 
results than the Salicylate of Sodium ; while being tasteless ancl non-nauseant 
it has a great advantage over the latter salt. 

Terebene, is a clear, colorless fluid, having a pleasant odor, something like 
that of pine wood, and is prepared by the action of Sulphuric Acid upon Oil 
of Turpentine. It imparts a violaceous odor to the urine, and does not mix 
with water; but its small doses for internal administration (lUv-xv), enables it 
to be given on sugar. Being less irritating and less disagreeable than Oil of 
Turpentine, and possessing most of the properties belonging to the latter, it 
will doubtless largely displace it in many affections for which Turpentine is 
now employed. 

It has been extensively used by Dr. Murrell, with excellent results, as a 
remedy for obstinate winter-cough and emphysema of the lungs, in flatulence, 
and flatulent dyspepsia, also in cystitis and in gleet. He has employed it with 
benefit as a spray in phthisis and post-nasal catarrh, also with Cocaine in solu- 
tion as a spray for coryza and hay-fever. Other observers, of several years' 
experience with this remedy in England, praise it highly as an inhalant rem- 
edy in phthisis, bronchiectasis, chronic bronchitis, and other pulmonary affec- 
tions characterized by profuse, purulent expectoration. Dr. Rieu employs it 
extensively in bronchitis and bronchorrhcea, in doses internally of gr. xv-xxx 
per diem, — but says that it does not affect the muco-purulent expectoration of 
phthisis [Bull. Gen. de Therap., April 30, 1886). It probably has no superior 
efficacy to Creasote, Venice Turpentine, etc., except that it is without much 
odor, and has no taste. 

Urethan, the new hypnotic, is chemically a Carbamate of Ethyl, very soluble 
in water, and may be administered hypodermically, as it is free from local 
irritant action. It is decidedly hypnotic, slows the pulse and lowers the tem- 
perature. In large doses it produces complete muscular resolution and gen- 
eral anaesthesia. It does not derange nutrition, nor does it coagulate the fluids 
of the body. Extensive experimental observations have been made with Ure- 
than on animals, by Prof. Coze, of Nancy, which prove it to be a complete 
functional antagonist to the action of Strychnine. It should be useful in any 
form of convulsions and especially in tetanus. 



794 



SPECIFIC GRAVITIES AND SPECIFIC VOLUMES. 



TABLE OF SPECIFIC GRAVITIES AND 
SPECIFIC VOLUMES. 

(Temperature at 59 F., except when otherwise stated.) 



Liquid. * 


Specific 
Gravity. 


Specific 
Volume. 


Liquid. 


Specific 
Gravity. 


Specific 
Volume. 


Acid, Acetic 

Ac. Acet. Dil 

Ac. Hydrobromic 

(34 per cent.) 

Ac. Hydrobrom. Dil 

Ac. Hydrochloric 


1.048 
1.008 

1-303 
1.077 
1. 160 
1.049 

I. 212 

I.42O 

I.O59 

0.800 

1.347 

I.057 

I.84O 

I.O94 

•750 

.725 

.820 

.812 

.928 

.920 

I. OOO 

•959 
.9OO 
.670 
I.272 
I.488 
I.47O 
I.250 
I. 160 
I.405 


• 954 

.992 

.767 

.928 
.862 
•953 
.833 
.704 

•944 

1.250 

.742 

• 945 
•543 
.914 

1-333 
1-379 
1 .219 
1. 231 
1.077 
1.087 

I.ODO 

I.O43 

I. Ill 

1.403 

.786 

.672 

.680 

.800 

.862 

.711 


Liq. Ferri Tersulph 

Liq. Potassse 

Liq. Sodae 


1.329 
1.036 
1.059 

1-333 
.900 

.917 

.860 

.875 

1.050 

.890 

.920 

.900 

I-I73 

.9 2 5 

.890 

.850 

•936 

.900 

.920 

.916 

.960 

.900 

1. 091 

.918 

.862 

.824 

.920 

.93o 

1.310 

1. 000 

1. 000 


•757 

• 9°5 

•944 

.75o 

1. in 

1. 091 

1. 163 

1. 143 

.952 
1. 123 
1.087 
1. in 

.852 
1. 081 
1. 123 
1. 1 76 
1.068 
1. 111 
1.087 
1.092 
1.042 
1. in 

.917 
1.089 
1. 160 
1. 214 
1.087 
1.075 

.763 
1. 000 
1. 000 


Mel (Honey) 


Ol. Adipis 


Ol. Amyg. Expres 

Ol. Aurant. Cort 


Ac. Hydrochlor. Dil 

Ac. Lactic 

Ac. Nitric 


Ol. Bergamii.. 


Ol. Caryophilli 


Ac. Nitric. Dil 

Ac. Oleic 


Ol. Copaibae 


Ol. Cubebae 


Ac. Phosphoric 


Ol. Eucalypti 


Ac. Phosphor. Dil 

Ac. Sulphuric 


Ol. Gaultheriae 

01. Gossyp. Sem 


Ac. Sulphuric, Dil 


Ol. Lavandulae 

01. Limonis 


^Ether 


.^Ether Fortior 


01. Lini 


Alcohol, at 6o°F. 
Alcohol, at 77°F 


Ol. Menthae Pip 


Ol. Morrhuae 


Alcohol, Dil., at 6o°F.... 
Alcohol, Dil., at 77 F.... 
Aqua Destill., at 39 F... 
Aqua Ammoniae 


Ol. Olivae 


Ol. Rifiini 


Ol. Rosmarini 


Ol. Sassafras 


Aq. Ammon., Fort 


01. Sesami 


Ol. Terebinthinae 

Spt. /Etheris Nitrosi... 
Spt. Frumenti 


Carbon Bisulphide 

Chloroform, Purif 


Chloroform. Venale 

Glycerin 


Spt. Vini Gallici 


Syrupus Simplex 

Vinum Album 


Liq. Ferri Acet 




Vinum Rubrum 







DROPS IN A FLUIDRACHM. 



795 



TABLE SHOWING THE NUMBER OF DROPS IN A 
FLUIDRACHM OF VARIOUS LIQUIDS, ALSO THE 
WEIGHT OF ONE FLUIDRACHM IN GRAINS. 

(Compare page 469.) 



Liquid. 



Acetum Opii 

Acetum Sciliae , 

Acid. Acetir 

Ac. Acetic. Dil 

Acid, Carbolic 

Ac. Hydrochloric. 
Ac. Hydrocyanic. 

Acid, Lactic 

Acid, Nitric 

Ac. Xitro-hydrochlor... 
Ac. Phosphor. Dil.., 

Ac Sulphuric 

Ac. Sulph. Aromat.. 

Ac Sulph Dil 

Ac. Sulphurosum.... 

.Ether Fortior 

Alcohol 

Aqua 

Aqua Destillata 

Bals. Peruvian , 

Bromine 

Chloroform, Pur 

Copaiba 

Creasote 

Ext. Belladon. Fl.... 

Ext. Buchu Fl 

Ext. Digitalis Fl .... 

Ext. Ergotae Fl 

Ext. Ipecac. Fl 

Ext. Rhei Fl 

Ext. Senegse Fl 

Ext. Valerianae FL... 

Ext. Zingib. Fl 

Glycerin , 

Hydrargyrum 

Liq. Acidi Arseniosi 
Liq. Ferri Chloridi... 



Drops 


Weight 


in f 5j. 


of f 5j in 


(TTUx.) 


grains. 


90 


61 


68 


57 


108 


58 


68 


55 


in 


59 


70 


65 


60 


54 


in 


66 


102 


77 


76 


66 


59 


57 


128 


101 


146 


53 


6g 


58^ 


59 


55 


176 


39 


146 


44 


60 


55 


60 


53^ 


101 


60 


250 


165 


250 


80 


no 


5i 


122 


56y 2 


156 


57 


I50 


47^ 


134 


62 


*33 


60 


120 


60 


158 


61 


137 


62 


150 


49 


142 


48 


6 7 


68 


150 


760 


57 


55 


7* 


72 



Liquid. 



Drops Weight 
in f 3j. of f3j in 

(TTUx.) grains. 



Liq. Iodi Compos 

Liq. Potassas 

Liq. Zinci Chloridi 

Oleores. Aspidii 

Oleores. Capsici 

Oleores. Cubebae 

Oleum Anisi 

Oleum Bergamii 

Oleum Cari 

Oleum Juniperi , 

Oleum Limonis 

Oleum Ricini 

Oleum Rosse 

Oleum Terebinth 

Oleum Tiglii 

Spt. JEtheris Comp 

Spt. .Etheris Xitrosi.... 

Spt. Camphorae 

Syrupus Simplex 

Syrupus Acacias 

Syrupus Ferri Iod 

Syrupus Sciliae 

Syr. Sciliae, Comp 

Syrupus Senegse 

Tinctura Aconiti 

Tinctura Belladonnse... 
Tinct. Benzoini Comp., 

Tinct. Cantharidis 

Tinct. Digitalis 

Tinct. Ferri Chlor 

Tinct. Iodi 

Tinct. Opii 

Tinct. Opii Camph 

Tinct. Opii Deodor 

Vin. Colchici Rad........ 

Vin. Colchici Sem 

Vinum Opii 



63 
62 

8g 
130 
120 
123 
119 
130 
132 
148 
129 

77 
132 
136 
104 
148 
146 

*43 

65 

44 

65 

75 

102 

106 

146 

137 
148 

131 
128 
150 
148 
130 

i3<=> 
no 
107 
in 
100 



5^ 

5i 

52 

54 

46 

5o 

49 

47 

5^A 

47, 

45^ 

50 

45 

47 

47 

72 

73 

77 

74 

70 

70 

46 

53 

48 

5i 

53 

53 

47 

53 

52 

54 

55 

54 

55 



796 



METRIC CONVERSIONS. 



TABLE FOR CONVERTING APOTHECARIES' WEIGHTS 
AND MEASURES INTO GRAMS. 







(Maisch. 


) 






Troy Weight. 


Metric. 


Apothecaries' 


Grams for Liquids. 












Grains. 


Grams. 


Measure. 


Lighter* than 
Water. 


Specific 

Gravityf of 

Water. 


Heavier^ 
than Water. 


I-64 


.OOI 


rrj> 1 


•055 


.06 


.08 


I-40 - 


.OOI5 


2 


.IO 


.12 


.15 


I-30 


.002 


3 


.16 


.18 


.24 


I-20 


.003 


4 


.22 


.24 


.32 


I-I6 


.004 


5 


.28 


•30 


.40 


I-I2 


.005 


6 


.32 


.36 


.48 


. I-IO 


.006 


7 


.38 


.42 


•55 


H 


.008 


8 


•45 


•50 


.65 


H 


.OIO 


9 


•5o 


•55 


•73 


X 


.Ol6 


10 


•55 


.60 


.80 


l A 


.02 


15 


.80 


.72 


.96 


% 


.03 


16 


.90 


1. 00 


1.32 


1 


.065 


20 


1. 12 


1.25 


1.60 


2 


.13 


25 


1.40 


i-55 


2.00 


3 


.20 


30 


1.70 


1.90 


2.50 


4 


.26 


35 


2.00 


2.20 


2.90 


5 


.32 


40 


2.25 


2.50 


3-3^ 


6 


•39 


48 


2.70 


3.00 


4.00 


8 


.52 


5o 


2.80 


312 


4.15 


10 


.65 


6of 5 j 


3.40 


3-75 


5.00 


l S 


1. 00 


72 


4.00 


4-50 


6 00 


20 9j 


1.30 


80 


4.50 


5.00 


6.65 


24 


1.50 


90 


5.10 


5.60 


7.50 


26 


1.62 


96 


5-4o 


6.00 


8.00 


303SS 


i-95 


100 


5.60 


6.25 


8.30 


40 


2.60 


I20f^ij 


6.75 


7.50 


10.00 


50 


3.20 


I60 


9.00 


10.00 


13-30 


60 jjj 


3-9o 


180 f ziij 


10.10 


11.25 


15.00 


120 3 ij 


7.80 


240 f .$ss 


13-50 


15.00 


20.00 


180 


11.65 


fgv 


16.90 


18.75 


25.00 


240 gss 


15.50 


f 3 v J 


20.25 


22.50 


30.00 


300 


19.40 


f zvrj 


23.60 


26.25 


35.00 


360 


23-3° 


*3J 


27.00 


30.00 


4000 


420 


27.20 


f $ 


54.00 


60.00 


80.00 


480 5J 


31.10 


f|iij 


81.00 


90.00 


120.00 


3}i 


62.20 


f Jiv 


108.00 


120.00 


160.00 


%iv 


124.40 


f |v 


135.00 


150.00 


200.00 


«I V * 


186.60 


fgyj 


162.00 


180.00 


240.00 


gviij 


248.80 


fgviij 


216.00 


240.00 


320.00 



* Lighter than water are tinctures, spirits, compound spirits of ether, sweet spirit of 
nitre, fixed and volatile oils. .^Ether Fortior, f 3j=grams 2.80. 

f Same as water are waters, liquids, decoctions, infusions, most fluid extracts, and tinct- 
ures made with dilute alcohol. 

t Heavier than water are syrups, glycerin, a few fluid extracts, and chloroform. Of the 
latter, f 3j=grams 5.50. 



INDEX. 



Note. — This Index has been arranged with the object of enabling 
instant reference to be made to the mention of every article of the Materia 
Medica — every drug, official or unofficial, and each preparation, derivative 
or constituent thereof, which is treated of in the first part of the book — 
every article, preparation or operation discussed in the pharmaceutical 
portion, and every disease or other title contained in the therapeutical 
section. Many of the entries are onlv made once, but double and even 
treble entries are made for every item which seemed of sufficient importance 
to warrant such repetition. 

Salts are each placed but once in the Index, under their English names 
and the titles of their acid factors, thus, Acetate of Potassium. A basic 
view of the salts under their basis titles, is seen in the section on Materia 
Medica, but as no such view of the Allyl, Ethyl, Methyl, Propyl, and 
similar compounds is in the book, these are each indexed twice, under 
both the acid and basic portions of their names, as Cetyl Palmitate and 
Palmitate of Cetyl. 

Plants are indexed under both English and Latin names, except where 
the technical name of the plant corresponds in part with the official drug- 
title, in which case the one entry serves for both. Thus the entrv Conium 
answers for the plant Conium maculatum, as well as for the official dirug; but 
the drug Nux Vomica and the plant Strychnos Nux-vomica require separate 
index entries. 

Alkaloids are each entered once only and under their chemical termi- 
nation, ine; their salts following the same rule as other salts. 

Glucosides and similar principles (except such as are acids) are indexed 
under their chemical termination, in. 

Preparations are indexed under their Latin names where the reference 
is to the class, as Infusa, 451 ; but the several individual preparations are 
placed under their English titles, thus, Infusion of Digitalis, 173 ; the refer- 
ence being to the Infusum Digitalis, page 173. 



Abbreviations, their use, 475 

Table of, 749 
Abdominal Plethora, 515 
Abies, 301 
Abies balsamea, 375 

canadensis, 301 

excelsa, 301 
Abortion, 516 
Abrus, 17 
Abscess, 516 

of the Liver, 639 

Multiple, 692 
Absinthe, 18 
Absinthium, 18 
Absorbent Cotton, 206 
Abstract of Aconite, 40 

of Belladonna, 95 

of Conium, 158 



Abstract of Digitalis, 172, 

of Hyoscyamus, 226 

of Ignatia, 229 

of Jalap, 238 

of Podophyllum, 307 

of Senega, 353 

of Valerian, 385 
Abstracta, 459 
Acacia, 18 

Catechu, 130 
Aceta (see also Vinegars), 458 
Acetate of Copper, 167 

of Ethyl, 43 

of Iron, 190 

of Iron and Ammonium, 193 

of Lead, 303 

of Morphine, 277 

of Potassium, 309 



79 3 



INDEX. 



Acetate of Sodium, 360 

of Zinc, 394 
Acetic Ether, 43, 46 
Acetous Preparations, 458 
Acetum, i9 
Acid Abietic, 322 

Abric, 17 

Acetic, 19 

Aconitic. 39 

Agaric, 47 

Aloetic, 55 

Anemonic, 316 

Angelic, 371 

Arabic, 18 

Arsenious, 84 

Artanthic, 259 

Benzoic. 93, 99 

Boracic, 20 

Boric, 20 

Brassic, 358 

Calumbic, 113 

Camphoric, 115 

Camphretic, 115 

Capronic, 82 

Caprylic, 82 

Carbazotic, 35 

Carbolic, 21, 52, 301 
Solutions of, 22 
Gauze, 22 

Carminic, 155 

Caryophyllic, 127 

Caryophyllinic, 127 

Catechufc, 130 

Catechu-tannic, 130 

Cathartic, 325, 354 

Cathartogenic, 354 

Cerotic, 131 

Cetraric, 132 

Cevadic, 387 

Chelidonic, 133, 343 

Chromic, 23 

Chrvsammic, 55 

Chrvsophannic, 145, 325, 335 

Cinnamic, 93, 99, 367 

Citric, 247 

Coca-tannic, 182 

Copaibic, 161 

Cresylic, 21 

Cubebic. 166 

Ergotic, 178 

Ergotinic. 178_ 

Erucic, 358 

Eugenic, 267 

Euonic, 188 

Euphrastic, 189 

Filicic, 90 

Fluoric, 25 

Gallic. 25 

Gallo-tannic, 38 

Gambogic, 114 

Gelsemic, 201 

Gentesic, 202 

Gentianic, 202 

Glycyrrhizic, 205 

Guaiac, 209 

Guaiaconic, 209 

Guaiarec, 209 

Gurjunic, 211 

Gviiocardic, 133 

Hydriodic, 232, 235 

Hvdrobromic, 26 



Acid Hydrochloric, 27 

Hydrocyanic, 29, 64. 65, 315 
Hypopicrotoxic, 295 
Igasuric, 270 
Ipecacuanhic, 235 
Juglandic, 239 
Kinic, 148 

Kinotannic, 148, 242 
Kinovic, 148 
Kinovo-tannic, 148 
Lactic, 31, 275, 339 
Lactucic, 244 
Linoleic, 249 
Lobelic, 250 
Lupulinic, 215 
Maizenic, 394 
Malic. 95 
Mastichic. 259 
Meconic, 275 
Melassic, 338 
Methyl-salicylic, 200 
Mezereinic, 264 
Muriatic, 27 
Mvristic. 268 
Nitric, 27, 32 

Nitro-hydrochloric. 27, 32 
Xitro-muriatic. 27, 32, 
Oleic. 33, 273 
Ophelic, 135 
Palmaric, 322 
Palmitic, 273 
Phenic, 21 
Phosphoric, 27, 34 
Picric, 35 
Picrotoxic, 295 
Pinic, 322 
Piperonylic, 163 
Podophvllinic, 307 
Polygonic, 308 
Prussic, 29 
Punico-tannic, 208 
Pyrogallic, 25, 26 
Pyroligneous, 301 
Quercitannic, 38, 321 
Rhatania-tannic, 38, 242 
Rheotannic, 325 
Rheumic, 325 
Ricinoleic, 330 
Sabadillic, 387 
Salicylic, 340 
Salicvlous, 340 
Salicyluric, 340 
Sanguinarinic, 343 
Sclerotinic, 178, 179 
Silvic, 322 
Sphacelinic, 178 
Strychnic, 270 
Sulphuric, 27, 35 
Sulphuric, Aromatic, 35 
Sulphurous, 36 
Succinic, 57, 133 
Tannic, 25 37 
Tannic and Iron, 486 
Tartaric, 39 
Thebolactic, 275 
Tiglinic, 380 
Toxicodendric, 328 
Tropic, 95, 226 
Valerianic, 216, 371, 384, 390 
Vanillic, 386 
Veratric, 387 



INDEX. 



799 



Acid Vibumic, 390 

Xylic, 21 
Acids, their action, 414 
Acidity, 517 
Acipenser Huso, 228 
Acne, 518 
Aconine, 39 
Aconite, 39 
Aconitine, 39, 40 
Aconitum, 39 

Cam ma rum, 39 
Chinense, 39 
ferox, 39 
Japonicum, 39 
Napellus, 39 
Acorin, 111 
Acorus Calamus, 111 
Acrinyl, Sulpho-cyanate, 358 
Acrolein, 204 
Addison's Disease, 519 
Administration of Medicines, 12 
Adynamia, 519 
Adeps, 42 

Benzoinatus, 42, 99 
^Ether, 42 

^Ether, Acetic, 43, 46 
After-pains, 520 
Agalactia, 520 
Agaricin, 47 
Agaricus albus, 47 
chirurgorum, 48 
muscarius, 48 
Agave Americana, 55 
Ague, see Intermittent Fever, 649 
Ailanthus glandulosa, 49 
Albau, 212 
Albumin, 392 

Albuminate of Mercury, 222 
Albuminuria, 520 
Alcohol, 50, 339 
Caustic, 360 
Phenylic, 21 
Alcoholic Preparations, 452 
Alcoholism, 53, 521 
Aldehyde, 52, 285 

Proto-catechuic, 386 
Alder bark, 25, 55 
Alder, Black, 314 

Buckthorn, 197 
Ale, 51 

Alkalies, their action, 414 
Alkaline Mineral Waters, 76 
Alkaloids, Liquid, 372 
Allium cepa, 54 
porrum, 54 
sativum, 54 
Allspice, 299 
Allyl Sulphide, 54, 88 

Sulpho-cyanide, 358 
Almond, 63 
Alnus, 25 
Aloe socotrina, 55 
Alopecia, 522 
Aloes, 55 

Alstonia scholaris, 175 
Alteratives, 420 
Uterine, 428 
Althaea officinalis, 57 
Alum, 57 

Alum, Ammonio-ferric, 192 
Alum root, 25 



Alumen, 57 

Alumen Exsiccatum, 58 
Aluminium, 58 
Amanita Muscaria, 48 
Amaurosis, 523 
Amber, 367 
Amblyopia, 407, 523 
Amenorrhcea, 523, 792 
Ammonia, 59 
Ammonia-alum , 57 
Ammoniated Mercury, 217 
Ammoniacum, 59 
Ammonium, 59 
Amorphous Bodies, 443 
Amygdala, 63 
Amara, 29, 63 
Dulcis, 64 
Amygdalin, 29, 64, 315 
Amyl Chloride, 45 
Hydrate, 52 
Hydride, 46 
Nitrite, 65 
Amylene, 45 
Amylic Alcohol, 52 
Amylum, 67, 338 

Iodatum, 68, 231 
Anaemia, 524 

cerebral, 551 
Anaesthesia, 45, 526 

Local, 184 
Anaesthetics, 45, 404 
Local, 402 
Mixtures, 44 
Modes of using, 142 
Analgesics, 404 
Anamirta paniculata, 295 
Anaphrodisiacs, 427 

Pills, 503 
Anasarca, see Dropsy, 582 
Ancyclus Pyrethrum, 318 
Andira Araroba, 145 
Anemone, Meadow, 316 
patens, 316 
pratensis, 316 
Pulsatilla, 316 
Anemonin, 316 
Aneurism, 526 
Angelate of Butyl, 69 
Angina.— See Croup, Laryngitis, Pharyn- 
gitis, Throat, Tonsillitis, etc. 
Angina Pectoris, 527 
• Anhidrotics, 426 
Anilin Red, 198 
Anise, 68 

Star, 230 
Anodynes, 404 
Local, 402 
Ant-acids, 414 
Antagonists, 433 

List of, 484 
Anthelmintics, 419 
Anthemis, 68 

Anthrax.— See Carbuncle, 546 
Antidote, Jeaunel's, 767 
Antidote-bag. 768 
Antidotes, 433 
Anti-emetics, 415 
Anti-fat, 199 
Antifebrin,790 
Antilithics, 424 
Antimonial Powder, 70 



8oo 



INDEX. 



Antimony, 69 

Sulphurated, 70 
Antiperiodics. 122 
Antiphlogistics, 422 
Antipyretics, 151, 154, 421, 790 
Antipyrine, 72 
A ntiseptics, 224, 431 
Antisialics, 413 
Antispasmodics, 404 
Antizymotics, 431 
Anus,* Fissured, 527 
Aperients, 416 
Aphonia, 527 
Aphrodisiacs, 426 
Aphthae, 528 
Apiin, 73 
Apiol, 73 

Apis mellirica, 131, 260 
Apnoea, 784 
Apocynin, 74 
Apocynum, 74 
Apomorphine, 74, 275 
Apoplexy, 528 
Apotheme, 459 
Appetite, 529 

Approximate Measures, 469 
Aqua, 75 

Bulliens, 75 

Communis, 75 

Destillata, 75 

Fervens, 75 

Fluvialis, 75 

Fontana. 75 

Marina. 75 

Pluvialis, 75 
Aquae (see also Water of), 448 
Aqueous Preparations, 448 
Arabin, 18, 382 
Arbor Vitae, 134 
Arbutin, 134, 151, 384 
Arctostaphylos glauca, 384 

Uva-ursi, 383 
Argentum, 80 
Argol, 309 
Argyria, 81 
Aristolochia reticulata, 355 

Serpentaria, 355 
Aristolochine, 355 
Arnica, 82 
Arnicin, 82 

Aromatic Fluid Extract, 155 
Aromatic Powder, 155 
Aromatic Sulphuric Acid, 35 
Arseniate of Iron, 193 

of Sodium, 85 
Arsenic, 84 
Arsenium, 84 
Artemisia Absinthium, 18 

maritima, 345 
Arterial Transfusion, 13 
Artanthe elongata, 259 
Asafcetida, 88 
Asagrsea officinalis, 387 
Ascarides.— See Worms, 745 
Ascites, 529 
Asclepias, 89 
Ash. Flowering, 258 

Prickly, 392 
Asparagin, 57, 188, 205 
Asphyxia, 784 
Aspidium , 89 



Aspidosperma Quebracho, 320 

Aspidospermine, 320 

Asthenia. —See Adynamia, Convales- 
cence, Atrophy. 

Asthenopia, 530 

Asthma, 530 

Astigmatism, 531 

Astragalus gummifer, 382 

Astringents, 25, 421, 430 
Intestinal, 417 
Urinary, 424 

Atheroma, 532 

Atrophy, 532 

Atropine, 95 

and Morphine, 281, 283 

Atrosin, 95 

Aurantiin, 90 

Aurantlum, 90 

Aurum, 91 

Ava-kava, 241 

A vena Sativa, 791 

Ayer's Cherry Pectoral, 766 

Azedarach, 92 

Azoturia.— See Urinary Disorders, 736 

Azulen, 260 

Balanitis, 532 

Baldness.— See Alopecia, 522 

Balm, 261 

of Gilead, 375 
Balnea, 495 
Balneum Maris, 75 

Vaporis, 75 
Balsam of Copaiba, 161 

of Fir, 375 

Friar's. 99, 367 

of Peru, 93 

of Tolu. 94 
Balsam odendron Myrrh a, 269 
Balsamum Dipterocarpi, 211 

Peruvianum, 93 

Tolutanum, 94 
Bandoline, 171 
Baptisia, 94 
Baptism. 94 
Barberry, 100 
Bark, Cuprea, 148 

Peruvian, 147 
Barley, 255 
Barosma, 107 
Barosmin, 107 
Basham's Mixture, 193, 521 
Basilicon Ointment, 322 
Bassorin, 382 
Baths, Formulae, 495, 496 
Bav-berrv, 267 
Bay Rum, 267 
Bear-berry, 383 
Bed-sores, 532 
Beer, 51 
Belladonna, 95 
Belladonnine, 95 
Benne, Benne Oil, 356 
Benzene, 45, 98 
Benzin, 98 
Benzoate of Ammonium, 60, 99 

of Lithium, 99 

of Sodium, 99 
Benzoin, 99 
Benzoinated Lard, 42 
Benzol, 98 



INDEX. 



801 



Benzyl Cinnamate. 93 

Berberine, 100, 113, 224, 261, 285, 307 

Muriate of, 101 
Berberis, 100 
Bergaptene, 101 
Bergamium, 101 
Bergaruot, Oil of, 101 
Beta vulgaris, 337 
Bhang, 118 

Bibliography and References, 514 
Bicarbonate of Potassium, 309 

of Sodium, 360 

commercial, 360 
Bichloride of Ethene, 46 

of Mercury. 217 

of Methylene, 140 
Bichlorinated Chloride of Methyl, 139 
Bichromate of Potassium, 23, 24 
Bile, Agents affecting the, 417 
Biliary Solvents, 425 
Biliousness, 533 
Bilious Remittent Fever, 779 
Biniodide of Mercury, 218 
Bird-lime, 391 
Bismuth, 101 

Bismuth Mixture for Children, 490 
Bisulphate of Quinine, 149 
Bisulphide of Carbon, 45, 124 
Bisulphite of Sodium, 36 
Bitartrate of Potassium, 310 
Bites and Stings, 722 
Bitters, Action of the Simple, 114 
Bittersweet, 176 
Black-berrv, 25 

Bark, 333 
Black Draught, 354 
Black Drop, 276 
Bladder, Inflammation of, 570 

Irritable, 533 

Paralysis of, 534 
Bladder-wrack, 198 
Blende, 394 
Blepharitis, 534 
Blistering Cerate, 120 
Blisters, 429 
Blood-root, 342 
Blood-stains, 722 ' 
Blue Flag, 237 

Mass, 217 

Ointment, 217 

Pill, 217 
Boiling, 438 
Boils, 534 
Boldine, 102 
Boldo, 102 
Boldus, 102 
Bolus, 496 
Bone Diseases, 535 
Boneset, 188 
Borate of Quinine, 149 

of Sodium, 20 
Borax, 20 

Boro-citrate of Magnesium, 20, 545 
Boro-glyceride, 20 
Bos-taurus, 189 
Bots, 93 

Bougie's, Formulae for, 509, 510 
Boxwood, 285 
Brain Disorders,— See Cerebral Anaemia, 

Cerebral Concussion, etc. 



6 7 



Brain Fever. — See Meningitis, Cerebro- 
spinal Meningitis, Typhoid Fever, 

Tvph us Fever, 
Brandfeth's Pills, 766 
Brandy, 50 
Brayera, 103 
Breasts.— See Abscess, Lactation, Mastitis, 

Nipples. 
Breath, Fetid, 535 
Bright's Disease, Acute, 535 

Chronic, 536 

Diagnosis, 773 
Bromide of Ammonium, 60, 103 

of Calcium, 103 

of Ethyl, 43, 45 

of Iron, 104, 105 

of Lithium, 103 

of Methyl, 45 

of Potassium, 103 

of Sodium, 103 

of Zinc, 103 
Bromidrosis, 605 
Bromine and Bromides, 103 
Bromism, 104 
Bronchiectasis, 537 
Bronchitis, Acute, 537 

Capillary, 538 

Chronic, 539 
Bronchocele.— See Goitre, 616 
Bronchorrhoea, 541 
Broom, 352 
Brown Mixture, 205 
Brucine, 229, 270, 271 
Bruises, 541 
Bryonia, 106 
Bryonin, 106 
Bubo, 542 
Buchu, 107 
Buckthorn, 197 
Bulimia, 529 
Bunion, 542 
Burdock, 214 

Burnett's Disinfectant, 395, 432 
Burns, 542 
Bursitis, 543 
Butternut, 239 
Butyl Angelate, 69 
Butvl-chloral Hydrate, 139 

Chloride, 45 

Hydride, 46 

Valerianate, 69 
Buxine, 285 
Buxus sempervirens, 285 

Cacao-butter, 377 
Cachets, 505 
Cachexias, 543 
Cadmium, 108 
Caffea, 108 
Caffeine, 109, 378 
Cajuput Oil, 110 
Cajuputene Bihydrate, 110 
Cajuputol, 110 
Calabar Bean, 292 
Calabarine. 293 
Calamine, 394 

Ointment, 397 
Calamus, 111 
Calcination, 439 
Calcium, 111 
Calculi, Biliary, 544 



S02 



INDEX. 



Calculi, Renal, 544 

Solvents of, 425 

Vesical, 544 
Calendula, 113 
Calomel, 70, 217 
Calumba, 113 
Calx, 111 

Chlorata, 143 

Sulphurata, 369 
Cambogia, 114 
Camellia Thea, 109 
Camp Fever.— See Typhus, 734 
Camphor, 115 

Baldrian, 384 

Bergamot. 101 

Carbolated, 117 

-Chloral, 117 

-Cymol, 115 

Monobromated, 116 

Peppermint, 262 

Salicylated, 117 
Canadian Hemp, 74 
Cancer, 545 

Diagnosis of, 774 

of Uterus, 738 
Cancrum Oris, 546 
Cane Sugar, 337 
Cannabene, 118 
Cannabin, 118 
Cannabis, 117 

Americana, 118 

Indica, 118 

saliva, 117 
Cantharides, 120 
Cantharidin, 120 
Cantharis, 120 
Capsicin, 122 
Capsicum, 122 
Capsules, 503 
Carawav, 126 
Carbo, 123 

Animalis, 123 
Purified, 124 

Ligni, 124 
Carbolate of Iodine, 231 
Carbon, 123 

Bisulphide, 45 

Dioxide, 45 

Monoxide, 46 

Tetrachloride, 45, 140 
Carbonei Bisulphidum, 124 
Carbonate of Ammonium, 60 

of Calcium, Precipitated, 111 

of Iron, 190 

Saccharated, 190 

of Iron and Manganese, 256 

of Lead, 303 

of Lithium, 249 

of Magnesium, 253 

of Potassium, 309 

of Sodium, 360 
Dried, 360 

of Zinc, Precipitated, 395 
Carbonated Mineral Waters, 76 
Carbonization, 439 
Carbuncle, 546 
Carcinoma.— See Cancer, 545 
Cardiac Disorders.— See Heart. 

Sedatives, 411 

Stimulants, 410 

Tonics, 411 



Cardialgia.— See Pyrosis, 708 
Carica Papaya, 284 
Caries, 547 
Carminatives, 416 

De wees', 253 
Carmine, 155 
Caroval, 169 
Carron Oil, 112, 249 
Carthamus tinctorius, 165 
Carueu, 126 
Carum, 126 
Caruol, 126 
Caryophyllin, 127 
Caryophyllus, 126 
Casca Bark, 127 
Cascara Amarga, 128 

Sagrada, 128 
Cascarilla, 128 
Cascarillin, 128 
Cassia acutifolia, 354 

elongata, 354 

Fistula, 129 
Castanea, 25, 129 

vesca, 129 
Castor Oil, 330 

Emulsion, Formula, 564 
Catalepsy, 547 
Cataplasmata, 512 
Cataract, 547 
Catarrh, Acute Xasal. 548 

Broncho-pulmonary.— See Bronchitis 
Bronchorrhcea. 

Chronic Nasal, 549 

Duodenal, 584 

Epidemic. — See Influenza, 647 

Gastric— See Gastritis, Chronic, 612 

Genito-urinary.— See Bladder,Catarrh 
of, Cystitis, Endometritis, Gonor- 
rhoea, Leucorrhcea, etc. 
Catarrh, Intestinal. — See Dysentery, 
Jaundice, etc. 

Summer.— See Hay Fever, 621 
Catechol, 151 
Catechu, 25, 130 
Cathartics, 416 
Catharto-mannite, 354 
Caullophyllin, 130 
Caulophyllum, 130 
Caustic Potash, 309 
Caustics, 429 
Cedar, Oil of, 344 

Red, 336 
Celandine, 133 
Cellulose, 206, 338 
Centaurea benedicta, 126 
Cephaelis Ipecacuanha, 235 
Cephalalgia, 622 
Cera, 131 
Cera Alba, 131 

Flava, 131 
Cerata, 463, 510 
Cerate of Camphor, 116 

of Cantharides, 120 

of Cantharides Extract, 120 

of Cetaceum, 132 

of Lead Subacetate, 304 

of Resin, 322 

of Sabine. 336 
Cerates, 463, 510 

Compounding of, 511 
Ceratum, 42, 131 



INDEX. 



803 



Cerebellum, Agent? affecting, 405 
Cerebral Anaemia, 551 

Compression, Diagnosis, 774 

Concussion, bbl 
Diagnosis, 774 

Congestion, 551 

Depressants, 403 

Excitants, 402 

Softening. 552 

Vomiting— Diagnosis, 780 
Cerebro-spinal Fever. — See Meningitis, 

Cerebro-spinal, 666 
Cerium Oxalate, 131 
Cerolein, 131 
Cetaceum, 132 
Cetin, 132 
Cetraria, 132 
Cetvl Palmitate, 132 
Cevadilla, 387 
Cevadilline, 387 
Cevadine, 387 
Chalk, Prepared, 111 
Chalybeate Waters, 77 
Chamomile, 68 

German, 260 
Chamomilla, 260 
Chancre, 552 

Diagnosis of, 775 
Chancroid. 562 

Diagnosis of, 775 
Change of Life — See Climacteric. 
Chapped Hands and Lips, 553 
Charcoal. 124 

Chartae. (See also Papers). 464 
Chartulae, 506 
Chaulmoogra Oil, 133 
Chelerythrine, 133, 343 
Chelidonine, 133 
Chelidonium, 133 
Chelidoxanthin, 133 
Chelsea Pensioner, 505 
Chemical Incompatibility, 480 
Chenopodium, 133 
Cherrv-laurel, 29. 31 
Cherry, Wild, 315 
Chestnut, 129 
Chestnut-leaves, 25 
Chest-pains, 553 
Chian Turpentine, 375 
Chicken-pox, 553 
Chilblains, 553 
Children, Dosage for, 16 
Chimaphila, 134 
Chimaphilin, 134 
China, Pride of, 92 

Chininum Amorphum Boricum, 149 
Chinoidiu, 150 
Chinoline, 135 
Chiratin, 135 
Chiretta, 135 
Chittem Bark, 128 
Chlorasrna.— See Pityriasis, 695 
Chloral. 136 

Butvlic, 139 

Hvdrate. 136 
Chloral-habit, 137 
Chlorate of Potassium, 309 

of Sodium, 360 
Chloride of Ammonium, 60 

of Amyl, 45 

of Arsenic, 80 



Chloride of Butyl, 45 

of Calcium, 111 

of Cocaine, 182 

of Ethene, 45 

of Ethvl, 45 

of Ethvlidene, 140 

of Gold. 91 

of Gold and Sodium, 91 

of Iron, 190 

of Lime, 143 

Mereur-ammonium, 217 

of Mercury Corrosive, 217 
Mild, 217 

of Methane, 45 

of Methyl, 45 

of Sodium, 360 

of Zinc, 395 
Chlorinated Waters, 77 
Chlorine, 143 
Chlorine-water, 143 
Chlorodyne, 140 

Formulae for, compared, 765 
Chloroform, 44, 46, 139 

Commerical, 139 

Methylic, 139 

Purified, 139 
Chlorosis, 554 
Chlorum, 143 
Chocolate, 377, 378 
Choking, 554 
Cholagogues, 417 

Purgatives. 416 
Cholera Asiatica, 554 

Infantum, 555 

Simplex, 556 

Diagnosis of, 775 
Cholera Mixture (Squibb), 276, 555 
Cholesterin, 189, 392 
Chondodendron tomentosum, 285 
Chondrus, 145 
Chordee, 556 
Chorea. 557 
Choroiditis, 557 
Chrysarobin, 145, 212 
Chrysophan, 325 
Churrus, 118 

Cigarettes. Formulae for, 531 
Ciliary Excitants, 409 
Cimicifuga, 146 
Cimicifugin. 146 
Cinchona, 147 

Flava, 148 

Rubra, 148 
Cinchonidine, 148 
Cinchonine. 148, 150 
Cinchonism, 152 
Cinnabar, 218 
Cinnamein, 93 
Cinnamomum, 154 

Camphora, 115 
Cinnamon, 154 

Circulation, Agents affecting, 410 
Circumcision. 692 
Cissampeline, 285 
Cissampelos Pareira, 285 
Citrate of Bismuth, 101 

of Bismuth and Ammonium, 101 

of Caffeine, 109 

of Cocaine, 183 

of Iron, 190 

of Iron and Ammonium, 192 



804 



INDEX. 



Citrate of Iron and Quinine, 193 

of Iron and Strychnine, 193 

of Lithium. 249 

of Magnesium, Granulated, 253 

of Potassium, 310 
Citrates. 247 
Citrine Ointment, 218 

Brown, 219 
Citron, 217 

Citrullus Coloeynthis, 157 
Citrus aeris. 247 

Aurantium. 90 

Bergamia, 101 

Limonum, 246 

rnedica, 247 

vulgaris, 90 
Clarification, 442 
Classification of Medicines, 399 
Claviceps purpurea. 178 
Clavus.— See Headache. 623 
Climacteric Disorders, 558 
Cloves, 126 
Club-moss. 252 
Clysters. 494 
Cnicin, 126 

Cnicus benedictus, 126 
Coca. 109, 182 
Cocaine. 110. 1S2. 791 
Cocaine-habit, 1n4 
Cocculus Indicus, 295 
Coccus, 155 
Coccyotiynia, 558 
Cochineal, 155 
Cocoa, 110 
Codamine, 275 
Codfish, 204 
Codeine, 275. 277 
Cod-liver Oil, 264 

Emulsion, 492 
Coffee, 108 
Cohosh, Black, 146 

Blue. 130 
Colation. 442 
Colchiceine, 156 
Colchicine, 155, 156 
Colchicum, 155 
Coldnes-. 
Colic, Hepatic, 560 

Intestinal, 558 

Lead, 559 

Renal, 560 
Colic-root, 175 
Collodia. 457 
Collodion, 206 

with Cantharides, 120, 206 

Flexible. 206 

Stvptic, 38, 206 
Colloids, 444 
Collunarium, 495 
Colly rium, 493 

Formulae for. 494 

of Four Sulphates, 494 
Colocynth , 157 
Colocynth ein. 157 
Colocynth in. 157 
Coloeynthis, 157 
Colocynth itin, 157 
Uoiogne-water, 5 J 
Colophony. 322 
Columbo,113 
Coma, 560 



Combination. Principles of, 473 
Comminution, 440 
Compounding Medicines, 465 

a Mixture, 489 
Condylomata, 560 
Condy's Fluid, 432 
Confectio Damocratis, 505 
Confection of Rose, 332 

of Senna, 354 
Confectiones, 461 , 504 

Formulae for, 504, 505 
Conhydrine, 158 
Conine, 158 
Conium, 158 
Conjunctivitis, Catarrhal, 560 

Diphtheritic, 562 

Gonorrhceal, 562 

Granular, 562 

Phlyctenular, 562 

Purulent, 563 
Conspergative, 498 
Constipation, 564 
Constituents of Drugs, 436 
Convalescence, 565 
Convallamarin, 160 
Convallaria Majalis, 160 
Convallarin, 160 
Convolvulin, 238, 350 
Convolvulus Scammonia, 350 
Convulsions, 565 

Infantile. 565 

Puerperal, 705 
Copaiba. 161 

Emulsion, 492 
Copaifera Langsdorffii, 161 
Copper, 167 
Cordial, Cascara, 128 
Coriander, 163 
Coriandrum, 163 
Corneal Opacities, -^66 
Corneitis.— See Keratitis, 654 
Corn, Indian, 393 

Silk, 394 

Smut, 393 
Cornin, 163 
Corns, 567 
Corn us, 163 
Cornutin, 178 

Corpulence.— See Obesity, 678 
Corrosive Sublimate, 217 
Coryza. — See Catarrh, Acute, 548 
Cot6 Bark, 163 
Cotoin, 163 
Cosmoline, 288 
Cotton, 206 

Iodized, Formula for, 628 
Cotton-seed Oil, 273 
Couch-grass, 382 
Cough, 567 

Mixtures, Formulae, 568 
Counter irritants, 429 
Court Plaster, 229 
Coxalgia. 569 

Coxe's Hive Mixture, 70, 351 
Cramp Bark, 390 

Cramps.— See Trismus, Spasmodic Affec- 
tions. 
Cranberry Tree, 390 
Cranesbill. 25, 203 
Cream, Cold, 332 

of Tartar, 39, 310 



INDEX. 



80 5 



Creasol, 164 
Creasote, 22, 164, 301 
Creta Pneparata, 111 
Crocus. 165 
Croton-chloral, 139 
Croton Eluteria, 128 

Oil, 3*0 

Tigliuni, 380 
Croup, Catarrhal, 569 

Membranous, 569 

Diagnosis, 775 
Cryptopine, 275 
Crystallization, -443 
Cubeba, 166 
Cubeben, 166 
Cubebene, 166 
Cube bin, 166 
Cuca, 182 

Cucumber. Squirting, 177 
Cucumber tree, 254 
Cucurbita Pepo, 286 
Cucurbitine, 286 
Culver's Root, 246 
Cuprea Bark, 148 
Cuprum, 167 

Ammoniatum, 167 
Curare, 169 
Curarine, 169 
Cutaneous Irritants. 429 
Cvanide of Mercury. 218 

of Potassium, 29, 30 

of Silver, 80 
Cyanosis, 570 
Cydonin, 170 
Cydonium, 170 
Cymene, 379 

Cynips Gallse tinctorial, 199 
Cyprepedin, 171 
Cyprepedium, 171 
Cystitis, Acute. 570 

Chronic, 571 
Cysts, 572 

Damiana, 171 

Dandelion, 374 

Dandruff.— See Pityriasis, 695 

Daphne Mezereum, 263 

Daphnin, 263 

Datura Stramonium, 365 

Tatula, 172 
Daturine, 172, 366 
Deafness, 573 

Death, Signs of. — See Asphyxia, 785 
Debility.— See Adynamia, Anaemia, Con 

valescence. 
Decantation, 442 
Decocta, 451 
Decoction of Cetraria, 132 

of Chimaphila. 134 

of Dulcamara, 176 

of Granatus, 208 

of Hsematoxylon, 212 

of Hydrangea. 217 

of Inula, 230 

of Prinos, 314 

of Quercus, 321 

of Quillaia, 322 

of Rumex, 335 

of Sarsaparilla, Compound, 348 

of Stillingia, 364 

of Viola Tricolor, 391 



Decoction of Viscum, 391 

of Xanthoxylum, 393 
Decoloration, 442 
Deer, Musk, 266 
Deflagration, 439 
Deliquescence, 444 
Deliquescent Salts, List of, 500 
Deliriants, 402 
Delirium, 573 

Tremens, 573 
Delphinine, 364 
Delphinium Staphisagria, 363 
Dementia, 574 

Paralytica, 575 
Demulcents, 431 
Dengue, 575 
Dentition, 576 
Dentifrices, 412 
Deodorants, 432 
Depressants, Cerebral, 403 

Hepatic, 418 

Renal, 423 

Respiratory, 408 

Uterine, 428 
Dessication, 438 
Destructive Metamorphosis, 421 
Dew-berry, 334 
Dewees' Carminative, SS, 253 
Dextrin, 338 
Dextrose, 260, 338 
Diabetes Insipidus, 576 

Mellitus, 576 
Diachylon Ointment, 304 

Plaster, 304 
Diagnosis, Differential, 773 
Dialvsis, 444 

Dialysed Iron, 87, 193, 444 
Diaphoretics. 425 
Diarrhoea, 577 
Diastase, 255, 338 

Pancreatic. 284 
Dichloro-methane, 140 
Diffusate, 444 
Digestive System, Agents which affect 

it, 412 
Digitalein, 172 
Digitalin, 172, 173 
Digitalis, 172 
Digitonin, 172, 353 
Digitoxin, 172 
Diluents, 425, 488 
Dioscorea, 175 
Dioscorein, 175 
Diospyros, 25 
Dioxide of Carbon, 45, 339 
Diphtheria, 579 

Diagnosis of, 775 
Dipsomania.— See Alcoholism, and De- 
lirium Tremens. 
Discutients. 420 
Disinfectants, 432 

Burnett's, 395. 432 

Condy's, 432 

Labafraque's, 143, 432 
Dislocations, 609 
Dispensatories, 436 
Dispensing, 465 

by Physicians, 477 
Displacement, 445 
Distillation, 438 

Dry, 438 



8o6 



INDEX. 



Distillation, Fractional, 438 
Dita Bark. 175 
Ditaine, 175 
Ditamine, 175 
Diuretics. 422 

Formulae for, 583 
Dizziness.— See Vertigo, 742 
Dock, Yellow, 334 
Dog- wood, 163 

Jamaica, 300 
Domestic Measures, 469 
Donovan's Solution, 85 
Dorema Ammoniacum, 59 
Dosage of Medicines, 16 

of Opium, 276, 280 
Dover's Powder, 236, 277 

Fluid, 277 
Drastic Purgatives, 416 
Draught, 492 

Black, 354, 492 

Effervescing, 492 
Drink, 493 

Imperial, Formula, 493 
Drops, 469 

Table of Drops to a drachm, 469, 795 
Dropsy, 582 

Drowning.— See Asphyxia, 785 
Drugs, Their constituents, 436 
Drug-experimentation, 11 
Duboisia, 175 
Duboisine, 175 
Dulcamara, 176 
Dulcamarin, 176 
Duodenal Catarrh, 5S4 
Dutch Liquid, 140 
Dyscrasia?.— See Cachexia?, 543 
Dysentery, 584 
Dyspepsia. 587 
Dysphagia, 589 
Dysmenorrhea, 586 
Dyspnoea, 589, 595 
Dysuria, 590 

Ear, Agents affecting it, 407 

Earache, 683 

Eau Sedatif, 61, 63, 116 

Ebullition, 438 

Ecballium Elaterium, 177 

Ecbolics, 427 

Ecboline, 178 

Ecchymosis, 590 

Ecgonine, 182 

Eclampsia— See Puerperal Convulsions, 

705 
Ecthyma, 590 
Ectropium, 591 
Eczema, 591 
Efflorescence, 444 
Efflorescent Salts, List of, 500 
Egg, Yolk of, 392 
Elaterin, 177 
Elaterium. 177 
Elder, 342 
Elecampane, 230 
Electuaria, 461, 504 
Electuary for Piles, 505 
Elephantiasis, 593 
Elm, Slippery. 383 
Elutriation, 441 
Elixir of Orange, 91 
Elixiria, 456, 492 



Emaciation, 593 
Embrocation, 494 
Emetics, 414 

General or Systemic, 415 

Local, 415 
Emetine, 235, 236 
Emissions, 594 
Emmenagogues, 427 

Formula? for, 524 

Pills, 502 
Emollients, 431 
Emphysema of Lungs, 594 
Emplastra. 463, 511 
Empyema, 595 
Emulsincation, 490 
Emulsin, 29, 64, 315 
Emulsion of Cod-liver Oil, 265, 492 

of Copaiba, 492 

Pancreatic, 284 
Emulsions, 490 

Natural, 490 
Encephaloma.— See Cancer, 545 

Diagnosis of, 774 
Endarteritis.— See Atheroma, 532 
Endocarditis, 595 

Diagnosis of, 774 
Endometritis, 595 
Enema of Tobacco, 372 
Enemas, Formula? for, 495 
Enemata, 596 

Enteralgia.— See Colic, Intes., 558 
Enteric Fever.— See Typhoid, 732 
Enteritis, 597 
Entropium. 591 
Enuresis, 597 
Epididymitis, 598 
Epilation.— See Tinea Circin. 728 
Epilepsy, 598 

Diagnosis of, 776 
Epispastics, 429 
Epistaxis, 599 
Epsom Salt, 253 
Epulis.-See Teeth, 727 
Equinia.— See Glanders, 614 
Erections, 594 
Ergot of Rye, 178 

of Corn— See Ustilago, 393 
Ergota, 178 
Ergotine, 179 
Ergotinine, 178 
Ergotism, 179 
Ericolin, 200, 383 
Erigeron, 181 
Eriodyction, 181 
Errhines, 408 
Eructations.— See Dyspepsia, Flatulence, 

587, 608 
Eruptions caused by Drugs, 600 
Erysipelas, 600 # 

Erythema, 602 
Ervthrophleine, 127 
Erythrophloeum Guinense, 127 
Ervthroretin, 325 
Erythroxylon, 182 
Escharotics, 429 
Eserine, 294 
Essence of Lemon, 247 

of Peppermint, 262 

of Spearmint, 263 
Ethene, 45 

Chloride, 45 



INDEX, 



807 



Ethene Dichloride, 46 
Ether, 42 

Chloric, 140 

Chlorinated Muriatic, 140 
Met hylic, 45 
Petroleum, 98 
Ethereal Oil, 43 

Preparations, 456 
Ethics 

Ethyl Acetate, 43 
cohol, 50, 52 
Bromide, 43, 45 
Carbamate, 793 
Chloride, 45 
Hydrate, 52 
Hvdride, 46 
Iodide, 43. 233 
Nitrite, 43, 65 
Oxide, 42 
Ethylate of Sodium, 360 
Ethylene Bichloride, 140 
Ethyl idene Chloride, 140 
Eucalvptene, 186 
Eucalyptol, 186 
Eucalyptolen, 186 
Eucalyptus, 186 
Eugenia caryophyllata, 126 
Eugenia Pimenta, 299 
Eugenin, 127 
Eugenol, 127 
Euonymin, 188 
Euonymus, 188 
Eupatorin, 188 
Eupatorium, 188 
perfoliatum, 188 
purpureum, 188 
Euphrasia, 189 
Evaporation. 437 

ntaneous, 438 
Exanthemata, Diagnosis of, 777 
Excipients, 46". 488 
for Emulsions, 490 
for Pills, 497 
Excitants, Cerebral, 402 

Ciliary, 410 
Excoriation. — See Intertrigo. 651 
Excretion.— Agents affecting, 422 
Exhaustion, 603 
Exogonium purga, 238 
Exophthalmos, 603 

:osis, 603 
Expectorants, 409 
Explosive Compounds, 482 
Expression, 445 
Exsiccation, 439, 444 
Extemporaneous Pharmacy, 464 
Preparations, 486 
acriptions, 470 
Extract of Aconite. 40 
of Aloes, Watery, 55 
of Arnica- root, 83 
of Baptisia, 94 

of Belladonna, Alcoholic, 95 
of Cannabis Indica, 118 
of Cinchona. 149 
of Colocynth. 157 

Compound, 157, 350 
of Colchicum-root, 156 
of Conium, Alcoholic, 158 
of Convallaria, 160 
of Dainiana, 171 



Extract of Digitalis, 172 

of Duboisia, 175 

of Ergot, 179 

of Eriodyction. 185 

of Euonvmus, 188 

of Gentian, 202 

of Glycvrrhiza, 205 
Pure, 205 

of Haematoxylum, 212 

of Black Hellebore, 214 

of Hvoscvamus, Alcoholic, 226 

of Iris, 237 

of Juglans, 239 

of Krameria. 242 

of Leptandra, 246 

of Malt, 255 

of Mezereum, 264 

of Opium, 276 

of Phvsostigma, 293 

of Podophyllum, 307 

of Polygonum, 308 

of Quassia, 319 

of Quebracho, 320 

of Rheum, 325 

of Rhus Toxicodendron, 328 

of Stramonium, 365 

of Taraxacum, 375 
Extracta. 458 

Extracta Fluida.— See Fluid Extracts, 432 
Extractive. 459 
Eye-bright, 189 
Eye Diseases. 603 

Ointments.— Formulae for, 561 

Sensibility, Agents affecting it, 406 

Water, Formulse for, 561 
Eyelids, 604 

Face, 604 

Face-ache.— See Neuralgia, also Tic Dou- 
loureux. 
Fainting.— See Syncope, 724 
False Pains, 605 
Farcy, 614 

Fat.— See Obesity, 678 
Fatigue.— See Exhaustion, 603 
Favus.— See Tinea Favosa, 729 
Febricula.— See Fever, Simple, 607 
Febrifuge, 150 
Feet. 605 

Fehling's Solution, 167, 787 
Fel Bovis, 189 

Inspissatum, 189 
Purificatum, 189 
Felon.— See Onychia, 679 
Fennel, 197 

Fermentation, Lactic. 339 
Ferrier's Snuff, Formula, 549 
Ferro-cyanide of Potass., 29, 31 
Ferrum, 189 

Dialyzatum, 87, 193, 444 

Reductum, 189 
Ferula galbaniflua, 199 

Narthex, 88 

Scorodosma, 88 

Sumbul, 371 
Fever, 605 

Bilious Remittent, Diagnosis, 779 

Cerebro-spinal. — See Meningitis, Cere- 
brospinal, 666 

Hectic, 627 

Intermittent, 648 



8o8 



INDEX. 



Fever, Miliary, 669 

Milk.— See Lactation, 655 

Pernicious.— See Intermittent Fever, 
Remittent Fever. 

Puerperal, 705 

Relapsing, 709 

Remittent, 709 

Diagnosis of, 779 

Rheumatic, 710 

Scarlet, 715 

Diagnosis of, 777 

Simple, 607 

Spotted.— See Typhus Fever, also 
Meningitis, Cerebro-spinal. 

Surgical, 723 

Traumatic— See Surgical Fever, 723 

Typhoid, 732 

Diagnosis of, 778 

Tvpho-malarial.— See Typhoid, 732 

Typhus, 734 

Diagnosis of, 778 

Yellow, 747 

Diagnosis of, 779 
Ficus (Fig), 197 
Filtering-paper, 442 
Filtration, 442 
Fir, Balsam of, 375 

Silver, 375 
Firs, 301 
Fistula, 607 

Fits.— See Apoplexy, Convulsions, Epi- 
lepsy, Hysteria, Svncope. 
Flatulence, 608 
Flavoring Agents, 488 
Flax-seed, 248 
Flea-bane. 181 

Fleming's Tincture of Aconite, 40 
Flooding.— See Hemorrhage Postpartum, 

Menorrhagia and Metrorrhagia. 
Fuavil, 212 
Fluid Extract of Aconite, 40 

of Ailanthus, 50 

of Arnica-root, 83 

Aromatic, 155 

of Aurantium Amarum, 91 

of Baptisia, 94 

of Belladonna, 95 

of Berberis, 100 

of Brayera, 103 

of Buchu, 107 

of Calamus, 111 

of Cannabis Indica, 118 

of Capsicum, 122 

of Cascara Amara, 128 

of Cascara Sagrada, 128 

of Castanea, 129 

of Chimaphila, 134 

of Chirata, 136 

of Cimicifuga, 146 

of Cinchona, 149 

of Cocculus, 295 

of Coffee, Green, 109 

of Colchicum-root, 156 

of Colchicum-seed, 156 

of Conium. 158 

of Com all aria, 160 

of Corn-silk, 394 

of Cornus, 163 

of Coto, 164 

of Cotton-root, 206 

of Cubeb, 166 



Fluid Extract of Cyprepedium, 171 
of Damiana, 171 
of Digitalis, 173 
of Dulcamara, 176 
of Ergot, 179 
of Eriodvction, 182 
of Erythroxylon, 182 
of Eucalyptus, 186 
of Eupatorium, 188 
of Frangula, 198 
of Gelsemium, 201 
of Gentian, 202 
of Geranium, 203 
of Ginger, 398 
of Glycyrrhiza, 205 
of Go'ssypium, 206 
of Granatum, 208 
of Grindelia, 209 
of Guarana, 211 
of Hamamelis, 213 
of Hellebore, Black, 214 
of Hydrangea, 217 
of Hydrastis, 225 
of Hyoscyamus, 226 
of Ipecacuanha, 236 
of Iris, 237 
of Jaborandi, 297 
of Krameria, 242 
of Lactucarium, 244 
of Leptandra, 246 
of Liquorice, 205 
of Lobelia, 251 
of Lupulin, 216 
of Manaca, 256 
of Matico, 259 
of Mezereon, 264 
of Orange, Bitter, 91 
of Pareira, 286 
of Phytolacca, 294 
of Pilocarpus, 297 
of Pink-root. 363 
of Piscidia, 300 
of Plantago, 303 
of Podophyllum, 307 
of Poke-root, 294 
of Polygonum, 308 
of Prunus Virginiana, 315 
of Quassia, 319 
of Quebracho, 320 
of Rhatany, 242 
of Rheum, 325 
of Rhubarb, 325 
of Rhus Aromatica, 327 
of Rhus Glabra, 327 
of Rose, 332 
of Rubus, 334 
of Rumex. 335 
of Sabina, 336 
of Sanguinaria, 343 
of Santalum, 344 
of Sarsaparilla, 348 
Compound, 348 
of Savine, 336 
of Scilla, 351 
of Scutellaria, 352 
of Senega, 353 
of Senna, 354 
of Serpentaria, 355 
of Spigelia, 363 
of Stigmata Mavdis, 394 
of Stillingia, 364 



INDEX. 



809 



Fluid Extract of Stramonium, 365 

of Sumach, Smooth, 327 
Sweet, 327 

of Taraxacum, 375 

of Triticum, 383 

of Ustilago. 393 

of UVa-ursi, 384 

of Valerian, 385 

of Veratrum Viride, 387 

of Viburnum, 390 

of Wild Cherry, 315 

of Witch-hazel, 213 

of Xanthoxylum, 393 

of Zingiber, 398 
Fluid Extracts, 452 
Flushing-heats, 608 
Fly-agaric, 48 
Foeniculum, 197 
Foetal Development, 783 

Skull, Its Diameters, 784 
Fomentation, 493 
Food, Horlick's, 255 

Mellin's, 255 
Foods, 419 
Foreign Bodies, 608 
Formulae, Hypodermic, 760 
Formyl Iodide, 231 
Fotus, 493 

Fowler's Solution, 85 
Fox-glove, 172 
Fractures, 609 
Franciscea uniflora, 255 
Frangula, 197 
Frangulin, 197 
Frank Unite, 394 
Fraxin, 258 
Fraxinus Ornus, 258 
Freckles, 609 
Friar's Balsam, 99, 367 
Fuchsin, 198 
Fucus Vesiculosus, 198 
Furuncle.— See Boils, 534 
Fusel Oil. 52 
Fusion, 439 

Gaduin, 264 

Gadus Morrhua, 264 

Galactagogues, 428 

Galbanum, 199 

Galla, 25, 199 

Galena, 303 

Gallipots, 511 

Gall-stones.— See Calculi, Biliary. 

Gallus Bankiva, 392 

Gamboge, 114 

Gangrene, 610 

of Lungs, 660 
Garcinia Hanburii, 114 

mangostana, 258 
Gargarysma, 493 

Gargles, Formulae for, 493, 581, 692 
Garlic, 54 

Gaseous Preparations, 513 
Gastralgia, 610 
Gastric Dilatation, 611 
Gastric Fever. — see Fever Simple, Ty 

phoid Fever, Gastritis. 
Gastric Pain, 415 

Sedatives, 415 

Tonics, 413 

Ulcer, 613 



Gastric Vomiting, Diagnosis, 780 
Gastritis, Acute, 612 

Chronic, 612 
Gastrodvnia, 610 
Gaultheria. 200 
Gaultherilene, 200 
Gauze of Thymol, 379 
Gelatin, 228 

Capsules, 503 
Gelsemine, 201 
Gelsemium, 200 

Generative System, Agents affecting, 426 
Genitive Case-endings, 763 
Gentian, 202 
Gentianin, 202 
Gentopicrin, 202 
Geranium, 25, 203 
Gin, 51, 240 
Ginger, 397 
Glanders, 614 

Glandular Enlargements, 614 
Glass, Soluble, 310, 357 
Glauber's Salt, 360 
Glaucoma, 615 
Gleet, 615 
Glonoin, 65, 67 
Glossitis, 616 
Glottis, (Edema of, 616 
Gluco-pepsin, 287 
Glucose, 338 
Glycerin, 203 

Preparations, 458 
Glycerita, 458 

Glycerite of Carbolic Acid, 22 
* of Tannin, 38 

of Starch, 68 

of Yolk-of-egg, 392 
Glyceryl, 273 

Trinitrate, 65 
Glycocholate of Sodium, 189 
Glycogen, 338 

Agents affecting production, 418 
Glyconin, 392 

Emulsion of, 265 
Glycyrrhetin, 205 
Glycyrrhiza, 205 
Glycyrrhizin, 205 

Glycyrrhizinum Ammoniatum, 205 
Gnoscopine, 275 
Goa-powder, 145 
Goitre, 616 
Gold, 91 

Golden Seal, 224 
Gonorrhoea, 617 
Gossypii Radicis Cortex, 206 
Gossypium, 206 
Goulard's Cerate, 304 

Extract, 304 
Gout, 619 

Diagnosis of, 776 
Granatum, 25, 208 

Granular Lids.— See Conjunctivitis, Oph- 
thalmia. 
Granulation, 444 
Granule, 496 
Grass. Ribbed, 303 
Gravel-root, 188 

Graves' Disease.— See Exophthalmos, 608 
Grav Powder, 217 
Griffith's Mixture, 190 

Pills, 190 



68 



8io 



INDEX. 



Grindelia, 208 
Guarana, 110, 210 
Guaranine, 110, 211 
Guaiac, 209 

Lignum, 209 

Resina, 209 
Guaiacol, 164 
Gum Arabic. 18 
Gumboil.— See Gums, 620 
Gum-tree, Blue, 186 
Gums, 620 
Gun-cotton, 206 
Gunjah, 118 
Gurjun Balsam, 211 
Gutta, 212 
Gutta-percha, 211 
Guttae (Drops), 469 
Gynocardia odorata, 133 

Hair, 620 
Hair-tonic, 522 
Hair Washes, Formulae, 620 
Haller's Dictum, 11 
Hamamelin, 213 
Hamamelis, 25, 213 
Hamburg Tea, 766 
Hamlin's Wizard Oil, 766 
Hands.— See Chapped Hands. 
Hashish, 118 
Haustus, 492 
Haw, Black, 390 
Hay-fever, 621 
Haematics, 419 
Haematoxylin, 212 
Hi.ematoxylon, 25, 212 
Head-ache. Bilious Sick, 622 

Congestive, 623 

Nervous, 623 
Heart, Fattv, 625 

Dilated, 625 

Diseases, 624 

Hypertrophied, 626 

Palpitation, 626 

Valvular Disease, 627 
Heartburn.— See Pyrosis, 708 
Heart's-ease, 391 
Hectic Fever, G27 
Hedeoma, 214 
Helenin, 230 
Hellebore, 214, 389 

American, 387 

-Swamp, 387 

White. 387 
Helleborein, 214 
Helleborin, 214 
Helleborus, 214 
Hematemesis, 627 

Diagnosis of, 776 
Hematocele, Pelvic, 628 
Hematuria, 628 
Hemeralopia, 629 
Hemicrania, 629 
Hemiopia, 631 
Hemiplegia, 631 
Hemlock, 158 
Hemlock Spruce, 301 
Hemoptysis, 631 

Diagnosis of, 776 
Hemorrhage, 632 

Intestinal, 633 

Post-partum, 633 



Hemorrhagic Diathesis, 632 
Hemorrhoids, 634 
Hemostatics, 430 
Hemp, 118 

American, 118 

Canadian, 74 

Indian, 118 
Henbane. 226 
Hepar Sulphuris, 369 
Hepatalgia, 636 
Hepatic Abscess, 639 

Congestion, 636 

Cirrhosis, 636 

Depressants, 418 

Diseases, 638 

Stimulants, 417 

Vomiting, Diagnosis, 780 
Hepatitis, 639 
Hernia, 639 
Herpes, 639 

Zoster, 640 
Hesperidin, 90 
Heuchera, 25 
Hiccough, 640 
Hip-joint Disease, 569 
Hippocratic Oath, 788 
Hive Mixture, 351 

Syrup, 70 
Hives.— See Urticaria, 737 
Hoang Nan, 791 
Hoarseness —See Aphonia, 527 
Hoffman's Anodvne, 43 
Horf's Malt Extract, 255 
Homatropine, 96 
Honduras Bark, 128 
Honev, 260 

Clarified, 260 

of Rose, 260 
Honeys (Mellita), 450 
Hong-Pang-Chong. 326 
Hooper's Female Pills, 503 
Hope's Mixture, 579 
Hopeine, 215 
Hops, 215 

Hordeolum.— See Eyelids, 604 
Hordeum distichum, 255 
Horehound, 258 
Horlick's Food, 255 
Housemaid's Knee.— See Bursitis, 543 
Humulus, 215 
Hunger.— See Appetite, 529 
Huxham's Tincture of Bark, 149 
Hydragogue Purgatives, 416 
Hydrangea, 216 
Hydrargyrism, 220 
Hydrargyrum, 217 

Ammoniatum, 217 

cum Creta, 217 
Hydrastin, 101, 225 
Hvdrastine, 224 
Hydrastis, 224 
Hydrate of Aluminium, 58 

of Amvl, 52 

of Butyl-chloral, 139 

of Chloral, 136 

of Ethyl, 52 

of Magnesium, 253 

of Methyl, 52 

of Potassium, 309 

of Sodium, 359 
Hydrated Oxide of Iron, 191 



INDEX. 



811 



Hydrated Oxide of Iron with Magnesia,191 
Hydrated Silicate of Magnesium, 357 
Hydride of Amyl, 46 

of Butvl, 46 

of Ethyl, 46 

Trichloracetvl, 136 
Hydriodic Ether, 43, 46 
Hydrobromate of Conine, 159 

of Hyoscine, 227 

of Quinine, 149 
Hydrobromic Ether, 43, 46 
Hydrocele, 641 
Hvrocenhalus, 641 
Hydrochlorate of Apomorphine, 74 

of Cocaine, 182 

of Quinine, 149 

Carbamide, 149 

of Morphine, 277 

of Narcotine, 278 

of Oxy-ethyl-chinoline-hydride, 151 

of Pilocarpine, 297 

of Rosanilin, 198 
Hvdrocotarnine, 275 
Hydrocotvle, 226 
Hydrogen, Sulphuretted, 369 
Hydrophobia, 642 
Hydroquinone, 151, 323, 383 
Hydrothorax, 642 
Hygrine, 182 
Hygroscopic Bodies, 444 
Hyoscine, 226 
Hyoscyamus, 226 
Hyoscyamine, 226 
Hyperidrosis, 689 
Hypnotics, 403 
Hypochondriasis, 642 
Hypodermic Formulae, 760 

Injections, 13, 762 
Hypophosphite of Calcium, 289 

of Iron, 191, 289 

of Potassium, 289 

of Sodium, 289 
Hypophosphites, 289 

with Iron, Syrup of. 193 
Hyposulphite of Sodium, 36 
Hysteria, 643 

Diagnosis of, 776 

Ice, 78 

Iceland Moss, 132 

Ichthvocolla, 228 

Ichthyol, 791 

Ichthyosis, 643 

Icterus.— See Jaundice, 652 

Igasurine, 270 

Ignatia, 229 

Ignition, 439 

Ileus.— See Intestinal Obstruction, 651 

Ilex Paraguayensis, 110 

Illicium, 230 

Anisatum, 68 
Impetigo, 644 
Impotence, 644 
Incineration, 439 
Incompatibility, 480 

Chemical, 480 

Pharmaceutical, 483 

Therapeutical, 484 

Rules for avoiding, 485 
Indigestion.— See Dyspepsia, 587 
Indigo, Wild, 94 



Inflammation, 645 
Influenza, 647 
Infusa, 451 
Infusion of Arnica, 83 

of Bravera, 103 

of Buchu, 107 

of Caraway. 126 

of Cascarilla, 129 

of Cinchona, 149 

of Cloves, 127 

of Convallaria. 160 

of Digitalis, 173 

of Gentian, Compound, 202 

of Hops, 216 

of Juniper, 240 

of Linseed, 249 

of Lobelia. 251 

of Pareira, 286 

of Quassia, 319 

of Sassafras, 349 

oi Senna, Compound, 354 

of Spigelia, Compound, 363 

of Tansv. 374 

of Tar, 302 

of Wild Cherry, 315 

of Uva-ursi, 384 
Infusions, 451 
Ingluvin, 2b7 

Inhalations, Formulae for, 513 
Injections, Formula, 494. 495 
Injuries.— See Bruises, Burns, Ecchy- 

mosis, Fractures, Sprains, Wounds. 
Inoculation, 15 
Inosit, 338 
Insanity, 574 

Insolation.— See Sunstroke, 723 
Insoluble Salts, 482 
Insomnia, 648 

Intemperance. — See Alcoholism, Deliri- 
um Tremens. 
Intermittent Fever, 648 
Intertrigo, 651 
Intestinal Astringents, 417 
Intestinal Diseases.— See Colic, Constipa- 
tion, Diarrhoea, Duodenitis, Dysentery, 

Enteritis, Hemorrhoids, Hernia, Intes- 
tinal Obstruction, Intussusception, 

Typhlitis, Tabes Mesenterica, Worms. 
Intestinal Obstruction, 651 

Parasites.— See Worms, 745 
Intussusception, 651 
Inula, 230 
Inulin, 82, 230 
Iodide of Ammonium, 60, 231, 234 

of Arsenic. 85 

of Cadmium, 108 

of Ethyl, 43, 233 

of Formyl, 231 

of Iron, 191 

Saccharated, 191 
and Manganese, 193 

of Lead, 303 

of Manganese 256 

of Mercurv, 85 
Green,* 218 
Red, 218 

of Potassium, 231, 234 

of Silver, 80 

of Sodium, 231 

of Sulphur, 369 

of Zinc, 395 



8l2 



INDEX. 



Iodides, 232 
Iodine, 231 
Iodism, 232 
Iodized Cotton, 628 

Phenol, 231 

Starch, 68,231 
Iodoform, 231, 235 
Iodum. 231 
Ipecacuanha, 235 
Iridin, 237 
Iris, 237 
Irish Moss, 143 
Irisin, 237 
Iritis, 652 
Iron, 189 

Dialysed, 193,444 

and Tannic Acid, 486 
Irritability, 651 
Irritants, Cutaneous,. 429 
Ischuria. — See Urinary Disorders. 
Isonandra Gutta, 211 
Itch. — See Scabies, 714 
Itching. — See Lichen, Prurigo, Pruritus, 

Pediculi, Scabies, Urticaria, etc. 

Jaborandi, 297 
Jaborine, 297 
Jalap, 238 
Jalapin, 238,350 
James' Powder, 70 
Jamestown Weed, 365 
Japaconitine, 39 
Jasmine, Yellow, 200 
Jateorrhiza Calumba,113 
Jaundice, 652 
Jeriquit\\ 17 
Jervine,' 387, 388 
Joint Affections, 653 
Juglans, 239 
Juniperin, 240 
Juniper, 240 
Juniperus communis, 240 

Sabina, 336 

Virginiana, 336 

Kairine, 73, 151 

Kairoliue, 151 

Kalium, 309 

Kalmia latifolia, 261 

Kamala. 241 

Kavahin, 241 

Kava-kava, 241 

Kawin, 241 

Kefir, 244 

Keratitis, 654 

Kidneys, Diseases of.— See Albuminuria, 
Bright's Disease, Calculi, Diabetes, 
Dropsy, Hematuria, Lithsemia, Ne- 
phritis. 

Kino, 25, 242 

Kinoin, 242 

Kino-red, 242 

Kinovate of Calcium, 148 

Kinovin, 148 

Koussin, 103 

Kousso, 103 

Krameria, 25, 242 

Kumyss, 52, 54, 243 

Kurung Oil, 308 

Labarraque's Solution, 143, 432 
Labor, 654 



Labor, Positions in, 782 

Signs of, 782 
Lac Sulphuris, 368 
Lactate of Iron, 191 
Lactation, 655 
Lactopeptine, 287 
Lactophosphates, 290 
Lactose, 339 
Lactuca virosa, 244 
Lactucerin, 244 
Lactucin, 244 
Lactucarium, 244 
Ladies' Slipper, 171 
La Fayette's Mixture, 162 
Lallemand's Specific. 619 
Lanolin, 792 
Lanthopine, 275 
Lapathin, 335 
Lappa, 244 
Larch, 47 

European, 375 
Lard, 42 

Benzoinated, 42 

Oil. 42 
Larix Europeea. 375 
Laryngismus Stridulus, 655 
Laryngitis, 656 
Laryngotomy, 657 
Latin Phrases and Terms, 749 
Laudanine, 275 
Laudanosine, 275 
Laudanum, 276 
Laurel, Mountain, 261 
Laurocerasus, _9 
Lavandula, 245 
Lavender, 245 

Water, 246 
Laville's Anti-gout Remedy, 157 
Laxatives, 416 
Lead, 303 

Colic, 559 

Plaster, 304 

Sugar of, 303 

Water, 304 

and Laudanum, 493 

White, 303 
Leek, 54 
Lemon, 246 

Juice, 247 

Peel, 247 
Lentigo.— See Freckles, 609 
Leopard's Bane, 82 
Lepra,— See Psoriasis, 703 
Leprosy.— See Elephantiasis, 593 
Leptandra, 246 
Leptandrin, 246 
Lettuce, 244 
Leucocythsemia, 657 
Leucoline, 135 

Leucoma.— See Corneal Opacities, 566 
Leucorrhcea, 657 
Levigation, 440 
Levulose, 260, 338 
Lice.— See Pediculi, 687 
Lichen, 658 
Lichenin, 132 

Licoperdon giganteum, 246 
Lignum Vita?, 209 
Lily-of-the-Valley, 160 
Lily, Water, 273 
Lime, 111, 247 



INDEX. 



8'3 



Lime, Chlorinated, 143 

Water, 112 
Limon, 246 
Limonis Cortex, 247 

Succus, 247 
Linimenta, 457, 494 
Liniment, Aconite, 40 

Ammonia, 60 

Belladonna, 95 

Camphor, 116 

Cantharides, 120 

Chloroform, 140 
Compound, 140 

Croton, 381 

Lime, 112 

Mustard, Compound, 358 

Soap, 347 

Turpentine, 375 
Liniments, Formulae for, 494 
Linseed, 248 
Linum, 248 

Lips.— See Chapped Lips, 553 
Lip-salve, Red, 378 
Liquid-ambar orientalis, 366 
Liquids, Normal, 454 
Liquor es (See Solution of), 449 
Liquorice Root, 205 

Wild, 17 
Litheemia, 659 
Litharge, 304 
Lithium, 249 
Lithontriptics, 424 
Liver.— See Hepatalgia, etc., 636 
Lixiviation, 445 
Lobelacrin, 250 
Lobelia, 250 
Lobelin, 251 
Lobeline, 250 

Lochia.— See Labor and Puerperal Disor- 
ders, 654, 705 
Lock-jaw.— See Tetanus, 727 
Locomotor Ataxia, 659 
Log-wood, 25, 212 
Lotion, 493 

Black, of Mercury, 219 

Yellow, of Mercury, 219 
Loxopterygium Lorentzii, 320 
Lozenges, 461, 504 
Lugol*s Solution, 231, 
Lumbago, 659 

Lumbrici.— See Worms, 745 
Lungs, Diseases of, 660 

Gangrene of, 660 
Lupulin, 215 
Lupuline, 215 
Lupus, 661 
Lycopodium, 252 
Lyctonine, 39 
Lymphangeitis, 661 

Mace, 268 

Oil of, 268 
•Maceration, 445 
Macis, 268 
Macro tin, 146 
Magendie's Solution, 277 
Magenta, 198 
Magma, 443 
Magnesia. 253 

Ponderosa, 253 
Magnesium, 252 



Magnolia, 254 

Magnolin. 255 

Maize, 393 

Malaria. 662 

Male Fern, 89 

Mallotus phillipinensis, 241 

Malt, 255 

Extract, Hoff's, 255 
Maltum, 255 
Mammary Abscess, 516 
Manaca. 255 
Mandrake, 307 
Manganese, 256 

Oxide, 792 
Manganum, 256 
Mangifera indica, 258 
Mango, 258 
Mango-fruit, 258 
Mangosteen, 258 
Mania, 663 
Manna. 258 
Mannit, 2-58 
Manzanita, 384 
Marasmus.— See Atrophy, Emaciation, 

Tabes Mesenterica. 
Marginal Shield Fern, 89 
Marigold, 113 
Marjoram, Wild, 283 
Marrubiin, 258 
Marrubium, 25S 
Marsh-mallow, 57 
Mass of Copaiba, 162 

of Ferrum Carbonate, 190 

of Mercury, 217 
Massse, 460 
Mastic, 259 
Mastiche, 259 
Ma^tichin, 259 
Mastodvnia, 664 
Mastitis, 663 

Masturbation.— See Emissions, Sperma- 
torrhoea, 594, 719 
Mate, 110 
Materia Medica, 9 
Matico, 259 
Matricaria, 260 

Chamomilla, 69, 260 
May Apple, 307 

McMunn's Elixir of Opium, 276 
Meadow Saffron, 155 
Measles, 664 

Diagnosis of, 777 

False. — See Roseola, 714 
Measures, Approximate. 469 

Domestic, 469 

and Weights, 465 
Meconidine, 275 
Meconoiosin, 275 
Meconin, 275 

Medicines, Administration of, 12 
Mel, 260 

Despumatum, 260 

Rosse, 260, 333 
Melaleuca Cajuputi, 110 
Melancholia, 665 
Melia Azedarach, 92 
Melissa, 261 
Mellin's Food, 255 
Mellita, 450 
Meningitis, Cerebral, 665 

Cerebro-spinal, 666 



814 



INDEX. 



Meningitis, Spinal, 667 

Tubercular.— See Hydrocephalus, 641 
Menispermin, 295 
Menisperrnum, 261 

Cocculus, 295 
Menopause. — See Climacteric, 558 
Menorrhagia, 667 
Menstrual Disorders, 668 
Menstruum, 445 
Mentagra, 668 
Mentha Piperita, 262 

Viridis, 263 
Menthol, 262 
Mercurial Ointment, 217 

Plaster, 217 
Mercuric Chloride, 217 

Iodide, 218 
Mercurio-vegetal, 256 
Mercurous Chloride, 217 

Iodide, 218 
Mercury, 217 

Ammoniated, 217 

with Chalk, 217 
Mesenteric Disease.— See Tabes Meson- 

terica, 726 
Metabolism, Agents affecting, 419 
Methane, 45 
Methene Chloride, 45 
Methyl Alcohol, 45 

Bromide, 45 

Chloride, 45 

Bichlorinated, 139 

Conine, 158 

Creasol, 164 

Ether of Protocatechuic Aldehyde,386 

Hydrate, 52 

Salicylate, 200 

Terchloride, 139 
Methylal, 45 

Methylene Bichloride, 140 
Methylic Alcohol, 52 

Ether, 45 
Methysticin, 241 
Metric Prescriptions, 468 

System of Weights, etc., 467 

Table for Converting, 796 
Metritis, Acute, 669 
Metrorrhagia, 669 
Mezereon, 263 
Mezereum, 263 
Migraine, 629 
Miliary Fever, 669 
Milk.— See Agalactia, Lactation. 
Milk Fever.— See Lactation, 655 
Mineral Waters, 76, 79 
Mint, 263 

Miscarriage.— See Abortion, 516 
Mistletoe, 391 
Misturse, 450, 486 
Mixture, Almond, 64 

Ammoniac, 59 

Asafetida, 88 

Bismuth, 490 

Chalk, 112 

Chloroform, 140 

Copaiba, Compound, 162 

Coxe's Hive, 351 

Ferro-saline, 194 

Gentian, Alkaline, 202 
and Senna, 202 

Xron, Aromatic, 194 



Mixture Iron and Ammonium Acetate, 
193 
Iron, Compound, 190 
Iron, Laxative, 194 
Liquorice, Compound, 205 
Magnesia and Asafetida, 88, 253 
Neutral, 310 
Quinine, 490 
Potassium Citrate, 310 
Rhubarb and Soda, 325 

Mixtures. 450, 486 

Compounding of, 489 
Substances suitable to, 486 

Molasses, 338 

Mole.— See Nsevus, 671 

Mollities Ossium.— See Bone Diseases, 
Rachitis, 535, 708 

Monoxide of Carbon, 46 

Monsel's Solution, 192 

Moonseed, Canadian, 261 

Morbilli. — See Measles, 664 

Morphine, 275, 277, 280 
and Atropine, 281, 283 
Habit, 681 

Morrhuse Oleum, 264 

Morrison's Pills, 115 

Moschus, 266 

Motor Depressants, 401 
Excitants, 400 

Mouth Diseases.— See Aphthae, Cancrum 
Oris, Gums, Parotitis, Ptyalism, Stom- 
atitis, Toothache, Tongue. 

Mouth W T ashes, Formulae, 620 

Mucilage of Acacia, 18 
of Cydonium, 170 
of Elm, 383 
of Sassafras-pith, 349 
of Tragacanth, 382 

Mucilagines, 450 

Mullein, 389 

Mumps, 687 

Muriate.— See Hydrochlorate. 
of Berberine, 225 
of Cocaine, 182 

Muse* Volitantes, 669 

Muscarine, 48 

Muscular Disorders.— See Atrophy. Cho- 
rea, Hydrophobia, Laryngismus, Lum- 
bago, Myalgia, Pleurodynia, Rheum- 
atism, Tetanus, Torticollis. 

Musk, 266 

Mustard, 357 
Black, 358 
Flour of, 358 
Oil of, 358 
White, 357 

Myalgia, 670 

Mydriasis, 96 

Mydriatics, 405 

Myelitis, 670 

Mykose, 178 

Myopia, 670 

Mvotics, 406 

Myrcia, 267 

Myrica, 25 

cerifera, 131 

Myricin, 131 

Myristica, 268 

Myristicol, 268 

Myronate of Potassium, 358 

My rosin, 358 



INDEX. 



8iS 



Myroxylon toluifera, 94 

Pereirse, 93 
Myrrh, 269 
Myrrhin, 269 
Myrrhol,269 
Myrtle, 25 

Nsevus, 671 
Nails, Ingrowing, 671 
Napelline, 39, 42 
Naphthalin. 269 
Narceine, 275, 280 
Narcotics, 403 
Narcotine, 275, 280 
Nasal Affections, 671 

Injections, Formulae, 581 
Natrium, 359 
Nausea, 671 
Necrosis, 672 
Nectandra, 285 
Nervous Affections, 672 

Exhaustion, 673 
Nervousness, 673 

Nervous System, Agents affecting, 400 
Neuralgia, 674 

Ovarian, 683 
Neutral Mixture, 310 
New Remedies, Notes on, 790 
Nicotiana Tabacum, 371 
Nicotianin, 372 
Nicotine, 372 
Nightshade, Black, 176 
Deadly, 95 
Woody, 176 
Night-mare, 677 
Night Sweats.— See Hectic Fever, Perspi 

ration, Phthisis. 
Nipples, Sore, 677 
Fissured, 677 
Nitrate of Ammonium, 60 
of Ethyl, 43, 65 
of Lead, 304 
of Mercury, 218 
of Muscarine, 48 
of Potassium, 226, 310 
of Silver, 80 
Fused, 80 
of Sodium, 360 
Nitre, 310 
Chili, 360 
Sweet Spirit of, 43 
Nitrite of Amyl, 65 
of Ethyl, 66 
of Potassium, 65 
of Sodium. 65, 67 
Nitro-benzol, 64 
Nitro-glycerin, 65, 67 
Nitrous Ether, 43, 46 
Nitrous Oxide, 45 
Nodes, 677 
Normal Liquids, 454 
Norway Spruce, 301 
Nucin, 239 
Nutgall, 25, 199 
Nutmeg, 268 
Nux Vomica, 270 
Nyctalopia, 629 
Nymphsea, 25 

Odorata, 273 
Nymphomania, 678 



Oak-bark, 25 

Black, 321 
Oak, Dyer's, 199 

White, 321 
Obesity, 678 

Obstetrical Memoranda, 782 
Odontalgia, 678 
(Esophagus, Affections of, 679 
Official Operations, 437 

Preparations, 448 
Officinal.— See Preface. 
Oil of Amber, 367 

of Allspice, 299 

of Almond, Bitter, 64, 331 
Expressed, 64 

of Anise, 68 

of Anthemis, 69 

of Aurantium Cortex, 91 
Flores, 91 

of Bay, 267 

Benne, 356 

of Bergamot, 101 

of Cade, 240 

of Cadinum, 240 

of Cajuput, 110 

of Caraway, 126 

of Carum, 126 

Carron, 249 

Castor, 330 

of Oarvophyllus, 127 

of Cedar, 345 

Chaulmoogra, 133 

of Cbenopodium, 134 

of Cinnamon, 154 

of Cloves, 127 

Cod-liver, 264 

of Copaiba, 162 

of Coriander, 163 

of Cotton-seed, 206, 273 

of Cubeb, 166 

Ethereal, 43 

of Erigeron, 181, 

of Eucalyptus, 186 

of Fennel, 197 

of Gaultheria, 200 

of Gossypium-seed, 206, 273 

of Hedeoma, 214 

of Hemlock, 302 

of Juniper, 240 

of Lavender, 245 

Flowers, 245 

of Lemon, 247 

of Linseed, 248 

of Linum, 248 

of Mace, 268 

of Mentha Piperita, 262 

of Mentha Viride, 263 

of Mirbane, 64 

of Morrhua, 264 

of Mustard, Volatile, 358 

of Myrcia, 267 

of Myristica, 268 

of Neroli, 91 

of Nutmeg, 268 

Olive, 206, 273 

of Orange-flowers, 91 

of Orange-peel, 91 

of Origanum, 283 

of Pennyroyal, 214 

of Pepper-mint, 262 

Phosphorated, 289 



8i6 



INDEX. 



Oil of Pimenta, 299 

of Pinus Sylvestris, 302 

of Pix Liquida, 240, 301 

of Pongamia, 308 

of Ricinus, 330 

of Rose, 331, 332 

of Rosemary, 333 

of Rue, 335 

of Ruta, 335 

of Sabina, 336 

Salad, 273 

of Sandalwood, 344 

of Santal, 344 

of Sassafras, 349 

of Sesamum, 356 

of Sinapis, Volatile, 358 

of Spearmint, 263 

of Spruce, 302 

Sweet, 273 

of Succinum, 367 

of Tabacum, 372 

of Tanacetum, 374 

of Tansv, 374 

of Tar, 240, 301 

of Terebinthina, 375 

of Theobroma. 377 

of Thuja, 378 

of Thyme, 379 

of Tiglium, 380 

of Turpentine, 375 

of Valerian, 385 

of Wintergreen, 200 

Wood, 211 
Oils. Expressed, 445 

Fixed, 445 
Ointment, 42, 131 

Basilicon, 322 

Belladonna, 95 

Calamine, 397 

Carbolic Acid, 22 

Chrvsarobin, 145 

Citrine, 218 

Diachylon, 304 

Gallic Acid, 25 

Gall, 199 

Hamamelis, 213 

Iodine, 231 

Iodoform, 232 

Lead Carbonate, 304 
Iodide, 304 

Mercurial, 217 

of Mercury, Ammoniated, 217 
Nitrate. 218 
Red, 219 
Oxide, Red, 218 
Yellow, 218 

Mezereum, 264 

Nutgall, 199 

Petroleum, 288 

of Pix Liquida, 301 

of Potasiium Iodide, 231 

of Rose-water, 332 

of Staphisagria, 363 

Stramonium, 866 

Sulphur. 368 

Alkaline, 368 

of Tannic Acid, 37 
Tar, 301 

Thymol, 379 

Veratrine, 388 
Witch-hazel, 213 



Ointment of Zinc Oxide, 395 
Ointments, 462, 510 

Compounding, 511 

Formulse for, 511, 592, 635 
Olea Europaea, 273 
Oleaginous Preparations, 457 
Oleata, 33, 34, 457 
Oleate of Aconitine, 34 

of Aluminium, 34 

of Arsenic, 34 

of Atropine. 34 

of Bismuth, 34 

of Cocaine, 183 

of Copper, 34 

of Iron, 34 

of Lead, 34, 304 

of Mercury, 33, 218 

of Morphine. 34,277 

and Mercury, 34 

of Quinine, 34 

of Silver, 34 

of Strychnine, 34 

of Veratrine, 34, 388 

of Zinc, 34 
Oleates, 33, 34, 457 
Olein, 273 
Oleoresina, 456 
Oleoresin of Aspidium, 90, 103 

of Capsicum, 122 

of Cubeb, 166 

of Lupulin, 216 

of Pepper, 299 

of Zingiber, 398 
Oleoresins, 456 
Onion, 54 
Onychia, 679 
Operations, Official, 437 
Ophelia Chirata, 135 
Ophthalmia, 680 
Opisthotonos.— See Tetanus, 727 
Opium, 274 

Denarcotized, 276 

Habit, 681 
Opodeldoc, 347 
Orange, 90 
Orchitis, 682 
Ordeal Bark, 127 
Origanum, 283 
Otalgia, 683 
Otitis, 683 
Otorrhcea, 683 
Ovarian Neuralgia, 683 

Tumors.— See Cysts, 572 
Ovaritis, 684 
Ovis Aries, 356 
Oxalate of Iron, 191 
Oxaluria, 684 
Ox-gall, 189 
Oxide of Antimony, 70 

of Calcium, 111 

of Ethyl, 42 

of Iron, Hydrated, 191 

with Magnesia, 191 

of Lead, 304 

of Magnesium, 253 

of Manganese. Black, 256 

of Mercury, Red, 218 

of Mercury, Yellow, 218 

of Propyl, 264 

of Silver, 80 

of Zinc, 395 



INDEX. 



817 



Oxymel, 261 
Oxytocics, 427 
Oyster-shell, 112 
Ozaena, 684 

Pagliari's Styptic, 633 
Pain, 685 

Gastric, 415 
Pains, False, 605 
Paints. 512 

Palmitate of Oetyl, 182 
Palm i tin, 273 
Pancoast's Styptic, 633 
Pancreas, Agents affecting, 419 
Pancreatin, 284 
Pancreopepsin, 287 
Pannus.— See Corneal Opacities, 566 
Pansy, 391 
Papain, 284 
Papaiva, 284 

Papaver Somniferum, 274 
Papaverine, 275 
Papaw Milk, 285 
Paper of Cantharides, 120 

of Mustard, 358 

of Potassium Nitrate, 310 
Papers (Chartse),464, 506 
Papine, 276 
Parachinanisols, 151 
Paraconine, 158 
Paracoto Bark, 164 
Paracotoin, 164 
Paraldehyde, 285 
Paralysis, 686 
Paramenispermin, 295 
Paramorphine, 275 
Paraphimosis.— See Phimosis. 692 
Paraplegia.— See Paralysis, 686 
Parasiticides. 432 
Paregoric, 276 
Pareira, 285 
Parigenin, 348 
Parillin, 348 
Paronychia, 679 
Parotitis, 687 
Participles, 764 
Parvule, 496 
Pastilles, 461 
Pasque-flower, 316 
Patent Medicines, 766 
Paullinia curare, 169 
Paullinia sorbilis, 110, 210 
Pearson's Solution, 85 
Pectin, 321 
Pediculi, 687 
Pelletierine, 208 
Pellitory, 318 

Persian, 318 
Pelosine, 285 
Pelvic Diameters, 783 
Pemphigus, 687 
Pencils, 509 
Penis.— See Chancre, Chancroid, Chor- 

dee, Gleet, Gonorrhoea, Phimosis, 

Urethra. 
Pennyroyal, 214 
Pennywort, 226 
Pepo, 286 
Pepper, Black, 299 

Water, 308 
Peppermint, 262 



Pepsin, 286 

Liquid, 287 

Saccharated, 287 
Pepsinum, 286 

Peptogenic Milk Powder, 287 
Perchloride of Iron, 190 
Percolation. 445 
Pericarditis, 688 

Diagnosis of, 774 
Periostitis, 688 
Peritonitis, 688 

Puerperal, 706 
Permanganate of Potassium, 256, 792 
Pernicious Fever.— See Intermittent Fe- 
ver, Remittent Fever. 
Perry Davis' Pain-Killer, 766 
Persimmon, 25 
Perspiration, 689 
Pertussis, 690 
Peruvian Bark, 147 
Petrolatum, 288 
Petroleum Ether, 98 

Ointment, 288 
Petroselinum sativum, 73 
Peumus Boldo, 102 
Phaeoretin. 32o 
Phagedena.— See Chancre, Chancroid, 

Gangrene, Ulcers. 
Pharmaceutical Incompatibility, 483 
Pharmaceutists. — Their objectionable 

practices, 476 
Pharmacology, 9 
Pharmacopoeias, List of, 435 
Pharmacy, 9, 435 

Extemporaneous, 464 

Official, 437 

Pules for neophytes, 480 
Pharyngitis, 691 
Phaseo-mannit, 338 
Phenol, 21, 52 

Iodized, 231 

Salicyl. 792 
Pheno-resorcin, 151 
Phenyl-acetamid, 790 
Phenylic Alcohol, 52 
Phimosis, 692 
Phlebitis, 692 

Phlegmasia Alba Dolens, 692 
Phlegmon, 693 
Phlorol, 164 
Phosphate of Ammonium, 60 

of Calcium, Precipitated, 290 

of Iron. 191 

of Iron and Manganese, 193 

of Sodium, 290 
Phosphates, 290 

Syrup of the, 193 
Phosphide of Zinc, 289 
Phosphites, 289 
Phosphorus, 289 
Photophobia, 693 
Phthisis, 693 

Diagnosis of, 777 
Physeter macrocephalus, 132 
Physiological Antagonists, 484 
Physostigma, 292 
Physostigmine, 293 
Phytolacca, 294 
Picrsena excelsa, 319 
Pic rates, 35 
Picroglycion, 176 



8iS 



INDEX. 



Picropodophyllin. 307 

Picrotoxin, 295 

Pierce's Favorite Prescription, 766 

Golden Discovery, 766 
Pigmenta, 512 
Piles, 634 
Pill of Aloes, 56 

of Aloes and Asafetida, 56, 88 

of Aloes and Iron, 56 

of Aloes and Mastic, 56 

of Aloes and Myrrh, 56 

of Antimony. Compound, 70 

of Asafetida, 88 

Compound Cathartic, 115, 157 

of Galbanum, Comp., 88, 199 

of Iodide of Iron, 191 

of Iron, Compound, 190 

Lady Webster's, 56 

of Opium, 276 

of Phosphorus, 289 

of Rhubarb, 325 

of Rhubarb, Compound, 326 

Tanjore, 722 
Pill-masses, 460 
Pills, 460, 496 

Coated, 501 

Compressed, 501, 502, 507 

Excipients for, 497 

Formulae for, 502 

Process of making, 496 

Official, 460 

Substances suitable for, 498 

Substances unsuitable for, 499, 500 
Pilocarpine, 297 
Pilocarpus, 297 
Pilulse, 460, 496 
Pimenta, 299 
Pimpinella Anisum, 68 
Pimples.— See Acne, 518 
Pine, Prince's, 134 

Yellow, 375 
Pines, 301 
Pinipicrin, 378 
Pinites Succinifer, 367 
Pink, Carolina, 363 
Pink -root, 363 
Pinus, 301 

Australis, 375 

Palustris, 301 
Piper, 299 

angustifolium, 259 

methysticum, 241 
Piperlne, 299 
Pipsissewa, 134 
Piscidia, 300 
Piscidin, 300 
Pissenlit, 374 

Pistacese Terebinthus, 375 
Pistacia Lentiscus, 259 
Pitch, 301 

Burgundy, 301 

Canada, 301 

Hemlock, 301 
Pityriasis, 695 
Pix, 301 

Pix Liquida, 301 
Planat's Tincture, 295 
Plantago, 303 
Plantain, 303 
Plaster, Adhesive, 323 

Ammoniac, 59 



Plaster, Ammoniac, with Mercury, 59 

Arnica, 83 

Asafetida, 88 

Belladonna, 95 

Capsicum, 122 

Carbolic Acid, 22 

Galbanum, 199 

Ichthyocolla, 229 

Iron, 191 

Lead, 304 

Mercurial, 217 

Opium, 277 

Pitch, Burgundv, 302 

Pitch with Cantharides, 120, 302 

Pitch, Canada, 302 

Resin, 323 

Soap, 347 

Strengthening, 191 

Warming, 302 
Plasters, 463, 511 

Formulae for, 512 

Preparation of, 464 
Plethora, 696 

Abdominal, 515 
Pleurisy, 696 

Diagnosis of, 777 
Pleurisy-root, 89 
Pleuritis, 696 
Pleurodynia, 697 
Pleuro-pneumonia, 697 
Plumbum, 303 
Plummer's Pills, 70 
Pneumonia, 697 

Diagnosis of, 777 
Podopyhyllin, 307 
Podophyllitoxin, 307 
Poisoning by Acids, 768 

Acid, Acetic, 768 
Arsenious, 87, 769 
Carbolic, 23, 768 
Chromic, 24 
Gallic, 26 

Hydrocyanic, 31, 768 
Mineral, 28, 768 
Oxalic, 768 
Sulphuric, 768 
Sulphurous, 36 
Tannic, 38 

Aconite, 41, 768 

Agaricus, 49 

Alcohol, 53, 768 

Alkalies, 312, 362, 769 

Alum, 769 

Ammonia, 62, 769 

Antimony, 71, 769 

Arsenic, 87, 769 

Atropine, 97, 769 

Barium, 769 

Bees, 769 

Belladonna, 97, 769 

Bromides, 105 

Camphor, 116, 769 

Cannabis Indica, 119, 769 

Cantharis, 121, 769 

Chloral, 138, 769 

Chlorine, 144. 769 

Chloroform, 140, 769 

Coculus Indicus, 772 

Colchicum, 156, 770 

Conium, 159, 770 

Copper, 168, 770 



INDEX. 



819 



Creasote,770 

Curare, 170 

Digitalis, 174, 770 

Duboisine, 176 

Ergot, 180 

Ether, 45, 769 

Fish, 770 

Gamboge, 770 

Gas, Carbcnic Acid, 770 

Sulphuretted Hydrogen, 770 

Gelsemium, 201, 770 

Glass, 770 

Gold Salts, 92, 770 

Hyoscyamus, 228 

Insects, 769 

Iodine. 233, 770 

Ipecacuanha, 236 

Iron, 770 

Lead, 305, 770 

Lime. 112, 770 

Lobelia, 251 

Mercury, 222, 771 

Mezereum, 771 

Muscarine, 49 

Morphine, 281. 771 

Mushrooms, 771 

Nitrites, 66 

Nux Vomica, 272, 772 

Oak or Ivy, 329, 772 

Opium, 281,771 

Phosphorus, 291, 771 

Physostigna, 293, 771 

Picrotoxin, 296, 772 

Pilocarpine, 298 

Potassa, 312 

Potassium Salts, 772 

Pulsatilla, 317 

Quinine, 153, 772 

Reptiles, 772 

Resorcin, 324 

Rhus, 329, 772 

Sanguinaria, 343 

Silver Salts, 81, 772 

Sodium, 362 

Stramonium, 366 

Strychnine, 272, 772 

Sulphur, 370 

Sulphuretted Hydrogen, 37C, 770 

Sumach, 329, 772 

Tin. 772 

Tobacco, 373, 772 

Turpentine, 377 

Vegetable Poisons, 772 

Veratrum Viride, 389, 772 
Zinc Salts, 396, 772 
Poisoning, 433, 767 

Antidotes and Antagonists, 433 
Indications for Treatment, 433 
General Principles, 767 
Poisonous Compounds, 483 
Poisons, Energetic, 767 
Poke-berry, 294 
Poke, Indian, 387 
Poke-root, 294, 387 
Polygala Senega, 353 
Polygonum Hydropiperoides, 308 
Polyporus fomentarius, 48 
Polypus, 699 

Polyuria. — See Diabetes Insipidus, 576 
Pomade de Bareges, 696 
Pomegranate, 25, 208 



Pond's Extract, 213 
Pond Lilv, 25 
Podophyllum, 307 
Pongamia, 308 
Poppy, White, 274 
Porphyrization, 441 
Porphyroxin, 343/275 
Porrigo Capitis.— Tinea Tonsurans, 729 
Porter, 51 
Port Wine, 51 
Potassa, 309 
Alum, 57 
cum Calce, 309 
Sulphurata, 369 
Potassio Cupric-Tartrate, 167 
Potassium, 309 
Potato, 176 
Potus, 493 
Poultices, 512, 699 

List of Br. official, 512 
Powder of Aloes and Canella, 56 
Antimonial, 70 

Aromatic. 155 

Chalk, Compound, 111 

Dover's, 236, 277 

Effervescing, Comp., 310 

Gray, 217 

Ipecac and Opium, 236, 277 

Jalap, Compound, 238 

James', 70 

Kino, Compound, 242 

Liquorice, Compound, 205 

Morphine, Compound, 277 

Opium, 275 

Rhubarb, Compound, 325 

Seidlitz, 310 

Tully's, 277 
Powders, 461, 505 

Formulae for, 506, 507 

Substances suitable to, 506 
Precipitant Solutions, Table of, 481 
Precipitate, White, 217 
Precipitation, 443 
Pregnancy, Disorders of, 700 

Signs of, 782 

Vomiting of, 743 
Premna tatiensis, 382 
Preparations, Acteous,458 

Alcoholic, 452 

Aqueous, 448 

Ethereal, 456 

Extemporaneous, 486 

Gaseous, 513 

Glycerin, 458 

Official, 448 

Oleaginous, 457 

Solid, 458 
Prepositions, 764 
Prescriptions, 470 

Analysis of, 471 

Blanks for, 475 

Filling of, 478 

Metric, 468 

Renewals of, 476 
Prescription- Writing, 474 
Prickly Heat.— See Lichen, 658 
Prince's Pine, 134 
Prinos, 314 

Proctitis.— See Rectum, 708 
Prolapsus Ani, 700 

Uteri, 700 



820 



INDEX. 



Propyl Oxide. 264 

Propylamine. 

Prosopalgia.— See Neuralgia, Odontalgia, 

Tie Douloureux. 
Prostate. Hvpertrophied. 701 
Prostatitis, 701 
Prostatorrhoea, 701 
Protectives, 431 
Protiodide of Mercury, 218 
Protopine, 27o 
Prune, 315 
Prunum. 315 
Prunus doinestiea, 315 

Lauroeerasus, 29 

serotina. 315 

Virginiana, 315 
Prurigo, 701 
Pruritus. 702 
Pseudaconitine, 39 
Paeudo-jervine. ^~ 
Pseudo-morphine, 275 
Pseudotropine, 226 
Psoriasis, 703 
Ptelea trifoliata. 328 
Pterocarpus ruarsupiuni, 242 

saDtalinus,345 
Pterygium, 704 
Ptosis. 704 
Ptyalism. 7W 
Puccine, 343 
Puerperal Conyulsions, 705 

Disorders, 705 

Feyer, 706 

Mania, 706 

Melancholia, 706 

Peritonitis, 706 
Puff-ball, 246 
Pulmonary Sedatiyes, 409 
Pulsatilla,*316 
Pulse, 706 
Pulveres. 461, 505 
Pulverization, 440 
Pumpkin-seed. 286 
Punica Granatuni, 20S 
Purgatives, 416 
Pursing Agaric 47 

Cassia. 129 
Purpura. 707 
Pustule. Malignant. 707 
Pustules. — See Ecthyma. Eruptions. Im- 
petigo, Pustule Malignant. 
Postulants, 429 
Pvaemia, 707 
Pvrethrine, 318 
Pyrethrum, 318 

Roseum, 318 
Pvridin, 372 

Pyrocatechin, 151. 301, 323 
Pyrophosphate of Iron, 191 

of Sodium, 290 
Pvrosis, 708 
Pyroxylin, 206 

Quassia, 319 

Surinam, 319 
Quassin, 319 
Quebrachine, 320 
Quebracho, 320 
Queen's Delight, 364 

Root, 364 
Quercin, 321 



Quercitrin, 321 
Quercus Alba. 25, 321 

Lusitanica, 199, 321 

Tinctoria. 321 
Quicksilver, 217 
Quillaia, 321 
Quince-seed, 170 
Quinetum, 150 
Quinidine.148 
Quinine. 14S 

Mixture, 490 
Quinoidin. 150 
Quinquinine, 150 
Quinsy.— See Tonsillitis, 730 

Rabies.— See Hydrophobia. 642 

Rachitis. 708 

Radway's Ready Relief, 767 

Resolvent. 7 1 
Raspails Eau Sedatif, 61, 63, 116 
Raspberry. 334 
Rectum, Absorption by, 13 

Diseases of. 1 8 

Ulceration of. 2 B 
Red Gum.— See Strophulus. 723 
References and Bibliography, 514 
Refrigerants. 413 
Relapsing Fever, 7 
Remittent Fever, 709 

Diagnosis of. 779 
Renal Depressants. 423 
Renewals of Prescriptions, 476 
Repercolation, 446 
Resin, 322 

Cerate 322 

of Copaiba, 162 

of Jalap. 238 

Plaster, 323 

of Podophyllum, 307 

of Scammony, 350 
Resina. 322 
Resinae, 460 
Resolvents. 420 
Kesorcin, 22, 323 

Respiration.— See Bronchitis.Croup. Dysp- 
noea, Emphysema, Pneumonia, etc. 
Respiration, Agents affecting 
Respiratory Depressants, 40b 

Stimulants, 408 
Restoratives, 419 
Retina, Affections of, 709 
Rhamnoxantliin. 198 
Rhamnus Frangula, 197 

Purshiana. 128 
Rhaphidophora vitiensis, 381 
Rhatanine, 242 
Rhatany, 25. 242 
Rheum. 324 

Rheumatic Arthritis, 710 
Rheumatism, Acute, 710 

Chronic, 712 

Diagnosis of, 776 

Gonorrhoeal. 713 

Muscular, 714 
Rhinacanthin, 326 
Rhinacanthus, 326 
Rhinitis.— See Catarrh Acute Nasal, also 

Nasal Affections. 
Rhoeadine, 275 
Rhubarb, 324 
Rhus Aromatica, 327 



INDEX. 



821 



Rhus Diversiloba, 328 

glabra , 327 

puinila, 328 

radicans, 328 

Toxicodendron, 328 • 

venenata, 328 
Eicinus communis, 330 
Rickets— See Rachitis, 708 
Rigors.— See under Fever, 605 
Ring- worn. 
Roasting, 440 
Rochelle Salt, 310 
Rosa cent i folia, 331 

Damascena, 332 

Gallica, 25, 332 
Rosanilin, 198 
Rose, 25 

Attar of, 332 

Cabbage, 331 

Pale, 331 

Red, 332 
Roseine, 198 
Rosemary, 25, 333 
Roseola, 714 
Rosin, 322, 375 
Rosmarinus, 333 
Rottlera, 241 

tinctoria, 241 
Rottlerin, 241 
Rubefacients, 429 
Rubeola.— See Measles, 664 
Rubijervine, 387 
Rubini's Tincture, 116 
Rubus, 25. 333 

Canadensis, 333 

Idaeus, 334 

occidentalis, 334 

trivialis, 334 

strigosus, 334 

villosus, 333 
Rue, 335 
Rules for Incompatibility, 485 

for Pharmaceutists, 480 
Rum. 51 

Bav. 267 
Rumex, 334 
Rumicin, 335 

Rupia— See Pemphigus, 687 
Ruta, 335 

Russian Spirit, 713 
Rye, 178 

Sabadilla, 387 
Sabina, 336 
Saccharum, 337 

Lactis. 339 
Sacred Bark, 128 
Safflower, 165 
Saffron, 165 

American, 165 

Meadow. 155 
Saffron-tea, 165 
Sage. 341 
Salicin, 340 
Salicylate of Cinchonidine, 150 

of Cocaine, 183 

of Lithium, 340 

of Methyl. 200 

of Physostigmine, 293 

of Sodium, 340 
Saligenin, 340 



Saline Mineral Waters, 76 

Purgatives, 416 
Saliva, Agents affecting, 413 
Salivation, 220. 413 

See also Ptvalism, 704 
Salix, 339 
Salol. 792 
Salt, Epsom, 253 

Glauber's, 360 
Salt, Rochelle, 310 
Salt-petre. 330 

Chili, 360 
Salt-rheum —See Eczema, 591 
Salts, Deliquescent, List, 500 

Efflorescent, List of, 500 
Salve, Red Lip, 378 
Salvia, 341 
Salviol, 342 
Sambucus, 342 
Sandal-wood Oil, 344 
White, 344 
Yellow, 344 
Sanguinaria, 342 
Sanguinarine,133, 343 
Santalum Album, 344 

citrinum. 344 

Rubrum, 34-5 
Santonica, 345 
Santonin, 345 

Santoninate of Sodium, 345 
Sapo. 346 

Animalis. 347 

Medicatus, 347 

Mollis, 347 

Viridis, 347 
Sapogenin, 353 
Saponification, 347 
Saponin, 130, 246, 322, 353 
Sarcinie, 714 

Sarcocele.— See under Cancer, Testicles. 
Sarothamnus Scoparius, 352 
Sarsaparilla, 348 
Sassafras. 349 

Medulla. 349 

Swamp, 2" 4 
Sassy Bark. 127 
Saunders, Red, 345 
Savine, 336 
Sayre's Method of administering Chloro- 

* form, 142 
Scabies, 714 

Scald-head. — See Eczema, Tinea Tonsu- 
rans, etc. 
Scalds, 542 
Scammonium, 350 
Scammony, 350 
Scarlet Fever, 715 

Diagnosis of. 777 
Sciatica, 716 
S cilia, 350 
Scillin, 351 
Scillipicrin, 351 
Scillitin, 351 
Sciliitoxin. 3-51 
Scirrhus — See Cancer, 545 

Diagnosis of, 774 
Sclererythrin, 178 
Scleroderma, 717 
Scleromucin, 178 
Scleroxanthin, 178 
Scoparin, 352 



822 



INDEX. 



Scoparius, 3-52 

Scorbutus.— See Scurry. 718 

Screaming.— See Nightmare, 677 

Scrofulosis, 717 

Scudamore's Mixture, 619 

Scurvy, 718 

Scutellaria, 3-52 

Scutellarin. 353 

Sea-sickness, 718 

Seborrhoea, 718 

Sea-wrack, 198 

Secale cereale,178 

Secalin, 393 

Sedatives. 400 
Cardiac. 411 
Gastric, 415 
Pulmonary, 409 
Urinary, 424 
Vascular, 412 
Vesical. 424 

Seidlitz Powder, 310 

Senega, 3-53 

Senegin, 3-53 

Senna, 354 

Sennacrol, 354 

Senapicrin, 3-54 

Separation, 443 

Septicaemia, 707 

Serpentana, 3-5-5 

Serpent-bites.— See Poisoning by Reptiles, 
also Stings. 

Sesamum, Oil of, 356 

Sevum, 3." 6 

Shampoo Mixtures, 695 

Sheep. 356 

Sherry Wine. 51 

Shingles.— See Herpes Zoster, 640 

Sialogogues, 413 

Sickness at Stomach. — See Nausea, Sea- 
sickness, Vomiting. 

Siddhi, 118 

Silicate of Maemesium, 357 
Hvd rated. 357 
of Potassium, 310, 357 
of Sodium. 357 

Siliciou- Mineral Waters. 77 

Silver 

Sinalbin. 58 

Sinapine. 58 

Sinapis. 357 
Alba, 357 
Nigra. 35^ 

Singultus.— See Hiccough, 640 

Sinigrin, 358 

Sinistrin, 351 

Skin, Agents affecting, 429 
as an Absorbent. 14 

Skin Diseases.— See Acne, Boils. Burns, 
Carbuncles. Chapped Hands and 
Lips, Chilblains, Condylomata, Ec- 
chymosis. Ecthyma, Eczema, Ele- 
phantiasis, Eruptions, Erysipelas, 
Erythema, Freckles. Herpes.* Herpes 
Zoster, Ichthyosis. Impetigo', Intertri- 
go, Lichen. Lupus, Mentagra. Ntevus, 
Onychia, Pemphigus. Phlegmon, 
Pityriasis, Prurigo, Pruritus, Psori- 
asis. Roseola, Scabies, Scleroderma. 
Seborrhoea, Strophulus, Syphilis, Tin- 
ea, Ulcer, Urticaria, Wart* Wen. 

Scull-cap, 3-52 



Sleep. Abnormal. — See Delirium. Insom- 
nia Nightmare. Som nam bulls ji. 
Slippery Elm Bark. 
Small-pox, 741 

Diaarnosi^of. 777 
Smart-weed, 308 
Smell, Agents affecting, 407 
Smilacin, 348 
Smilax. 348 
Snake-root. Black, 146 

Virginia, 355 
Sneezing 719 

Agents producing, 408 

See also Catarrh, Hay Fever, Inni* 
enza. 
Soaloin. -5-5 
Soap. 346 

Bark, 321 

Curd, Ml 

Green. 347 

Insoluble. ?47 

of Lead Monoxide, 347 

of Lime, 347 

Soft. 347 
Soda. Caustic, 359 

Chlorata, 143 

Chlorinated, 143 
Sodium, 359 
Solanine, 176 
Solanum Dulcamara. 176 
Solid Preparation-, 458 
Soluble Substances. 4^7 
Solution, 441 

Aids to, 4^7 

Circulatory, 441 

of Aluminium Benzoate, 59 

of Ammonium Acetate. 60 

of Arsenious Acid. 85 

of Arsenic and Mercuric Iodide, 85 

Donovan's, 8-5 

Fowler' 8, v " 

of Gutta-percha, 212 

of Iodine, Compound, 231 

of Iron Acetate, 190 

of Iron Citrate, 190 

of Iron Chloride, 190 

of Iron Nitrate, 191 

of Iron and Quinine Citrate, 193 

of Iron ^ubsulphate, 192 

of Iron Tersulphate, 192 

of Lead Subacetate. 3<-'»4 

of Lead Subaeet., Dilute, 304 

of Lime, 112 

of Lime, Chlorinated, 143 

of Lime, Saccharated, 23 

Labarraque's, 143 

Lugol's, 231 

Mageiidie's. 277 

of Magnesium Citrate, 253 

of Mercuric Nitrate, 218 

of Morphine Sulphate, 277 

of Opium. Compound, 276 

Pancreatic, 284 

Pearson's. 85 

of Pepsin, 287 

of Potassa, 309 

of Potassium Arsenite, 8-5 

of Potassium Citrate, 310 " 

of Potassium Silicate. 357 

of Soda, 3-59 

of Soda Chlorinated, 143 



INDEX. 



823 



Solution of Sodium Arseniate, 85 
: -odium Silicate, 357 

of Thvmol. 379 

of Zinc Chloride, 395 
Solutions (Liquores). 449 

Precipitant, Table of. 481 
ck. 479 
Solvents, 441 
Somnambulism, 719 

734 
Sorghum. 337 
Sorfell. 334, 768 
Sozodont, 766 
Span: 120 

Sparteine 

-modic Affections, 719 

Specific Gravity and Volume, 47t 

Table of, 794 
Spermaceti, 132 
Spermatorrhoea, 719 
Spigelia. 363 

1a Bifida, 720 
Spinal Concussion, 720 

Congestion. 720 

Inflammation.— See Meningitis, Mye 
litis. 

Irritation, 721 

Paralysis, 721 

Softening. 721 
Spirit of Ammonia. 60 

Aromatic, 60 

of Ammonia, Fetid, 88 

of Anisr - 

of Camphor, 115 

of Chloroform. 140 

of Cinnamon. 154 

of Ether, 43 

of Ether, Compound, 43 

of 1 Ether, 43 

of Gaultheria, 200 

Grain, 52 

of Hedeoma, 214 

of Juniper, 240 

of Juniper, Compound, 240 

of Lavender. 245 

of Lemon, 247 

of Mentha Piperita, 262 
"iride, 263 

of Myrcia. 267 

of Myristica, 268 

of Nutra 

of Orange, 91 

of Pennyroyal, 214 

of Peppermint, 262 

Potato, 52 

Proof, 51 

Rectified. "1 

Russian, 713 

-oearmint, 263 
[ : Turpentine, 45, 375 

"Wood, 52 
Spirits Spiritus). 456 
Spleen, Affections ::. 721 
Spongia Usta, 717 

::ed Fever.— See Typhus Fever, Men- 
ingitis Cerebro-spinal. 

sons, "_: 
Spruces, : .1 
Spunk, IS 



Squamse .— See Ichthyosis, Pityriasis, Pso- 
riasis. 
Squaw-root. 131 
Squibb's Mixture, 276, 555 
Squill. 350 

St. Ignatius' Bean, 229 
St. Jacob's Oil, 40 
Stains, 721 
Stammering, 722 
Staphisagria, 363 
Star Anise, 68, 230 
Starch, 67, 338 

Iodized, 231 
Static e, 25 
Stavesacre, 363 
Sterility, 722 
Sternutatories, 408 
Stigmata Mavdis, 394 
Stillingia. 364 
Stimulants, 399 

Cardiac, 410 

Hepatic, 417 
:al. 4<~>l 

Respiratory. 4 8 

Vascular, 411 
Stints. "__ 
Stock Solutions, 479 
Stomach Diseases.— See Dyspepsia, Gas- 

tralgia, Gastric L'lcer, Gastritis, etc. 
Stomachics, 413 
Stomatitis, 722 

.—See Calculi, -544 
Storax, 366 
Strabismus "- 
:.ing, 442 
Stramonium, 365 
Strangury.— See Cystitis, Dysuria. 

tore.— Sea Rectum, Urethral Stric- 
ture. 
Stricture of Urethra 
Strophulus _ 

Struma.— See Scrofulosis. 717 
Strychnin-r 22 _~. 
Strychnos Ignatii. 229 

Gaultheriana. 791 

Nux- Vomica, 270 
Sturgeon, 228 
Stve.— See Evelids, 604 

:ic Collodion, 38 

:ics, 430, E 
Styracin, 367 
Styra:-: 

Benzoin, 99 
Styrol, 367 

Subcarbonate of Bismuth, 101 
Subchloride of Mercury, 217 
Sublimation, 4:38 
Subnitrate of Bismuth, 101 
Substances best given alone, 485 

difficult to combine in pill, 499 

suitable for mixtures, 486 

suitable for pills, 498 

suitable for powders, 506 

unsuited to pill- form, 500 
Subsulphate of Iron, 192 

of Mercury, Yellow, 218 
Succinum, 367 
Sudoriiics, 425 
Suet, 356 
Sugar, 337 

Beet, 337 



824 



INDEX. 



Sugar Cane, 337 

Diabetic, 338 

Fruit, 3SS 

Grape, 338 

of Lead, 303 

of Milk, 339 

Starch, 338 

in Urine, Tests for, 787 
Sulphate of Aluminium, 58 

of Aluminium and Ammonium, 57 

of Aluminium and Potassium, 57 

of Ammoi ium, 60 

of Atropine, 95 

of Cadmium, 108 

of Cinchonidine, 150 

of Cinchonine, 150 

of Copper, 167 

of Doboisine, 175 

of Hvoscvamine, 227 

of Iron, L92 

of Iron, Dried, 192 

of Iron, Precipitated, 192 

of Iron and Ammonium, 192 

of Magnesium, 253 

of Manganese, 2-36 

of Morphine, 277 

of Potassium, 310 

of Quinidine, 150 

of Quinine, 149 

of Sodium, 360 

of Strychnine, 270 

of Tetxa-hydrornethyl-ehinoline, 151 

of Zinc, 395 
Sulphide of Allyl, 88 

of Antimony, 70 

of Antimony, Purified, 70 

of Calcium , 369 

of Hydrogen, 369 

of Mercury, Red, 218 
Sulphite of Magnesium, 36, 253 

of Potassium, 36 

of Sodium, 36 
Sulpho-earbolate of Sodium, 22 
Sulpho-cyanate of Acrinyl, 358 
Sulpho-cvanide of Allyl, 358 
Sulphur, 368 

Liver of, 369 

Lotum, 368 

Milk of, 368 

Precipitated, 368 

Sublimed, 368 

Washed, 368 
Sulphurated Antimony, 70 

Lime, 369 

Potassa, 369 
Sulphuretted Hydrogen, 369 
Sulphurous Mineral Waters, 77 
Sumach, Poison, 328 

Smooth, 327 

Swamp, 328 

Sweet, 327 
Sumbul, 371 
Sunstroke, 723 
Suppositoria, 462, 508 
Suppositories, Formula, 510 

Official in Br. Phar., 509 

of Tannic Acid, 38 
Suppuration. 723 
Surgeon's Agaric, 48 
Surgical Fever, 723 
Svapina, 276 



Swallowing.— See Dysphagia ; (Esopha- 
gus, Disorders of. 
Swamp Sassafras, 254 
Sweet Bav, 254 

Flag, 111 

Gum, 366 
Sycosis, 723 

Sydenham's Laudanum, 276 
Syncope, 724 
Synovitis, 724 
Syphilis, 724 
Syrup of Acacia, 18 

of Allium, 54 

of Almond, 64 

of Althaea, 57 

of Amygdala, 64 

of Citric Acid, 247 

of Garlic, 54 

of Ginger, 398 

of Hydriodic Acid, 232 

of Hypophosphites, 290 

of Hypophos. with Iron, 193, 290 

of Ipecacuanha, 236 

of Iron Bromide, 104, 190 

of Iron Iodide, 191 

of Iron and Mang. Iodide, 193, 256 

of Iron and Mang. Phosphate, 193 

of Iron. Quinine and Strvchnine Phos- 
phates, 193. 290 

of Krameria. 242 

of Lactophosphate of Calcium, 290 

of Lactucarium, 244 

of Lemon. 247 

of Lime, 23, 112 

of Manganese Iodide, 256 

of Orange, 91 

of Orange-flowers, 91 

of Phosphates, Compound, 290 

of Primus Virginiana, 315 

of Rhubarb, 325 

of Rhubarb, Aromatic, 325 

of Raspberry, 334 

of Rose, 333 

of Rubus. 334 

of Rubus, Aromatic, 334 

of Rubus Idasus, 334 

of Sarsaparilla, 348 

of Sarsaparilla, Comp., 348 

of Scilla, 351 

of Squill, 351 

of Squill, Compound, 70, 353 

of Senega, 353 

of Senna, 354 

of Stillingia, Comp., 364 

of Tar. 301 

of Tolu. 94 

of Wild Cherrv, 315 

of Zingiber, 398 
Syrupi (Syrups), 449 

Tabacum, 371 

Tabellse Nitroglycerin!, 65 

Tabes Mesenterica, 726 

Table of Drops, etc., in f5j, 470, 795 
of Latin Words, Phrases, etc., 749 
for Metric Conversion, 796 
of Precipitant Solutions, 781 
of Specific Gravities and Volumes, 794 
Tables of Differential Diagnosis, 773 
of Weights and Measures, 466, 467 

Tablets, 461 



INDEX. 



82 



Tablets, Compressed, List of, 504 

Hypodermic, List of, 504 
Tag Alder, 55 
Tamarind. 373 
Tamar-Indien, 354 
Tamarindus, 373 
Tanacetin, 374 
Tanacetum, 374 
Tanjore Pill, 722 
Tannate of Cannabin, 118, 120 

of Pelletierine, 208 
Tannin, 37 

and Iron, 486 
Tansy, 374 

Oil of, 374 

Tea of, 374 
Tapeworm, 90 
Tar, 301 
Tar-water, 301 
Taraxacerin, 374 
Taraxacin, 374 
Taraxacum, 374 
Tartar, Crude, 309 

Emetic, 69 
Tartra-borate of Potassium, 20, 545 
Tartrate of Antimony and Potas., 69 

of Chinoline, 135 

of Iron and Ammonium, 192 

of Iron and Potassium, 192 

Potassio-Cupric, 167 

of Potassium, 39, 310 

of Potassium, Acid, 310 

of Potassium and Sodium, 310 
Tartrates, 39 
Taste, Agents affecting, 407 

Disordered, 726 
Taurocholate of Sodium, 189 
Taeniafuges, 419 
Taeniae.— See Worms, 745 
Tea, 109 

German Breast, 57 

Tansy, 374 

Worm, 363 
Teeth, 727 

Agents affecting, 412 
Teething.— See Dentition, 576 
Temperature of the Body, 780 
Tenesmus.— See Dysentery, 584 
Terchloride of Methyl, 13*9 
Terebene,377, 793 
Terebinthina, 375 

Canadensis, 375 
Tersulphate of Iron, 192 
Testa Praeparata, 112 
Testicles, 727 
Testing, 447 
Tests for Morphine, 278 

for Opium, 278 
Tetanus, 727 

Tetrachloride of Carbon, 45, 140 
Tetter.— See Herpes, Pityriasis, Psoriasis. 
Thallin, 151 
Thebaine, 275, 280 
Theine, 109 

Theobroma Cacao, 110, 377 
Theobromine, 378 
Therapeutical Incompatibility, 484 
Therapeutics, 9 

Applied, 10, 514 

Empirical, 10 

Natural, 10 



Therapeutics, Rational, 11 

Special. 514 
Theriaca, 338 

Thermometer, Clinical , 780 
Thimble- berry, 334 
Thirst, 727 

Agents allaying, 413 
Thistle, Blessed, 126 
Thorn-apple, 365 
Thorough-wort, 188 

Throat.— See Aphonia, Croup, Diphthe- 
ria, Laryngitis, Pharyngitis, Scailet 

Fever, Tonsillitis, etc. 
Throat, Sore, 728 
Thrush.— See Aphthae, 528 
Thuja. 378 
Thujetin, 378 
Thujin, 378 
Thyme, Garden, 379 
Thymene, 379 
Thymol, 379 
Thymus vulgaris, 379 
Tic Douloureux, 728 
Tiglii Oleum, 380 
Tincture of Aconite, 40 

of Ailanthus, 50 

of Aloes, 56 

of Aloes and Myrrh, 56 

of Arnica-flowers, 83 

of Arnica-root, 83 

of Asafetida, 88 

of Aurantium Amarum, 91 

of Aurantium Dulce, 91 

of Baptisia, 94 

of Belladonna, 95 

of Benzoin, 99 

of Benzoin, Compound, 99, 367 

of Berberis, 100 

of Bryonia, 106 

of Calendula, 113 

of Cannabis Indica, 118 

of Cantharides. 120 

of Capsicum, 122 

of Cascarilla, 129 

of Catechu, Compound, 130 

of Chirata, 136 

of Cimicifuga, 146 

of Cinnamon, 155 

of Cinchona, 149 

of Cinchona, Compound, 149 

of Cocculus, 295 

of Colchicum, 156 

of Conium, 158 

of Coto, 164 

of Crocus, 165 

of Cubeb, 166 

of Digitalis, 173 

of Duboisia, 175 

of Eucalyptus, 186 

of Euphrasia, 189 

of Galls, 199 

of Gelsemium, 201 

of Gentian, Compound, 202 

of Ginger, 398 

of Guaiac, 210 

of Guaiac, Ammoniated, 210 

of Hemp, Indian, 118 

of Hops, 216 

of Humulus, 216 

of Hydrastis, 225 

of Hyoscyamus, 227 



69. 



S26 



INDEX. 



Tincture of Ignatia, 229 

of Iodine, 231 

of Ipecac and Opium, 236 

of Iron Acetate, 190 

of Iron Chloride, 190 

of Kino, 242 

of Krameria, 242 

of Lavender, Compound, 245 

of Lobelia, 251 

of Lupulin, 216 

of Matico, 259 

of Musk, 26$ 

of Myrrh, 269 

of Nitro-glycerin, 65 

of Nutgall, 199 

of Opium, 276 

of Opium, Camphorated, 276 

of Opium, Compound, 276 

of Opium, Deodorized, 276 

of Opium and Ipecac, 277 

of Orange Peel, Bitter, 91 

of Orange Peel, Sweet, 91 

of Phosphorus, 289 

of Physostigma, 293 

of Phytolacca, 294 

of Pulsatilla, 316 

of Pyrethrum, 318 

Pyrexialis, 150 

of Quassia, 319 

of Quebracho, 320 

of Rhubarb, 325 

of Rhubarb, Aromatic, 325 

of Rhubarb, Sweet, 325 

of Rhus Toxicodendron, 328 

of Sanguinaria, 343 

of Serpentaria, 355 

of Soap, Green, 347 

of Squill, 351 

of Stillingia, 364 

of Stramonium, 365 

of Sumbul, 371 

of Thuja, 378 

of Tolu, 94 

of Valerian, 385 

of Valerian, Ammoniated, 385 

of Vanilla, 386 

of Veratum Viride, 387 

of Viscum, 391 

of Zingiber, 398 
Tincturae, 454 
Tinea Circinata, 728 

Decalvans, 729 

Favosa, 729 

Sycosis.— See Mentagra, 668 

Tonsurans, 729 
Tobacco, 371 

Symptoms.— See Nervousness, 674 
Toe-nails.— See Nails, 671 
Tolene, 94 
Tomato, 176 
Tonga, 381 
Tongine, 382 
Tongue, 729 
Tonics, 420 

Cardiac, 41.1 

Formulae. 520, 525 

Gastric, 413 

Hair, 522 

Pills for Women, 503 

Uterine, 428 

Vascular, 412 



Tonics, Vesical, 424 
Tonsillitis, 730 
Tonsils, Enlarged, 730 

Ulcerated, 731 
Toothache.— See Odontalgia, 678 
Toothrash.— See Strophulus, 723 
Torrefaction, 440 
Torticollis, 731 
Torulse.— See Sarcinse, 714 
Tracheitis.— See Croup, 569 
Trachoma.— See Conjuctivitis Granular, 

Ophthalmia, 562, 680 
Tragacantha, 382 
Traumaticine, 212 
Traumatic Fever, 723 
Treacle, 338 
Tree of Heaven, 49 
Tri-chloracetyl Hydride, 136 
Tricophytosis Capitis.— See Tinea, 729 
Trimethylamine, 83, 84, 178, 215, 393 
Trinitrophenol, 35 
Trinitrate of Glyceryl, 65 
Trismus. 731 
Triticum, 382 

Vulgare, 67 
Trituration, 440 

of Elaterinum, 177 
Triturationes, 462, 507 
Triturations, Advantages of, 507 

Formulae, 508 

of Mercury, 218 
Troches, 461 

of Ammonium Chloride, 60 

of Catechu, 130 

of Chalk 112 

of Cubeb. 166 

of Ginger, 398 

of Ipecac. 236 

of Iron, 191, 386 

of Krameria, 242 

of Liquorice and Opium, 205, 277 

List of, 504 

of Magnesia, 253 

of Morphine and Ipecac, 236, 277 

of Peppermint, 262 

of Potassium Chlorate, 310 

of Santonin, 346 

of Sodium Bicarbonate, 360 

of Sodium Santoninate, 346 

of Tannic Acid, 38 
Trochisci, 461, 504 
Tropeius, 96 

Tropical Fruit-Laxative, 354 
Tropin, 95 
Trypsin, 2S4 

Tubercular Meningitis.— See Hydroceph- 
alus, Acute, 641 
Tuberculosis— See Phthisis, Scrofulosis, 

693, 717 
Tully's Powder, 277 
Tumors, 731 

Diagnosis of, 774 

Uterine, 731, 740, 774 
Turnera aphrodisiaca, 171 
Turpentine, 375 

Canada, 375 

Chian, 375 

Oil of, 375 

Venice, 375 
Turpeth Mineral, 218 
Tussllago, 718 



INDEX. 



827 



Tympanitis, 731 
Typhlitis, 731 
Typhoid Fever, 732 

Diagnosis of, 778 
Typho-malarial Fever.— See Typhoid 

ver, 732 
Typhus Fever, 734 

Diagnosis of, 778 

Ulcers and Sores, 734 
Ulcers of Stomach, 613 

of Tonsils, 731 

of Uterus, 740 
Ulmus, 383 
Umbelliferon, 199 
Umbrella-tree, 2r>5 
Unguenta, 462, 510 
Unguentum, 42, 131, 463 
Uraemia, 736 

Urea, Agents affecting, 418 
Urethan, 793 

Urethra, Stricture of, 736 
Urethral Injections, 615, 618 
Urethritis, 736 
Urginea Scilla, 350 
Uric Acid Diathesis.— See Lithaemia, 
Urinary Astringents, 424 

Disorders, 736 

Sedatives, 424 
Urine, Acidifiers of, 424 

Alkalinizers of, 423 

Examination of, 786 
Urticaria, 737 
Ursone, 200, 383 
Ustilago, 393 
Uterine Alteratives, 428 

Cancer, 738 

Congestion, 738 

Depressants, 428 

Diseases, 739 

Displacements, 739 

Hypertrophy, 738 

Tonics, 428 

Tumors, 740 

Ulceration, 740 
UvaUrsi, 383 
Uvula, 740 

Vaccination, 740 

Vaginismus, 741 

Vaginitis, 741 

Valerene, 384 

Valer.an, 384 

Valerianate of Ammonium, 60 

of Butyl, 69 

of Iron, 192 

of Quinine, 149 

of Zinc, 395 
Valerianates, 385, 386 
Valerol, 215, 384 
Vallett's Mass, 190 
Van Buskirk's Sozodont 766 
Vanilla, 386 
Vanillin, 386 
Vao, 169 
Vapores, 513 
Vaporization, 437 
Vapors, 513 
Varicella, 553, 741 
Varicocele, 741 
Varieosis, 741 



Fe- 



659 



Variola, 741 

Diagnosis of, 777 
Vascular Sedatives, 412 

Stimulants, 411 

Tonics, 412 
Vaseline, 288 

Vegetable Drugs, their Constituents, 436 
Veins.— See Phlebitis, Phlegmasia, Vari- 
eosis. 
Veins, Transfusion by, 13 
Vellarine, 226 
Venous Medication, 13 
Veratralbine, 387, 388 
Veratrine, 387 
Veratroidine, 387 
Veratrum Album, 387 

Sabadilla, 387 

Viride, 387 
Verbascum, 389 
Verbs, 763 
Vermicides, 419 
Vermifuges, 419 
Vertigo, 742 

Verucca .— See Warts, 745 
Vesical Tonics, 424 

Sedatives, 424 
Vesicants, 429 
Viburnin, 390 
Viburnum, 390 

Compound, 391 

Opulus, 390 

Prunifolium, 390 
Vienna Paste, 309 
Villate's Solution, 169, 547 
Vina (See also Wines), 455 
Vinegar, 19 

Bitters, 767 

of Lobelia. 251 

of Opium, 276 

of Sanguinaria, 843 

of Squill, 351 
Vinegars (Aceta), 458 
Vinum, 51 

Album, 51 

Aromaticum. 51 

Official (See Wine of—) 

Portense, 51 

Rubrum, 51 

Xericum, 51 
Viola Tricolor, 391 
Violine, 391 
Viscin, 391 
Viscum, 391 

Visions, Agents producing, 406 
Vitellin, 392 
Vitellus, 392 
Vitriol, Elixir of, 35 
Vomiting, 742 

of Pregnancy, 743 

Diagnosis of, 780 
Vulva, Eczema, etc., of, 744 
Vulvitis, 744 

W T ade's Bougies, 510 
Wafers, 505 
Wahoo, 188 

Walker's Vinegar Bitters, 767 
Warburg's Tincture, 150, 154 
Warming-plaster, 120 
Warts. 745 
Wash, 493 



828 



INDEX. 



Wash. Black. 219 ' 

Washing. 441 

^21 
j^aeiation. 532 

" : 
Almond Bitt~: 
of Amnioni;-. 

-zninonia, Stronger, 60 
Anise, 68 
Camphor, 115 
Carbolic Acid. 22 
Chlorine, 143 
Cinnamon, 15i 
164 
ilization, 444 

Elder-flower, 342 
Fennel. 197 
Laurel 2 
Orange-flowe: 
PepperminT. 

- 
3] earniint,263 
Water _~ 

Ware 

MineraJ " ' 
.enclanir 
LSI 

iynamia. Exhaustion, 

nd Meas 
- I 
British Pharmacopo. 

Mr 

Wen. 745 

50 

- — Sc :~ Phlegmasia, 692 
White Swelling. — See Joir> - 

734 
Whit. Onychia 

Wh«x<pir. - 590 

Wine 

of Antimony, 69 
Aromatic, 51 



Wine of Cocaine. 183 

of Colehicum-roo: 

of Colchicum-seed, : 

of ETgot. 179 

of Ipecac, 236 

of Iron, Bitter. 1 

of Iron Citrate, 191 

of Opium. 9 

Port. 51 

of Quebracho, 320 

Red, 51 

of Rhubarb, 325 

- rrrv. 51 

of Tar 

of Tobacco. '_ 
:e, 51 
Wines 'Tina >. 51, 455 
Winter-berry, 314 
Wintergreen, 200 
Witch-hazel, 25, 213 
Wood-Oil, 211 

rara. 169 
Words and Phrases, Latin, 749 

Worms. 
Wormseed,133 

Levant 
Worm Tea 
Wormwood, 18 
Is 

Oramp.— See Spasmodic Affec- 
tions, 719 

Xantho-puceine 224 

Xanthoxyline, 393 

Xanthoxvlun: 

Xeroderma, — See Ichthyosis, 643 

Yam, Wild, 175 

■ I 
- :ita. 181 
Yolk of Z__ 

Zincite, 394 
Zincum, 394 

Zona.— See Herpes Zoster, 640 



FIXIS. 



CATALOGUE No. 7. 



DECEMBER. '886. 




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Price of each Book, Cloth, $1.00. Interleaved for Notes, $1.25 



THE ? QUIZ-COMPENDS ?. 



Medical College, Philadelphia. Second Edition. En- 
larged and thoroughly Revised. In two parts. 
Part I. — Continued, Eruptive, and Periodical Fevers, 
Diseases of the Mouth, Stomach, Intestines, Peritoneum, 
Biliary Passages, Liver, Kidneys, Intestinal Parasites, etc., 
and General Diseases. 

Part II. — Diseases of the Respiratory System, Circu- 
latory System and Blood, Nervous System, etc. 

*£* These little books can be regarded as a full set of 
notes upon the Practice of Medicine, containing the 
Synonyms, Definitions, Causes, Symptoms, Prognosis, 
Diagnosis, Treatment, etc., of each disease, and includ- 
ing a number of new prescriptions. They have been 
compiled from the lectures of prominent Professors, and 
reference has been made to the latest writings of Pro- 
fessors Flint, Da Costa, Bartholow, Roberts, etc. 

" It is brief and concise, and at the same time possesses an accu- 
racy not generally found in compends." — fas. M. French, M.D., 
Ass't to the Prof, of Practice, Medical College of Ohio, Cincinnati. 

" The book seems very concise, yet very comprehensive. . . . 
An unusually superior book." — Dr. E. T. Bruen, Demonstrator 
of Clinical Medicine, University of Pennsylvania. 

" I have used it considerably in connection with my branches in 
the Quiz-class of the University of La." — % H Betniss. 

" Dr. Hughes has prepared a very useful little book, and I shall 
take pleasure in advising my class to use it." — Dr. George W. 
Hall, Prof, of Practice, St. Louis College of Phys. and Surgeons. 

No. 4. PHYSIOLOGY. Illustrated. 
third revised edition. 
A Compend of Human Physiology. By Albert P. 
Brubaker, m.d., Demonstrator of Physiology in Jef- 
ferson Medical College, Philadelphia. Professor of 
Physiology, Pennsylvania College of Dental Surgery. 
Thitd Edition. Enlarged and Revised. 
" Dr. Brubaker deserves the hearty thanks of medical students 
for his Compend of Physiology. He has arranged the fundamental 
and practical principles of the science in a peculiarly inviting and 
accessible manner. I have already introduced the work to my 
class." — Maurice N. Miller, M.D., Instructor in Histology, for- 
merly Demonstrator of Physiology , University City of New York. 
" ' Quiz-Compend ' No. 4 is fully up to the high standard estab- 
lished by its predecessors of the same series." — Medical Bulletin, 
Philadelphia. 

" I can recommend it as a valuable aid to the student." — C. N. 
Ellinwood, M.D., Professor of Physiology, Cooper Medical Col- 
lege, San Francisco. 
" This is a well written little book." — London Lancet. 

Price of each Book, Cloth, $1.00. Interleaved for Notes, $1 25 



THE ? QUIZ-COMPENDS ?. 



No. 5. OBSTETRICS. Second Ed. 
A Compend of Obstetrics. For Physicians and Students. 
By Henry G. Landis, m.d., Professor of Obstetrics 
and Diseases of Women, in Starling Medical College, 
Columbus. New Revised Ed. New Illustrations. 
" We have no doubt that many students will find in it a most 
valuable aid in preparing for examination." — The American Jour- 
nal of Obstetrics. 

" It is complete, accurate and scientific. The very best book cf 
its kind I have seen." — y. S. Knox, M.D., Lecturer on Obstetrics, 
Rush Medical College, Chicago. 

No. 6. MATERIA MEDICA, THERAPEU- 
TICS AND PRESCRIPTION WRITING. 

Fourth Edition. 
A Compend on Materia Medica, Therapeutics and 

Prescription Writing, with especial reference to the 

Physiological Actions of Drugs. By Saml. 0. L. 

Potter, m.a., m.d., Professor of Practice, Cooper 

Medical College, San Francisco, Late Surgeon U. S. 

Army. 

" I have examined the little volume carefully, and find it just 
such a book as I require in my private Quiz, and shall certainly re- 
commend it to my classes. Your Compends are all popular here in 
Washington." — John E. Brackett, M.D., Professor of Materia 
Medica and Therapeutics, Howard Medical College, Washington. 

" Part of a series of small but valuable text-books. . . . While 
the work is, owing to its therapeutic contents, more useful to the 
medical student, the pharmaceutical student may derive much use- 
ful information from it." — N. V. Pharmaceutical Record. 

No. 7. CHEMISTRY. Revised Ed. 

A Compend of Chemistry. By G. Mason Ward, m.d., 
Demonstrator of Chemistry in Jefferson Medical Col- 
lege, Philadelphia. Including Table of Elements and 
various Analytical Tables. 
" Brief, but excellent. ... It will doubtless prove an admirable 

aid to the student, by fixing these facts in his memory. It is worthy 

the study of both medical and pharmaceutical students in this 

branch." — Pharmaceutical Record, New York. 

No. 8. DISEASES OF THE EYE AND 

REFRACTION. 
Compend on Diseases of the Eye and Refraction, in- 
cluding Treatment and Surgery. By L. Webster 
Fox, m.d., Chief Clinical Assistant, Ophthalmological 
Department, Jefferson Medical College Hospital ; 

Price of each Book, Cloth, SI. 00. Interleaved for Notes, $1.25. 



THE ?QUIZ-C0MPEXD5?. 



Ophthalmic Surgeon, Germantown Hospital, Phila- 
delphia; late Clinic: :.nt at Moorfields, London, 
England, etc., and Geo. M. Gould, a.b. 60 Illus. 

No. 9. SURGERY. Second Edition. 

ILLUSTRATED. 
A Compend of Surgery; including Fractures, Wounds, 
Dislocations, Sprains, Amputations and other opera- 
tions. Inflammation, Suppuration, Ulcers. Syphilis, 
Tumors, Shock, etc. Diseases of the Spine, Ear, Eye, 
Bladder, Tes:::.es. Anus, and other Surgical Diseases. 
By Orville Horwitz, a.m., m.d., Demonstrator of 
Anatomy. Jefferson Medical College, Philadelphia. 
With 62 Illustrations. Second Edition. Enlarged. 
*** This compend has been prepared with great care, from the 
standard authorities on Surgery and from notes taken by the author 
during attendance on lectures by prominent professors. 

J] the essential facts of surgery are presented in a well- 
arranged and condensed manner." — Medical Brief. 

-eful to the student in fixing the essentials firmly in his 
mind." — Prof. G. F. Shears, Chicago. 

No. 10. ORGANIC CHEMISTRY. 
A Compend of Organic Chemistry, including Medical 
Chemistry, Urine Analysis, and the Analysis of Water 
and Food, etc. By Henry Leffmann. m.d., Pro- 
fessor of Clinical Chemistry and Hygiene in the Phila- 
delphia Polyclinic ; Professor of Chemistry, Penn- 
sylvania College of Dental Surgery. 

" Compa : rial and exact ; well suited as a remembrancer 

to students." — Pacific Medical and Surgical ypurnal. 

" It contains, in compact form, the most of modern organic and 
medical chemist: al to the student of medicine, and will be 

of great value in bringing this subject within his grasp." — C. C. 
Harvard, Prof, of Chemistry , Starling Med. College, Columbus. 
" It has the decided merit of being written in a clear and under- 
standable language." — Dr. J. Sickels, h in Chen:: 
University Medical College, Neiv York. 

No. 11. PHARMACY. 
A Compend of Pharmacy. Based upon " Remington's 
Text-Book of Pharmacy." By F. E. Stewart, m.d.. 
ph.g., Quiz Master in Che and Theoretical 

Pharmacy, Philadelphia College of Pharmacy; De- 
monstrator and Lecturer in Pharmacology, Medico- 
Chirurgical College, and Woman's Medical College; 

4^* The ? Quiz-Compends ? contain the latest and best infor- 
mation, in such a shape that it can be easily memorized. 

Price of each Book. Cloth. $1.00. Interleaved for Notes. S1.25. 



6 STUDENTS' TEXT-BOOKS AND MANUALS. 

ANATOMY. 

Holden's Anatomy. A manual of Dissection of the Human 
Body. Fifth Edition. Enlarged, with Marginal References and 
over 200 Illustrations. Octavo. Cloth, 5.00; Leather, 6.00 

Bound in Oilcloth, for the Dissecting Room, $4.50. 

" No student of Anatomy can take up this book without being 
pleased and instructed. Its Diagrams are original, striking and 
suggestive, giving more at a glance than pages of text description. 
* * * The text matches the illustrations in directness of prac- 
tical application and clearness of detail." — New York Medical 
Record. \ 

Holden's Human Osteology. Comprising a Description of the 
Bones, with Colored Delineations of the Attachments of the 
Muscles. The General and Microscopical Structure of Bone and 
its Development. With Lithographic Plates and Numerous Illus- 
trations. Sixth Edition. 8vo. Cloth, 6.00 

Heath's Practical Anatomy. Sixth London Edition. 24 Col- 
ored Plates, and nearly 300 other Illustrations. Cloth, 5.00 

CHEMISTRY. 

Bartley's Medical Chemistry. A text-book prepared specially 
for Medical, Pharmaceutical and Dental Students. With 40 
Illustrations, Plate of Absorption Spectra and Glossary of Chemi- 
cal Terms. Cloth, 2.50 

*** This book has been written especially for students and phy- 
sicians. It is practical and concise, dealing only with those parts 
of chemistry pertaining to medicine ; no time being wasted in long 
descriptions of substances and theories of interest only to the 
advanced chemical student. 

Bloxam's Chemistry, Inorganic and Organic, with Experiments. 
Fifth Edition, nearly 300 Illustrations. Cloth, 3.75; Leather, 4.75 

Richter's Inorganic Chemistry. A text-book for Students. 
Second American, from Fourth German Edition. Translated by 
Prof. Edgar F. Smith, ph.d. 89 Wood Engravings and Colored 
Plate of Spectra. Cloth, 2.00 

Richter's Organic Chemistry, or Chemistry of the Carbon 
Compounds. Translated by Prof. Edgar F. Smith, ph.d. 
Illustrated. Cloth, 3.00; Leather, 3.50 

Watt's (Fowne's) Chemistry. 13th Edition. 2 Volumes. 

Volume 1, Inorganic, 2.25; Volume 2, Organic. 2.25 
*#* These volumes are based on Fowne's Chemistry, being, in 

fact, the 13th edition of Fownes, etc. 

4&y See pages 2 to j for list of ? Quiz-Coiu/>en,is ? 



STUDENTS' TEXT-BOOKS AND MANUALS. 7 

Chemistry : — Continued. 

Trimble. Practical and Analytical Chemistry. A Course in 
Chemical Analysis, by Henry Trimble, Prof, of Analytical Chem- 
istry in the Phila. College of Pharmacy. Illustrated. Second 
Edition. 8vo. Cloth, 1.50 

Wolff's Applied Medical Chemistry. By Lawrence Wolff, 
m.d., Demonstrator of Chemistry in Jefferson Medical College, 
Philadelphia. Cloth, 1.50 

CHILDREN. 

Goodhart and Starr. The Diseases of Children. A Manual 
for Students and Physicians. By J. F. Goodhart, m.d., Physi- 
cian to the Evelina Hospital for Children ; Assistant Physician 
to Guy's Hospital, London. American Edition, Revised and 
Edited by Louis Starr, m.d., Clinical Professor of Diseases of 
Children in the Hospital of the University of Pennsylvania ; 
Physician to the Children's Hospital, Philadelphia. Containing 
many new Prescriptions, a List of over 50 Formulae, conforming 
to the U. S. Pharmacopoeia, and Directions for making Arti- 
ficial Human Milk, for the Artificial Digestion of Milk, etc. 
Just Ready. Demi-Octavo, 738 Pages. 

Cloth, 3.00; Leather, 3.50 

The New York Medical Record says : — " As it is said of some 
men, so it might be said of some books, that they are * born to 
greatness.' This new volume has, we believe, a mission, particu- 
larly in the hands of the younger members of the profession. In 
these days of prolixity in medical literature, it is refreshing to meet 
with an author who knows both what to say, and when he has said 
it. The work of Dr. Goodhart (admirably conformed, by Dr. Starr, 
to meet American requirements) is the nearest approach to clinical 
teaching, without the actual presence of clinical material, that we 
have yet seen. The details of management so gratefully read by 
the young practitioner are fully elucidated. Altogether, the book 
is one of as great practical working value as we have seen for many 
months." 

Day. On Children. A Practical and Systematic Treatise. 
Second Edition. 8vo. 752 pages. Cloth, 3.00; Leather, 4.00 

Meigs and Pepper. The Diseases of Children. Seventh 
Edition. 8vo. Cloth, 5.00; Leather, 6.00 

Starr. Diseases of the Digestive Organs in Infancy and 
Childhood. With chapters on the Investigation of Disease, 
and on the General Management of Children. By Louis Starr, 
m.d., Prof, of Diseases of Children, Hospital of the University 
of Pennsylvania. Illus. Cloth, 2.50 

See pages 2 to 5 for list of ? Quiz- Compends ? 



8 STUDENTS' TEXT-BOOKS AND MANUALS. 

DENTISTRY. 

Flagg's Plastics and Plastic Filling. 2d Ed. Cloth, 4.00 

Gorgas. Dental Medicine. A Manual of Materia Medica and 
Therapeutics, by Professor F. J. S. Gorgas, m.d., d.d.s , Pro- 
fessor of the Principles and Practice of Dental Science, in Den- 
tal Dept., University of Maryland. Second Edition. Cloth, 3.25 

Harris' Principles and Practice of Dentistry. Including 
Anatomy, Physiology, Pathology, Therapeutics, Dental Surgery 
and Mechanism. Eleventh Edition. Revised and enlarged by 
Professor Gorgas. 744 Illustrations. Cloth, 6.50 ; Leather, 7.50 

Richardson's Mechanical Dentistry. Fourth Edition. 458 
Illustrations. 710 pages. 8vo. Cloth, 4.50; Leather, 5.50 

Stocken's Dental Materia Medica. Third Edition. Cloth, 2.50 

Taft's Operative Dentistry. Dental Students and Practitioners. 
Fourth Edition. 100 Illustrations. Cloth, 4.25 ; Leather, 5.00 

Tomes' Dental Anatomy, Human and Comparative. Sec- 
ond Edition. 191 Illustrations. Cloth, 4.25 

Tomes' Dental Surgery. New Revised Edition. Preparing. 

DICTIONARIES. 

Cleaveland's Pocket Medical Lexicon. Thirty-first Edition. 
Giving correct Pronunciation and Definition of Terms used in 
Medicine and the Collateral Sciences. Very small pocket size, 
red edges. Cloth, .75 ; pocket-book style, r.oo 

Longley's Pocket Dictionary. The Student's Medical Lexicon, 
giving Definition and Pronunciation of all Terms used in Medi- 
cine, with an Appendix giving Poisons and Their Antidotes, 
Abbreviations used in Prescriptions, Metric Scale of Doses, etc. 
24010. Cloth, 1. 00; pocket-book style, 1.25 

EYE. 

Arlt. Diseases of the Eye. Including those of the Conjunc- 
tiva, Cornea, Sclerotic, Iris and Ciliary Body. By Professor 
Fred. Ritter von Arlt. Translated by Dr. Lyman Ware. Illus- 
trated. 8vo. Cloth, 2.50 

Higgins. Ophthalmic Practice. A Handbook for Students 
and Practitioners. i6mo. Cloth, .50 

Macnamara. On Diseases of the Eye. Fourth Edition, 
revised, with Marginal References, numerous Colored Plates and 
Diagrams, Wood Cuts and Test Types. Cloth, 4.00 

Morton. Refraction of the Eye. Its Diagnosis and the Cor- 
rection of its Errors. Third Edition. Illustrations and Test- 
types. Cloth, 1.00 
See pages 2 to 5 for list of ? Quiz- Compends ? 



STUDENTS' TEXT-BOOKS AND MANUALS. 9 

HYGIENE. 
Parke's Practical Hygiene. Sixth Edition, enlarged. Illus- 
trated. 8vo. Cloth, 3.00 
Wilson's Handbook of Hygiene and Sanitary Science. 

Sixth Edition. Revised and Illustrated. Cloth, 2.75 

MATERIA MEDICA AND THERAPEUTICS. 

Biddle's Materia Medica. Tenth Edition. For the use of 

Students and Physicians. By the late Prof. John B. Biddle, m. d. , 
Professor of Materia Medica in Jefferson Medical College, Phila- 
delphia. The Tenth Edition, thoroughly revised, and in many 
parts rewritten, by his son, Clement Biddle, m.d., Past Assistant 
Surgeon, U. S. Navy, assisted by Henry Morris, m.d., Demon- 
strator of Obstetrics in Jefferson Medical College. 8vo., illus- 
trated. Just Ready. Cloth, 4.00 ; Leather, 4.75 

" The larger works usually recommended as text-books in our 
medical schools are too voluminous for convenient use. This work 
will be found to contain in a condensed form all that is most valuable, 
and will supply students with a reliable guide." — Chicago Med. yi. 
Merrell's Digest of Materia Medica. 8vo. Half Calf, 4.00 
Potter, Materia Medica, Pharmacy and Therapeutics. 
Including Action of Medicines, Special Therapeutics, Pharma- 
cology, etc. Cloth, 3.00; Leather, 3.50 
Roberts' Compend of Materia Medica and Pharmacy. By the 
author of " Roberts' Practice." Cloth, 2.00 

" It contains an immense amount of matter." — The National 
Druggist. 

Headland's Action of Medicines. 9th Ed. 8vo. Cloth, 3.00 

Waring. Therapeutics. With an Index of Diseases and an 

Index of Remedies. A Practical Manual. Fourth Edition. 

Revised and Enlarged. Cloth, 3.00; Leather, 3.50 

MEDICAL JURISPRUDENCE. 
Reese. A Text-book of Medical Jurisprudence and Toxi- 
cology. By John J. Reese, m.d., Professor of Medical Juris- 
prudence and Toxicology in the Medical and Law Departments 
of the University of Pennsylvania ; Vice-President of the Med- 
ical Jurisprudence Society of Philadelphia ; Physician to St. 
Joseph's Hospital ; Corresponding Member of The New York 
Medico-legal Society. Cloth, 3.00; Leather, 3.50 

" Professor Reese is so well known as a skilled medical jurist, 
that h>s authorship of any work virtually guarantees the thorough- 
ness and practical character of the latter. And such is the case in 
the book before us. * * * * We might call these the essentials 
for the study of medical jurisprudence. The subject is skeletonized, 

See pages 2 to 5 for list of ? Quiz- Compends ? 



10 STUDENTS' TEXT-BOOKS AND MANUALS. 

Medical Jurisprudence ; — Continued. 

condensed, and made thoroughly up to the wants of the general 
medical practitioner, and the requirements of prosecuting and de- 
fending attorneys. If any section deserves more distinction than 
any other, as to intrinsic excellence, it is that on toxicology. This 
part of the book comprises the best outline of the subject in a 
given space that can be found anywhere. As a whole, the work is 
everything it promises, and more, and considering its size, con- 
densation, and practical character, it is by far the most useful one 
for ready reference, that we have met with. 'It is well printed and 
neatly bound." — New York Medical Record. 

Abercrombie's Students' Guide to Medical Jurisprudence. 
i2mo. Cloth, 2.50 

Mann's Manual of Psychological Medicine, and Allied Ner- 
vous Diseases. Their Diagnosis, Pathology and Treatment, and 
their Medico-Legal Aspects. Illus. Cloth, 5.00; Leather, 6.00 

Woodman and Tidy's Medical Jurisprudence and Toxi- 
cology. Chromo-Lithographic Plates and 116 Wood engravings. 

Cloth, 7.50; Leather, 8.50 

MISCELLANEOUS. 

Beale. Slight Ailments. Their Nature and Treatment. Illus- 
trated. 8vo. Paper cover, .75 ; Cloth, 1.25 

Dulles. Surgical and other Emergencies. Illustrated. Sec- 
ond Edition. i2mo. Cloth, .75 

Fothergill. Diseases of the Heart and Their Treatment. 
Second Edition. 8vo. Cloth, 3.50 

Tanner. Memoranda of Poisons. Their Antidotes and Tests. 
Fifth Edition. i2mo. Cloth, .75 

Allingham. Diseases of the Rectum. Fourth Edition. Illus- 
trated. 8vo. Paper covers, .75 ; Cloth, 1.25 

OBSTETRICS AND GYNECOLOGY. 

Parvin's Winckel's Diseases of Women. Edited by Prof. 
Theophilus Parvin, Jefferson Medical College, Philadelphia. 
130 Illustrations. Cloth, 3.00; Leather, 3.50 

Galabin's Midwifery. A New Manual for Students. By A. 
Lewis Galabin, m.d., f.r.c.p., Obstetric Physician to Guy's 
Hospital, London, and Professor of Obstetrics in the same Insti- 
tution. 227 Illustrations. Cloth, 3.00; Leather, 3.50 

" The illustrations are mostly new and well executed, and we 
heartily commend this book as far superior to any manual upon 
this subject." — Archives 0/ Gyncecology, New York, June, 1886. 
Rigby's Obstetric Memoranda. By Alfred Meadows, m.d. 

4th Edition. Cloth, .50 

&$f See pages 2 to 5 for list of ? Quiz- Commends ? 



STUDENTS' TEXT-BOOKS AND MANUALS. 11 

Obstetrics and Gynecology : — Continued. 

Meadows' Manual of Midwifery. Including the Signs and 
Symptoms of Pregnancy, Obstetric Operations, Diseases of the 
Puerperal State, etc. 145 Illustrations. 494 pages. Cloth, 2.00 

Swayne's Obstetric Aphorisms. For the use of Students 
commencing Midwifery Practice. 8th Ed. i2mo. Cloth, 1.25 

PATHOLOGY AND HISTOLOGY. 

Rindfleisch's General Pathology. By Tyson. For Students 

and Physicians. By Trof. Edward Rindfleisch, of Wurzburg. 

Translated by Wm. H. Mercur, m.d., of Pittsburg, Pa., Edited 

by James Tyson, m.d., Professor of Pathology and Morbid 

Anatomy in the University of Pennsylvania. i2mo. Cloth, 2.00 

Gilliam's Essentials of Pathology. A Handbook foi Students. 
47 Illustrations. i2mo. Cloth, 2.00 

*^*The object of this book is to unfold to the beginner the funda- 
mentals of pathology in a plain, practical way, and by bringing 
them within easy comprehension to increase his interest in the study 
of the subject. Though it will not altogether supplant larger works, 
it will be found to impart clear-cut conceptions of the generally 
accepted doctrines of the day, and to prevent confusion in the mind 
of the student. 

Gibbes' Practical Histology and Pathology. Third Edition. 
Enlarged. i2mo. Cloth, 1.75 

PHYSICAL DIAGNOSIS. 

Bruen's Physical Diagnosis of the Heart and Lungs. By 
Dr. Edward T. Bruen, Assistant Professor of Clinical Medicine 
in the University of Pennsylvania. Second Edition, revised. 
With new Illustrations. i2mo. Cloth, 1.50 

***The subject is treated in a plain, practical manner, avoiding 
questions of historical or theoretical interest, and without laying 
special claim to originality of matter, the author has made a book 
that presents to the student the somewhat difficult points of Physi- 
cal Diagnosis clearly and distinctly. 

PHYSIOLOGY. 

Yeo's Physiology. Second Edition. The most Popular Stu- 
dents' Book. By Gerald F. Yeo, m.d., f.r.c.s., Professor of 
Physiology in King's College, London. Small Octavo. 750 
pages. Over 300 carefully printed Illustrations. With a Full 
Glossary and Index. Cloth, 3.00; Leather, 3.50 

" The work will take a high rank among the smaller text-books 

of Physiology."— Prof. H. P. Bowditck, Harvard Med. School, 

Boston. 

" The brief examination I have given it was so favorable that I 

placed it in the list of text-books recommended in the circular of 

the University Medical College." — Prof. Lewis A. Stimpson, 

M. D.,37 East 33d Street, New York. 

4®=* See pages 2 to 3 for list of ? Quiz- Compends ? 



12 STUDENTS' TEXT-BOOKS AND MANUALS. 

Physiology : — Continued. 
Kirke's Physiology, nth Ed. Illus. Cloth, 4.00; Leather, 5.00 
Landois' Human Physiology. Including Histology and Micro- 
scopical Anatomy, and with special reference to Practical Medi- 
cine. Second Edition. Translated and Edited b) ? Prof. Stirling. 
583 Illus-trations. Cloth, 6.50; Leather, 7.50 

" So great are the advantages offered by Prof. Landois' Text- 
book, from the exhaustive and eminently practical manner in which 
the subject is treated, that, notwithstanding it is one of the largest 
works on Physiology, it has yet passed through four large editions 
in the same number of years. Dr. Stirling's annotations have 
materially added to the value of the work. . . . Admirably 
adapted for the practitioner. . . . With this Text-book at his 
command, no student could fail in his examination." — Lancet. 

Sanderson's Physiological Laboratory. Being Practical Ex- 
ercises for the Student. 350 Illustrations. 8vo. Cloth, 5.00 

Tyson's Cell Doctrine. Its History and Present State. Illus- 
trated. Second Edition. Cloth, 2.00 

PRACTICE. 

Roberts' Practice. Fifth American Edition. A Handbook 
of the Theory and Practice of Medicine. By Frederick T. 
Roberts, m.d. ; m.r.c.p., Professor of Clinical Medicine and 
Therapeutics in University College Hospital, London. Fifth 
Edition. Octavo. Cloth, 5.00; Leather, 6.00 

*#* This new edition has been subjected to a careful revision. 
Many chapters have been rewritten. Important additions have 
been made throughout, and new illustrations introduced. Recom- 
mended as a Text-book at University of Pennsylvania, Long Island 
College Hospital, Yale and Harvard Colleges, Bishop's College, 
Montreal, University of Michigan, and over twenty other Medical 
Schools. 

" I have become thoroughly convinced of its great value, and 
have cordially recommended it to my class in Yale College." — 
Prof. David P. Smith. 

" I have examined it with some care, and think it a good book, 
and shall take pleasure in mentioning it among the works which 
may properly be put in the hands of students." — A. B. Palmer, 
Prof, of the Practice of Medicine, University of Michigan. 

" A clear, yet concise, scientific and practical work. It is a capi- 
tal compendium of the classified knowledge of the subject." — 
Prof y. Adams Allen, Rush Medical College, Chicago. 

" It is unsurpassed by any work that has fallen into our hands, 
as a compendium for students preparing for examination. It is 
thoroughly practical, and fully up to the times." — The Clinic. 
Aitken's Practice of Medicine. Seventh Edition. 196 Illus- 
trations. 2 vols. Cloth, 12.00; Leather, 14.00 
Tanner's Index of Diseases, and Their Treatment. Cloth, 3.00 
" This work has won for itself a reputation. ... It is, in 
truth, what its Title indicates." — N. Y. Medical Record. 

See pages 2 to j for list of ? Quiz-Compends ? 



STUDENTS' TEXT-BOOKS AND MANUALS. 13 

PRESCRIPTION BOOKS. 

Wythe's Dose and Symptom Book. Containing the Doses 
and Uses of all the principal Articles of the Materia Medica, etc. 
Sixteenth edition. 321110. Cloth, 1. 00; Pocket-hook style, 1.25 

Pereira's Physician's Prescription Book. Containing Lists 
of Terms, Phrases, Contractions and Abbreviations used in 
Prescriptions, Explanatory Notes, Grammatical Construction of 
Prescriptions, etc., etc. By Professor Jonathan Pereira, m.d. 
Sixteenth Edition. 32m©. Cloth, 1. 00; Pocket-book style, 1.25 

SKIN DISEASES. 

Van Harlingen on Skin Diseases. A Handbook of the Dis- 
eases of the Skin, their Diagnosis and Treatment. By Arthur 
Van Harlingen, m.d., Prof, of Diseases of the Skin in the Phila- 
delphia Polyclinic; Consulting Physician to the Dispensary 
for Skin Diseases, etc. With colored plates. i2mo. Cloth, 1.75 
*#*This is a complete epitome of skin diseases, arranged in 
alphabetical order, giving the diagnosis and treatment in a concise, 
practical way. Many prescriptions are given that have never been 
published in any text-book, and an article incorporated on Diet. 
The plates do not represent one or two cases, but are composed of 
a number of figures, accurately colored, showing the appearance of 
various lesions, and will be found to give great aid in diagnosing. 

" This new handbook is essentially a small encyclopaedia. * * * 
We heartily commend it for its brevity, clearness and evidently 
careful preparation." — Philadelphia Medical Times. 

" This is an excellent little book, in which, for ease of reference, 
the more common diseases of the skin are arranged in alphabetical 
order, while many good prescriptions are given, together with clear 
and sensible directions as to their proper application." — Boston 
Medical and Surgical yournal. 

Bulkley. The Skin in Health and Disease. By L. Duncan 
Bulkley, Physician to the N. Y. Hospital. Illus. ' Cloth, .50 

SURGERY. 

Heath's Minor Surgery, and Bandaging. Eighth Edition. 142 
Illustrations. 60 Formulae and Diet Lists. Cloth, 2.00 

M ears' Practical Surgery. Second Edition. Enlarged. 490 
Illustrations. Cloth, $3.75; Leather, $4.75 

Pye's Surgical Handicraft. A Manual of Surgical Manipula- 
tions, Minor Surgery, Bandaging, Dressing, etc., etc. With 
special chapters on Aural Surgery, Extraction of Teeth, Anaes- 
thetics, etc. 208 Illustrations. 8vo. Cloth, 5.00 

Watson on Amputation of the Extremities, and their Compli- 
cations. 2 colored plates and 250 wood cuts. 8vo. Cloth, 5.50 

4^* See pages 2 to 5 for list of ? Quiz- Compends ? 



14 STUDENTS' TEXT-BOOKS AND MANUALS. 

THROAT. 

Mackenzie on the Throat and Nose. By Morell Mackenzie, 
m.d., Senior Physician to the Hospital for Diseases of the Chest 
and Throat ; Lecturer on Diseases of the Throat at the London 
Hospital, etc. 
Vol. I. Including the Pharynx, Larynx, Trachea, etc., with 

Formulae and 112 Illustrations. 
Vol. II. Diseases'of the (Esophagus, Nose and Naso-Pharynx, 
with Formulas and 93 Illustrations. 

The two volumes, Leather, 7.50 
Vol. II, separately, Cloth, 3.00; Leather, 4.00 

" It is both practical and learned ; abundantly and well illustrated ; 
its descriptions of disease are graphic and the diagnosis the best we 
have anywhere seen." — Philadelphia Medical Times. 

Cohen. The Throat and Voice. Illustrated. Cloth, .50 

James. Sore Throat. Its Nature, Varieties and Treatment. 
i2mo. Illustrated. Paper cover, .75; Cloth, 1.25 

URINE AND URINARY ORGANS. 

Acton. The Reproductive Organs. In Childhood, Youth, 
Adult Life and Old Age. Sixth Edition. Cloth, 2.00 

Beale. Urinary and Renal Diseases and Calculous Disorders. 
Hints on Diagnosis and Treatment. i2mo. Cloth, 1.75 

Ralfe. Kidney Diseases and Urinary Derangements. 42 Illus- 
trations. i2mo. 572 pages, just Ready. Cloth, 2.75 

Legg. On the Urine. A Practical Guide. 6th Ed. Cloth, .75 

Marshall and Smith. On the Urine. The Chemical Analysis 
of the Urine. By John Marshall, m.d., Chemical Laboratory, 
University of Pennsylvania, and Prof. E. F. Smith, ph.d. With 
Colored Plates. Cloth, 1.00 

Thompson. Diseases of the Urinary Organs. Seventh 
Edition. Illustrated. Cloth, 1.25 

Tyson. On the Urine. A Practical Guide to the Examination 
of Urine. By James Tyson, m.d., Professor of Pathology and 
Morbid Anatomy, University of Penn'a. With Colored Plates 
and Wood Engravings. 5th Ed. Enlarged. i2mo. Cloth, 1.50 

VENEREAL DISEASES. 

Hill and Cooper. Student's Manual of Venereal Diseases, 
with Formulae. Fourth Edition. i2mo. Cloth, i.co 

Durkee. On Gonorrhoea and Syphilis. Illus. Cloth, 3.50 
See pages 2 to 5 for list of ? Quiz- Comp ends ? 



Richter's Chemistries 

AUTHORIZED TRANSLATIONS. 



By EDGAR F. SMITH, M.A., Ph.D., 

Prof, of Chemistry in Wittenberg College, Springfield, Ohio ; 
formerly in the Laboratories of the University of Pennsylva- 
nia and Muhlenburg College; Me7nber of the Chemical 
Societies of Berlin and Paris ; of the Academy of 
Natural Sciences of Philadelphia, etc., etc. 

EACH VOLUME SOLD SEPARATELY. 

INORGANIC CHEMISTRY. Second American, 
from the Fourth German Edition; thoroughly revved 
and in many parts rewritten. With 89 Illustrations 
and Colored Plate of Spectra. Cloth, #2.00 

THE CHEMISTRY OF THE CARBON COM- 
POUNDS, or Organic Chemistry. First Ameri- 
can, from Fourth German Edition. Illustrated. 

Cloth, #3.00 
The success attending the publication of the first edi- 
tion of Richter's Inorganic Chemistry encourages the 
translator and publishers to believe that the companion 
volume will have an equally warm reception. Professor 
Richter's methods of arrangement and teaching have 
proved their superiority, abroad, by the very large sale 
of his books all over the Continent, translations having 
been made in Germany, Russia, Holland and Italy. 

From Prof. B. Silliman, Yale College, New Haven, Conn. 

" It is decidedly a good book, and in some respects the best 
manual we have." 

From John Marshall, m.d., nat. sc. d. (Tubingen), Demonstra- 
tor of Chemistry in the University of Pennsylvania, Medical 
Department. 

"The work is of undoubted value. The theory of chemistry, 
which is generally the bugbear of students, is, in this book, very 
clearly explained, and the explanations are so well distributed 
through the book that students are brought easily from the simplest 
to the most difficult problems. 

" That part descriptive of the elements and their compounds is 
full, and all that could be desired in a text-book, while the cuts, 
with which the work is profusely illustrated, are an excellent aid to 
the student. Altogether, it is one of our best modern works on 
chemistry." 



A New Series of Manuals 

FOR 

Medical Students. 

Price of each Book, Cloth, $3.00 ; Leather, $3.50. 

MIDWIFERY. By Alfred Lewis Galabin, m.a., m.d., Ob- 
stetric Physician to, and Lecturer on Midwifery and the Diseases 
of Women at, Guy's Hospital, London, etc. 227 fine Engrav- 
ings. 753 pages. 

PHYSIOLOGY. By Gerald F. Yeo, m.d., f.r.c.s., Professor 
of Physiology in King's College, London. Second Edition, re- 
vised. 750 pages. 301 carefully printed Illustrations. 

MATERIA MEDICA, PHARMACY AND THERAPEU- 
TICS, including the Physiological Action of Drugs, Special 
Therapeutics, Official and Extemporaneous Pharmacy, with 
numerous Tables, Formulae, Notes on Temperature, Clinical 
Thermometer, Poisons, Urinary Examinations and Patent Medi- 
cines. By Sam'l O. L. Potter, m.a., m.d., Professor of 
Practice of Medicine, Cooper College, San Francisco, late Sur- 
geon U. S. Army. 750 pages. 

CHILDREN. By J. F. Goodhart, m.d., Physician to the Eve- 
lina Hospital for Children; Assistant Physician, Guy's Hospital, 
London. American Edition. Revised and Edited by Louis 
Starr, m.d., Clinical Professor of Diseases of Children in the 
Hospital of the University of Pennsylvania : Physician to the 
Children's Hospital, Philadelphia. 50 Formulae, and Directions 
for preparing Artificial Human Milk, for the Artificial Digestion 
of Milk, etc. 738 pages. 

PRACTICAL THERAPEUTICS, With an Index of Diseases. 
By Ed. John Waring, m.d., f r.c.p. Fourth Edition. Re- 
written and Revised. Edited by Dudley W. Buxton, Assistant 
to the Professor of Medicine, University College Hospital, Lon- 
don. 744 pages. 

MEDICAL JURISPRUDENCE AND TOXICOLOGY. By 

John J. Reese, m.d., Professor of Medical Jurisprudence and 
Toxicology, University of Pennsylvania, etc. 6c6 pages. 

ORGANIC CHEMISTRY. By Prof. Victor von Richter, 
University of Breslau. Translated from Fourth German Edition 
by Edgar F. Smith, m.a., fh.d., Professor of Chemistry, Wit- 
tenberg College, Springfield, O., formerly in the Laboratories of 
the University of Pennsylvania, etc. Illustrated. 710 pages. 

DISEASES OF WOMEN. By Dr. F. Winckel, Professor of 
Gynaecology, etc., Royal University of Munich. The Transla- 
tion Edited by Theophilus Parvin, m.d., Professor of Ob- 
stetrics and Diseases of Women and Children, Jefferson Medical 
College, Philadelphia. 132 Engravings, most of which are new. 
700 pages. 

*** Other Volumes in Preparation. A complete illustrated circu- 
lar with sample pages sent free, upon application. 

Price of each Book, Cloth, $3.00 ; Leather, $3.50. 





















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